MINUTES FROM THE MEETING OF CORNWALL AND ISLES OF SCILLY LOCAL DENTAL COMMITTEE HELD ATALVERTON MANOR, TRURO ON TUESDAY 20th JANUARY
Present: Taylor Andy (chair), Taylor (Melissa), Blake, Harrington, Mount, Higgins, Bradburn, Kiernander, Brooks, Jones, Bason
Apologies: Taylor (Anna), Taylor (Charles), Ball
Charles Major and Naurouz Ismail (Noah’s Ark Dental)were welcomed to the meeting to discuss the pilot happening at their practice.
Charles and Naurouz discussed how they were currently on a type 3 pilot. Initially there was a problem with software, which has now been overcome. The pilot had decreased access. After they moved to a new location they were able to increase access with 3 surgeries but they do not have the money to employ dentists as thereis an increasing demand for hygienists and therapists and a decreasing need for dental associates. They had not had a visit from the local area team, who also seemed not well briefed about the pilot. They were advised they will have a visit from Lyn Coombe (area team) soon. They were finding the pilot was working well for children and that the traffic light system was good to motivate patients but cannot see how this will increase the care to the people that really need it more so than the current UDA situation. Patient charge revenue had plummeted and in some practices working with the pilots it was up to a 40% decrease. Banding charges will also have to be addressed. The practice will be applying for the prototype.
The minutes of the previous meeting were approved and signed by the chair.
ACTION POINTS
Update the constitution – it was agreed to remove a few more words and Mel to email members for final approval this week
Declaration of Interest – awaiting one further declaration of interest
Andrew has contacted the area team about breach notices but is awaiting a response
Audits have now been placed on the website for all to see. It was discussed about validating these audits but there are only a couple of people with the correct training still available for this and there is no funding for future people. It was agreed that we would not provide this service as validating is not compulsory and on the basis that for CPD it is easy for people to book onto courses.
REPORT ON PCH DENTAL
There was no report
CHAIRS REPORT
Andrew advised the meeting that the Devon and Cornwall area team have now merged with Bristol, Somerset, North Somerset, and South Gloucestershire. Representatives staying include Andrew Harris, Lynn Coombes and Sarah Mcfarlane. James Glanville, Bridget Sampson and Graham Lockerbie have all gone. The Clinical director is Anthony Farmworth. It is now called the South West sub group.
There is talk of the LPNs merging although the BNSSSG LPN never really formed or made any progress.
Dentistry is to be commissioned by the CCG’s although it will currently require a change in the law for this to happen. Time limited contracts maybe affected.
The area team and BSA have a specific group set up to look at gaming and how UDA’s are achieved in the period between January and April in Lincolnshire and Hull. Also the dental assurance framework progress is picking up pace.
There had been an infection control breach at the referral management centre when a radiograph was sent inside its packet. This was going to be addressed with the dentist responsible.
Providers are reminded that new performers are required to register with the DBS for the annual update process to enable providers to review the performers status in line with CQC and NHS England requirements.
The LDC special conference was well attended and the summary and photos were sent around the members via email and placed on the website.
Invites are now out for expressions of interest in prototypes. The details are on the LDC website and have been sent to the email list. The word is that joining would be beneficial.
TREASURERS REPORT
Carrie reported that the LDC account balance stood at £48,181.86 at the end of December.
The open meeting was a success despite a slow start for bookings.
GDPC REPORT
Peter Hodgkinson kindly provided us with a GDPC report:
The final meeting of the present triennium of GDPC will take place on Friday 30 January.
Elections will shortly be taking place and the first meeting of the new triennium will be on March 19th and 20th.
Contract Reform.
John Milne will have brought the LDC up to date with the progress of Contract Reform at his recent presentation in Truro. Expression of interest will be invited shortly for practices to take part in the propose Prototypes which are expected to commence in Autumn 2015.
