Meeting 4th March 2020
THE HUNTINGDON MARRIOTT HOTEL
WEDNESDAY 4th MARCH 2020
7pm Arrival for 7-30pm Start
Patrik Zachrisson - LDC Chairman & Treasurer
Amiras Chokshi - Secretary
Mariana De Villiers - LDC Administrator
Marlise De Vos
Tom Norfolk - LDN Chairman
LDC Chairman Patrik Zachrisson welcomed all attendees to the meeting and introduced new LDC member, Avtar Pardesi.
- Treasurer’s Report – Patrik Zachrisson
The Cambridgeshire and Peterborough LDC continues to be financially stable and secure. The LDC sponsored the Professional Dentistry Midlands Event in April 2019 as well as PASS (Practitioner Advice and Support Scheme) and the Benevolent Fund.
It was agreed the LDC will make a further contribution to the Benevolent Fund.
- Chairman’s Report: Patrik Zachrisson
NHS Dental Services will be implementing boundary changes into Compass with effect from 1st April 2020. The current Area Teams will be placed with Sustainability and Transformation Partnerships (STPs). The re-organisation into smaller local units (STPs rather than Area Team) has however led to a need for new administrative processes. The key change is that, for the purpose of levy collection, there will be one designated LDC bank account per STP to which the levy is paid on behalf of all LDCs within that STP.
All existing LDC Levies that are recorded in Compass will end on 31st March 2020.
All LDCs within the same STP boundary will need to agree one way which they would like the LDC levy to be collected by the NHSBSA from the following choices:
- Percentage levy: Set Percentage of contract value
- Fixed levy: Set amount per performer (e.g. £20)
- Overall levy: Set amount to be collected for the LDC apportioned across all GDS contracts.
The Cambridgeshire and Peterborough LDC has agreed that LDC levies will be collected as a Fixed Levy at the current rate of £10 per month.
Procurement in the region was cancelled and currently seems to be on hold in other areas. Contracts have now been extended to 31st March 2022.
There was a meeting arranged by the BDA to discuss the collapse. One of the suggestions was to sign the contract in dispute. Another to seek reimbursement of expenses incurred in the process, possibly through legal channels. However, at the moment this is not considered.
Public Health England continue to monitor and update their advice on steps all clinicians should take to manage suspected cases of Coronavirus (COVID-19).
It is important that all Practices ensure they regularly check NHS, Department of Health and Social Care and Public Health England’s advice.
NHS England procedures to deal with the outbreak and updates can be found on internet: Novel Coronavirus (COVID-19) standard operating procedures. Primary Dental Care Settings including Community Services.
Availability of Face masks appear to be a rather huge problem. In recent weeks dentists have faced a global shortage of face masks.
The Department of Health and Social Care have indicated that significant central stockpiles exist, including reserves built up for the UK's departure from the European Union. Supplies from these stockpiles were released to ease immediate pressures, including via a reverse public procurement – the government selling off some of its reserve. However, it has been reported that there are no more reserves to be send out.
Under the current guidance all dentists should wear Personal Protective Equipment (PPE) including disposable face masks, clinical gloves, and eye protection (where appropriate). Only Scotland permits visors and disposable masks to be used interchangeably.
NICE Guidelines state "face masks and eye protection must be worn where there is a risk of blood, body fluids, secretions or excretions splashing into the face and eyes."
Dental Practitioners are worried that hitting their UDA targets at the end of the year might be compromised. It was suggested to make a force majeure notification.
It is most important to reach more dentists, especially the newly qualified dentists, in order to make them aware of the role of the LDC and the support the LDC offers. It was suggested to contact dentist directly through mail and/or Email or to carry out some practice visits.
- Secretary’s Report – Amiras Chokshi
Amiras attended the Eastern Region Secretary’s Meeting with Commissioners on the 13th of February 2020.
