Hampshire & Isle of Wight Local Dental Committee
Committee Meeting – Wednesday 8 November 2017 at 7pm
Venue: Room 2, The Education Centre, RHCH, Romsey Road, Winchester SO22 5DG
Part One
- Welcome Tony Lynn welcomed all attendees to the meeting.
- Present: Tony Lynn (TL) (Chair); Keith Percival (KP) (Secretary); Claudia Peace (CP) (Treasurer); Philip Gowers (PG); James Kingham (JK); Nick Forster (NF); Denise Mattin (DM); Phillip Wray (PW); Nerina Hendrickse (NH); Konstanty Kostiw (KK); Eva Lewin (EL); Kim Jones (KJ); Mairead Hayes (MH); William Creedon (WC); Parimal Manek (PM); Ashkan Pitchforth (Observer); Caroline Short (Minutes)
Apologies:Kathy Cottrell; Verena Easterby-Smith; Victoria Brown; Helen Spencer; Stephen Robinson; Hardev Seehra; Ailsa Graham; Jeyanthi John
- Conflicts of Interest – not already notedNone.
- Minutes of the Meeting 13 September 2017(Part One) signed off as a true and accurate record of the meeting.
- Matters Arising None.
- PHE Report – Jeyanthi John by e-mail
There will be a national epidemiology survey of adults attending dental practice starting shortly. All local authorities in Wessex (and many across the South) are NOT participating in this survey – a key issue has been the lack of a protocol to date which has meant that they have not had sufficient notice to commission it. The protocol is still not finalised with ethics approval pending. The plan is randomly selected dental practices. They will secure a spare surgery in the practice and will approach patients to administer a questionnaire and clinical examination.
The FGDP has published Good Practice Guidelines on Dementia-Friendly Dentistry. This book is available free to FGDP members, charge of £25 for others.
PHE has published advice for dental professionals in light of the ongoing global shortage of the Hepatitis B vaccine. This is likely to continue until 2018 with ongoing severe impact on the UK supply. Advice was circulated via the LDC Secretary, giving details of prioritising staff for the vaccine.
NHS England chief executive Simon Stevens has announced a 250 calorie limit on confectionary sold in hospital canteens, stores, vending machines and other outlets. Hospital chiefs will have to ensure that four out of five items purchased on their premises do not bust the limit, which is an eighth of a woman’s and a tenth of a man’s recommended daily calories intake. If they do, they lose out on funding ring-fenced for improving the health of staff, patients and their visitors.
GDC is keen to engage with the local profession through LDCs. A number of presentations have taken place across the country. Cn the LDC invite the GDC to the HIOW LDC to a future meeting / organised evening event.
- HEE Report – Jane Powell No report. The LDC expressed concern that no apologies had been received and the lack of any reports from HEE Wessex. The Secretary will contact JP to check contact information and the current status quo in the light of recent staff changes.
Kim Jones advised that her last working day is 31.12.2017. JK advised that there were sweeping cuts in CPD provision and Tutors with many being made redundant. Richard Cox remains as the sole postgraduate tutor for the whole area. The skills room at the PGMC Winchester has been taken back – an alternative Service Level Agreement is being drawn up with the University of Portsmouth Dental Academy. Additionally, there are huge cuts in administratIve support throughout the Deanery. It is believed that peer appraisal will remain. The LDC needs to write to raise its concern to the PDD Prof John Darby re HEE plans for the future. PW asked what will happen to Dentists who are referred to the Deanery from the GDC – KJ believes that the support will still be available. TL reiterated his and the LDC’s concern for the future of postgraduate education and especially for essential CPD.
- NHS England – South Wessex report to LDCs Commissioning Team - Verna Easterby-Smith by e-mail
Service Specs for the Enhanced services have gone out to practices. A good response has been received with expressions of interest in all areas – Diabetes, Care Homes, Toddler Clinics, Homeless. It is anticipated that these will be progressed as soon as possible.
Orthodontic Tender – the two Wessex events take place during the week commencing 6th November, Dorchester this Wednesday and Thursday in Winchester. These are an opportunity to hear the proposals for the tender. Concerns were raised from within the committee regarding the procurement on the IOW as there is potentially only one provider which means a ‘monopoly’ situation. NF reminded all that they are not yet at the tendering process stage. TL reminded that most Orthodontic service providers do not automatically pay the statutory levy, but at this difficult time may need to consult with the LDC.
DERs – now looking to find a Wessex solution as it appears the National one is unlikely to happen for some years.KP noted that the CDO is looking for a National Solution however there is a question regarding the funding for this system.
Still awaiting confirmation of the agreement to appoint MCN chairs for Wessex – Orthodontics, Special Care, Oral Surgery and Restorative.
Oral Surgery evening event Thursday 23 November 2017 – all practices must be represented at this event.
The Contracting or Performance Teams are happy to respond toany specific questions.
- Other NHS England – South (Wessex) written reports (1) LDN Core and MCN (and non – MCN) Updates Oral Surgery, Orthodontic, Restorative, Periodontal, Urgent Care and Special Care
LDN Core
Concern regarding the redesign of the dental degree, Nicholas Taylor, Chair of COPDEND keen to turn into a linear degree process. A lot of support from the CDO. Liverpool University to pilot next year – All entry at the same level. Question, where is educational rigor?
JK added that the deanery had recently spent a whole day looking at the future of dental training – main area was around skill mix. Believed it to be cost savings driven as 80% of work currently being undertaken by the Dentist can be done by a hygienist or therapist. Report to NHS England end of March 2018 – KP to take concerns to LDC Officials’ Day and LDC Conference 2018. KP requested input from the committee. The LDC members felt that it might be useful for Nicholas Taylor to attend an LDC event in 2018.