Meetings with DoH and NHS England will continue in January and February.
Pay Review.
Discussions have been taking place with NHS Employers and the DoH over the last few months to discuss the uplift in Base Contract Value to be applied in April 2015. An efficiency saving of 4% is once again being imposed, and although GDPC Exec is always opposed to this effective pay cut, ‘negotiations’ are ongoing about possible area of change that will satisfy the Treasury but will be the least harmful to Providers of contract.
NHS England.
The two recent documents ‘NHS FiveYear Forward View’ and ‘Next steps towards primary care co-commissioning’ have been received and discussed.
LDC Levies.
There are still areas of the country, mostly cities, where agreements have not been concluded on how LDC levies should be collected and distributed. Thankfully, most areas have now reached a satisfactory working arrangement.
GDC ARF.
Both the GDC and the BDA are claiming ‘victory’ in the recent judicial review about the consultation process on the proposed increase in the Annual Retention Fee. Sadly all registrants have now had to pay the vastly increased sum. Those that haven’t for various reasons are now facing up to three weeks of not practicing while their late payment is being processed! There will be ongoing posturing and communications as the strong criticism of the GDC by the judge and the PSA (governing body) is analyzed
Dentists with Enhanced Skills.
There are four work streams meeting regularly looking at perio. oral surgery, restorative and orthodontics. GDPC has a representative on each but these groups are large and are heavily populated with dental academics. The progress is slow!
REPORT ON THE CQC MEETING
Dom attended the dental co-production workshop in London on 6/1/15. It was asked what does good and outstanding look like in a dental practice? Dom stressed the importance that what is best practice in one surgery is not the same as in another. E.g. a strict aseptic technique in implantology which would be completely inappropriate in orthodontics. It is also unjust to judge newly qualified dentists by standards of best practice which may reflect specialist knowledge,skill or experience. We need to take into account the overall holistic needs of a patient. Setting standards of best practice may also drive down quality of dental care as a successful business is only able to provide 2 of the 3 things of low price, quality, service. NHS practices have a fixed price dental service. To try and force the provision of high service and high quality will lead to failure of businesses who do. Much of the best practice proposed is improved service measures. In increasing the measures of service without increasing price there will be the unintended outcome of forcing down quality as businesses struggle to survive. The CQC does not have a legal remit to be rating dental practices. Practices would be rated on non-clinical criteria, which does not represent clinical care. This may drive down quality of care. Not one of the delegates at the last meeting agreed with a ratings system for dentistry. Cornwall made a formal submission against the rating system at this meeting. A role for a dental reference officer inspection is viewed as a way of assuring and promoting clinical quality. A compliments and suggestions box in reception is a good idea.
OCCUPATIONAL HEALTH
Steph and Andrew attended a tele-conference to discuss the occupational health situation. From April 2015 there will be no further funding for psychotherapeutic treatment. Needlestick injuries and initial assessments for psychotherapeutic assessments will be covered. Cornwall LDC had been asked if we will fund this service but figures had not yet been received. The LDC members agreed that to make any further decision on funding we would need the figures as a matter of urgency. Steph will chase up Linda Barry for this. Also we need to liaise with Devon LDC. As the timing is so tight it was agreed that this will have to be sorted out via emails in between meetings and that if an extraordinary meeting was needed then we would arrange this also. Andrew will ask at the LDC-GDPC regional liaison meeting in early February what the other areas are doing to fund this service.
ANY OTHER BUSINESS
It was agreed that the LDC would not try to provide a service for all practitioners for the friends and family test.
ACTION POINTS:
- Andrew to get an invite to the KCCG next meeting and future ones
- Steph to chase up figures form Linda Barry at occupational health urgently and the members to decide on a way forward via email in the next month.
- Andrew to look into continuation claims and email the members
The next meeting is to be held on Tuesday 21st April 6.30pm at Alverton Hotel, Truro
The meeting closed at 9.20pm.