Following the recent restructuring of the commissioning areas in the East of England it was tentatively agreed to meet with the commissioning team immediately after the four monthly secretary’s meetings at Fulbourn, Cambridge in order to interact with the newly organised commissioning team.
Jess Bendon has been appointed as Senior Contract manager for both primary and secondary care dentistry regionally. Her line manager is David Barter, head of primary care commissioning across the region. She will be supported by 3 contract managers who will have jurisdiction for the three areas, Essex (working out of Swift House, Chelmsford), Cambridgeshire/Norfolk/Suffolk (Victoria House, Fulbourn), and Herts/Beds/ Milton Keynes (Charter House, Welwyn Garden City) although there will be flexibility across the region. Under those 3 contract managers will sit contract workers
Dental Practice Advisers:
Tom Norfolk is the lead DPA in the region and is supported by Nick Lamb (Suffolk), Maria Ross Russell (Cambs), Steve Clayton (HertsBMK), Alec Owen and Ali Coven (Essex).
A lengthy discussion took place about the commissioning intentions from the Area Team and their approach was considered refreshing. David Barter was keen to incorporate flexible commissioning as part of their approach (the new Marham practice in West Norfolk being one example) although he emphasised that this 'wasn't the only commissioning game in town'. With reference to those practices seeing a high proportion of high needs patients he understood that dentists felt it a duty where capacity allowed to treat patients in pain as their first priority but they weren't there 'as a charity so needed funding properly' and therefore a sensible approach needed to be taken by the commissioners. Part of this was a PDS pilot in certain parts of the region where patients found difficulty in accessing a dentist when they had toothache.
He explained that the commissioners felt that 'they had got to remunerate providers properly' and to this end they were looking at those practices with a very low historical UDA rate (he mentioned £21 per UDA). He also mentioned that 'he wants a collaborative approach' towards commissioning. He was less concerned about undertaking an Oral Health Needs Assessment as he felt 'they just sat on the shelf gathering dust' but would use boots on the ground to identify those areas of need.
Some projects currently being advanced are
- pilots for improving oral health in care homes
- starting well core and dental check by 1
- more 'Marham like' practices in access hot spots in the region using the flexible commissioning approach but also the traditional procurement model
- review of sedation services
- review of Advanced Mandatory endodontic/perio/restorative services
- recycling recurrent UDAs from the rebasing of contracts to other providers able to increase their current contracts
- dental emergency pilot (see earlier paragraph)
- Long-term procurement – looking at Practice change of skill mix to provide sustainability, 8 to 8 services and incentivise Oral Health with a GDS contract plus PDS contract remunerated at a higher UDA value
- remunerated at a higher UDA value
He reminded the meeting that all these initiatives were supported by tax payer’s money and, as such had to be transparent and supported by other financial governance groups within NHSE, particularly the Commercial Executive Group (CEG).
Regarding the perio/endo/restorative level 2 pilots it was agreed to look closely at the Beds/MK model which has been running successfully for many years however the varying geography and demographics of the region meant that a one size fits all approach might not be appropriate and work would be undertaken to address this very important initiative.
- Other Business:
It was agreed that members would be entitled to a subsistence claim for attending LDC meetings based on:
- Travel distance and Time away from surgery:
Some of our committee members live quite far away from the LDC Meeting venue. Some practices have extended working hours which result in time away from surgery.
- Unsociable hours and Time away from home:
Time away from home and family commitments - sacrifices in order to attend meetings, late night return home and early morning start
Committee members to represent all of their colleagues, offering views that can be heard and understood by the Area Team and the rest of the profession and to offer advice and assist in making informed decisions on how to shape the future of dentistry and to allow dental practitioners to make decisions for dentists across the board.
This will be reviewed at the first LDC meeting in 2021.
Annual LDC Conference:
Claire Jackman would represent the Cambridgeshire and Peterborough LDC at the next LDC Conference on 4th/5th June 2020 in Brighton.
- Next Meeting:
24th June 2020.