Orthodontics MCN– Not met since last meeting.
Oral Surgery -Group wish to encourage clinical representatives to the meeting to be held on 23 November 2017 when the MCN and MOSRC will present the NHS local referral guidelines and pathways.
Practitioners are reminded that there is no indication to send a patient to a different provider to have panoral (OPG) imaging prior to MOS referral. It is essential to send diagnostic periapical images for teeth other than third molars. Intraoral images for third molars should show enough information and It is preferred but not essential that the apical area is shown. To support triage the angulation of the tooth should be demonstrated. If the indication of the referral is caries in the second molar, the images provided should demonstrate this. The Oral Surgery MCN continues to work with the commissioners and the restorative consultants to further develop and improve the apicectomy pathway, recognising that this surgery should only be required in exceptional cases. It is often felt that Practitioners raise patients’ expectations that they could have a GA – but this should be discouraged. Need to re-write referral paperwork to reflect that OPG is not a mandatory requirement.
Special Care – A rather depleted group of attendees attended the last meeting in October. Main focus was therefore on the forms for special care adults and children and the criteria for referral. The group is now looking at the care pathways for bariatric patients but there were no people from the task and finish group to report on this.
- Reports (2) Dental Academy; Salaried Services; BDA Wessex;
Dental Academy – Latha Davda
The refurbished West Clinic was formally inaugurated by the Chief Dental Officer, Sara Hurley on 26 October at a well-attended function. The CDO in her short speech stressed the importance of skill-mix and the value of Dental Hygiene / Therapy training and praised the work of the Dental Academy for its contribution.
The Dental Academy has established formal links with Manipal University in India and Dental College in Ethiopia and is working on several streams of educational and research activities. For the first time we had Visiting Faculty Professor Arathi Rao, Head of Paediatric Department.
This year the community outreach programmes include the Brush UP school tooth brushing programme, there are 11 schools enrolled. A similar programme is being piloted in Magalore, India through Manipal Universtiy. UPDA has joined with Pharmacy, to promote inter-professional learning between dental and pharmacy students to provide the NHS health checks using the University van. UPDA has added an oral health check element to the pre-existing NHS health check format and this will be the first time this has been combined. In addition, the University van will be used to provide free oral health checks for hard to reach adults in various locations across the city.
As part of the expanding CPD portfolio, UPDA is holding a series of study clubs in collaboration with QA. All are most welcome to attend and contribute. Details are published on the LDC link. The next study clubs are:
Wedensday 8 November – Shahib Romeed Dental implants and root canal treatments; which is better?
Wednesday 10 January – Helen Spencer and Sirisha Ponduri The Interface between Orhtodontics and Dentoalveolar surgery
Wednesday 14 February – Mo Al-Gholmy and Shahib Romeed The complex reconstruction. A 3D approach to Facial Implants
Wednesday 21 March – Sirisha Ponduri and Tom Aldridge Orthognathic Surgery for Dentofacial Deformity
Salaried Services– Denise Mattin
Contractsawaiting procurement tender for Special Care Dental Services next year but not sure if this will be delayed. The tender will be across the South Coast. Will involve, as last time, lots of hard work and impact on delivery of UDAs.
Prison Service on IOW out to tender, Solent approached by a healthcare provider to provide dental services. If it is unsuccessful current Solent staff will TUPE to another provider.
Recruitment - As reported previously Solent NHS Trust has allowed the service to over recruit as nine dentists are likely to retire out of 35 in the next few years, two have already done so. The 18/19 business plan will look at succession planning in particular. It is relatively easy to recruit to Band A positions however we need to recruit experienced dentists to Band B and C positions. This is proving difficult in the present climate.
GA – Following the 50% reduction in availability of GA sessions we are now working close to 18 weeks wait in most of the GA sites. The list in Southampton for adults with Learning Disabilities is operating at a much longer lead in period. There is currently only a single session a month for this and although meetings with UHS have been had the service have been unsuccessful to secure additional theatre time. An additional day has been secured at QA Hospital Portsmouth which will enable 4 more patients a month to be treated and will reduce the waiting times from December. Discussions are also ongoing with Hampshire Hospitals Foundation Trust for consideration of additional sessions in Basingstoke or Winchester. The service is looking for additional staff who are interested in working a Saturday a month on GA in QA (two Dentists on a list). It would be helpful to have oral surgery experience for some of these patients.
- BDA Wessex – Disappointingly only a few participants for the Kevin Lewis day event arranged for 24 November.
- Any Other Business - PW raised the issue of trying to access the necessary referral forms for Urgent 2 week patients Parimal Manek confirmed that each Consultant / Hospital FTs have their own forms – KP and the Web Manager to look into and follow this up.
IFR payments to specialist providers in Endodontic treatment are generally £700 - £1000.However, GDPs are only paid 3 UDAs why is there such a disparity? No set national tariffs. Eva Lewin confirmed that there are high levels of orthodontic IFRs. There was a discussion regarding theuse of appropriate IFR pathways. Removal of bonded retainers should not require an IFR. IFR criteria need to be reviewed / refined.
Over-performance that includes commissioned non-recurring activity maynot attract superannuation – Wessex contracting team are able to remedy this, if requested.
PW to provide contact to enable a replacement AED box – free of charge.
The LDC offered their congratulations to Eva Lewin on the safe arrival of her son.
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- Dates of next Meetings 17 January 2018; 7 March 2018; 9 May 2018 AGM (tbc) all to be held in Winchester. 7th March rearranged post meeting to be held on the 21st March 2018