• Bernard Alston

Bernard's Spring Blog


Hope you are all well and managing to keep going.

It is nice to be appreciated isn’t it but I have yet to hear one of the mainstream politicians actually recognise the fantastic effort of the profession under the circumstances. Boris gave one of his speeches the other day when he burbled on making a number of contradictory statements as usual and mentioned how well the NHS has responded during the Pandemic. He must have mentioned every healthcare professional with the exception of dentists - come on Boris give us some recognition!

He followed this up by romanticising about looking forward to walking down the street and dropping into a pub for a pint once everything was back to normal. He swiftly followed this up with the proviso that this could only happen if we stick to the rules in the meantime - this was probably due to a kick on the shins from one of his advisors!


Anyway let’s get off Covid for a while and look at how the NHS is moving forward in terms of development and structure. It is relatively early days yet but there are moves afoot that we all have seen and heard about which do have relevance to dentistry. By this I mean the emerging Integrated Care Systems (ICS) which are becoming established across the country albeit slowly. Covid (sorry to mention it again!) has put the brakes on progress, this time due to the mass vaccination programme.

Let’s park what is happening elsewhere in the country and concentrate on our own ICS...

Healthier Lancashire and South Cumbria

There is one heck of a lot of detail in all of this so I am going to attempt to simplify the situation in an abridged format. Please do some internet research for the more detailed stuff (especially if you can’t get to sleep!)

What is it all about?

  • The overall structure is based around committees/networks based at three levels similar to a pyramid – so let’s picture a pyramid.

  • At the top sharp end we have the ICS.

  • At the middle part we have the ICPs (reporting to the ICS).

  • At the base we have the PCNs (reporting to the ICPs).

So what is an ICS?

  • It is the top level governing body that integrates Health and Social Care across the particular footprint of the ICS in question – for us that is LASC.

  • The essential element of this restructure is to enable multi- disciplinary teams to work together in the best interests of patient care.

So what is an ICP?

  • As we progress down the pyramid to the middle element we have a second tier of the structure these are called Integrated Care Partnerships (ICPs) and in LASC we have five of these they are:

Morecambe Bay Fylde Coast Pennine Lancs Central Lancs West Lancs

  • These are matched to the catchment area of Acute Hospitals.

  • The concept of joint working across Health and Social Care will be enabled across the ICP footprint.

So what is a PCN ?

  • Underneath the ICPs will sit the Primary Care Networks (PCNs).

  • PCNs are based around a group of GP Practices and cover a population size of between 30,000 and 50,000.

  • We have 42 in LASC.

  • PCNs enable bespoke patient care again across both Health and Social Care to be delivered at grass roots level.

  • PCNs have much more relevance to Primary Care Dentists and will give practices the opportunity to get involved.

So where do we sit with this?

As part of the process an integrated approach is required and this will involve GPs/GDPs/Pharmacists/Optometrists working together, sharing ideas and providing the best patient care whilst making sensible savings for the NHS by developing robust prevention strategies linked across all clinical disciplines.

What is it like being part of a PCN?

  • I do have first-hand experience of this process in that I was the Dental Rep. on Fleetwood PCN for a couple of years in the early days.

  • We managed to get Oral Health as a priority standing item on the agenda.

  • Being part of a PCN is a great opportunity to mix with Multi- Disciplinary Teams and develop patient pathways which cut across the different professional disciplines.

  • Following the successful introduction of Oral Health support in Fleetwood we now have a local PCN Partner Dental Practice in place.

How could I get involved?

  • Inevitable delays have occurred due to Covid and further progress is not likely until after the summer.

  • We must use this time to bring the profession across LASC up to speed in preparation for what will probably come in the autumn.

  • Information will be forthcoming form LASC NHSE Area Team once the process has gained traction again.

  • The intention is that dentistry will be represented at all three levels to ensure robust input.

  • NB to avoid any confusion it is important that any practitioners wishing to get involved with the process do so through the official channels rather than making personal approaches.

What is the LDC input ?

  • We are working closely with the LASC Local Area Team to jointly ensure that dentistry is fully included in the process.

  • We need to remember that this development is going to happen.

  • If we are to be fully supported then we need to be fully involved.

  • We have established an ICS section on the LDC website which will include up to date information as we go forward.

  • Regular development updates will be following from us.

  • If anyone has any questions please do not hesitate to email me on:

(NB the above is my personal view of where we are up to with these developments – there is plenty more stuff available if you Google it!)

Practitioner Support

This has occupied much of our time recently at the Exec.

Remember - we are there for you if you need us.

All our Practitioner Support Facilitators have undergone appropriate training provided by HEE and we are determined that everybody experiencing difficulties will be offered all the help and advice needed. We will also be able to offer referral opportunities if required.

Working with HEE we are running a Resilience Training session on 20th April. The speaker will be Kieran Weil who some of you will already know. The event is now live on Maxcourse and places will be limited so do get yourselves booked in. Priority will be given to LASC practices in the first instance and this event is open to the whole dental team (please see the course information below the blog).

If you need support and advice do not hesitate to contact us by confidential email;

BA Top Tips

The NHS 111 service offer assessments for patients at potential risk of drug overdose. If you have a patient who has potentially overdosed on analgesics (particularly in this present climate) you can recommend that they ring 111 and ask for a “Toxic Assessment”. 111 will then be able to assess the situation and advise the patient accordingly. The Area Team have developed a funded Peer Review Programme and this has been launched - you will have had notice of this from a couple of weeks ago One of the topics for the future is engagement with PCNs. Bearing in mind my earlier article on the ICS developments it would be a good opportunity to engage with fellow practitioners in the discussion. The Peer Review on PCN engagement will be following in the next couple of months - watch out for it!

Just one more thing

Mrs A and myself are regulars down at the beach with our little Staffie who we are sure is part seal! It is convenient living close to the sea and being able to get plenty of exercise and sea air. At times it can get busy and there are some strange sights to be seen down there at times. Rossall Beach at Fleetwood is quite a treacherous coastline with big tides and onshore winds creating strong currents and large waves. However it is not Bondi Beach nor the California coast. What we do have though is our own Hawaii 5 0 throwback who provides surfing demonstrations regularly. This bloke gets out into the tide risking life and limb in the strong tidal flow and manages to get onto a wave for about 5 yards before he falls off again and again! I have to hand it to him for his grit and determination. The crowds gather and there are loads of people taking pictures and videos to post on Facebook. All he needs is the Beach Boys playing in the background!

Don’t forget your LDC Executive is available 24/7/365 Simply email us on

That’s all for now – take care and stay safe!


Bernard Alston

Secretary LASC LDC Executive