West Sussex Local Dental Committee

Meeting held on:

Wednesday 15th April 2015 at 6.30 pm

at the Roundabout Hotel, West Chiltington

MINUTES

Item / Action
Apologies, attendees & welcome
Attendees: A.Tarnowski, T.Hancock, M.Botha, A.Wilson, J.Clarke, M.Green, A.Pitchforth, Pa.Patel, M.O’Hara, E.McFarlane, P.Mellings, E.Lazanakis, G.Billis, D.Bryan, R.Sethi
Apologies: M. Ellis, Am and Pr Patel, C.Hallworth
Guests welcomed (TH):
  • B. Okeze
/ TH
Minutes of the previous meeting
The minutes of the previous meeting were approved. / TH
Matters arising
1. Venue Change
•All are happy with the change of venue.
•Parking is easier compared to the White House Pub in Storrington.
•Food is adequate but pizza and chips to be requested for subsequent meetings.
•Suggestions - M Green (MG) suggested green salad. Emma McFarlane (EM) suggested gluten free food.
•T Hancock (TH) will ask Simon (Roundabout Hotel) for more tables so space is available for all to sit and ask for the dietary changes.
2. Older Persons Project
•West Sussex LDC currently holds £20,000 for use in the project.)
•Stephen Lambert-Humble (SLH) is planning to work alongside commissioning teams with this project.
•Foundation Dentists to visit care homes and provide assessments, oral hygiene instructions to the care assistants. DCP’s to provide OHI too.
•Hoping CQC will implement essential requirements to include this oral health training. There is some national guidance behind it.
•M O’Hara (MOH) has not received a reply from the email he has sent to SLH.
3. AJ Ray-Chaudhuri (AJ)
•Two of his courses to go on the West Sussex LDC website.
•They are Section 63 funded and are at St George’s Hospital, London.
•AT highlighted that there are phantom head rooms in Chichester and Redhill Hospital which allows a scope to expand.
•TH to email AJ to help the uptake for his courses.
4. PCSS Update
•PCSS (Primary Care Support Service) is closing. TH and P Mellings (PM) are unsure exactly when but it is expected to be 1st May 2015.
•PM suggested to continue to use the service until they are no longer contactable. The service is likely to move to a south London location.
•Anne Godden to let us know who and when a replacement service will be in place.
5. Orthodontic PDS Contract Procurement
•This is likely to be delayed as the Orthodontic Pathway will not be published until after the General Election.
•PM stated that once the commissioning pathway has been agreed there will be a period of consultation prior to the procurement. It is therefore possible that there will be insufficient time to implement this by April 2016 as originally intended. The subject is on the agenda for the next DQUAP meeting and further information will be available after this meeting.
•J Clark (JC) has seen a draft of the final document (pathways). It was a working document.
•TH raised the question to JC on possible discussions with combining orthodontic practices and whether the draft document of needs assessment (which is currently out to comment) highlights whether areas of need correlate to existing orthodontic practice locations. JC highlighted that some areas of need are lacking in orthodontic practices such as Chichester and Bognor Regis so there may possibly be an attempt to provide services there.
•David Brian (DB) has stated there has been no communication to orthodontists.
•LOC Meeting coming up soon
6. LDC Conference Motion for Approval
•At the LDC Conference a motion for approval will be put forward stating that ‘any MCN (Managed Clinical Network) must have adequate funding from Central NHS England’.
•All committee members agree.
•TH to meet the 17th April deadline.
•Currently there is no funding for MCNs.
•M Green (MG) asked for TH to explain the role of an MCN. PM explained that once a clinical pathway has been agreed, an MCN is responsible for its implementation and its workings.
7. Pathway and MCN Update
•The LPN next meet on 7th May 2015.
•The publication of the pathways has been delayed until after the General Election
•The MOS Pilots is aiming to look to reduce inappropriate referrals. The idea is that a performer in each provider contract should be capable of MOS (Minor Oral Surgery). This may pose a problem to single handed providers who lack this expertise.
•PM has stated that to his knowledge the necessary contractual changes for Consultants to chair the MCN have yet to be done.
•Amit Rai has written to the two chairs of the Orthodontic MCN for Surrey and Sussex to combine. However the Chairs do not want this.
•Until the pathways are published it is unclear how the functions of the MCN are going to be financed.
8. Prototype Contracts
•Following initial pilot studies, 62 dental practices will be taken forward as prototypes for the blended NHS contracts in England. The remaining pilots will revert back to the UDA system.
•There are 2 blends of prototypes in formation. Type 1 prototype will only include Band 1 (and urgent care) activity in your capitation. Type 2 prototype will take Bands 1 and 2 into capitation payments.
•Planned improvements to the dental portal and implementation of Compass are all on hold. This was all part of the new contract/ system. The fact that this development has frozen is worrying.
9. Foundation Training Changes
•TH reports that a standard by which Foundation Dentists (FDs) will need to achieve at the end of their training year is to be implemented.
•Their EPDP (Electronic Personal Development Plan) will be part of this.
•With this satisfactory completion in place there is the possibility that a FD could fall into an outcome 3 or 4 in which an extension of their training year is required or they fail to complete at all. These dentists may still work in private practice.
•London is piloting this in 2015/2016 and it is thought to be rolled out nationally in 2016/17.
•MG highlighted how in one University, a student was deemed less than competent. The university was legally challenged by the husband of the student and then she was deemed to have passed. This therefore passed the responsibility onto the deanery and trainers.
•M Botha (MB) (agreed by A Pitchforth) believes the problem lies with lack of training from the Universities whereby dentists are not graduating fully competent. MOH, as a clinical teacher and examiner, highlighted that the pass/fail essential university ‘moto’ is whether the student is a ‘safe practitioner’. / TH
TH
TH
TH
TH
TH
TH
TH
TH
NHS England South (South East) Update.
•PM and MB just a week into the new structure.
•Still finding ‘ones’ feet’, it will take a few months for the new structure to settle down.
•The new structure is based is in Lewes, Horley. Worthing and Tonbridge..
•PAG & PLDP will now meet in Horley, PAG meets bimonthly PDLP will meet every month.
•The LDC’s have been invited to have an observer on PAG. East Sussex, West Sussex and Kent have each appointed an observer, they will attend in alternation. It was agreed that each LDC would fund their observers loss of earnings.
•When a complaint first arrive it is triaged and either referred to PAG, which provides a more support nature or to PDLP. PAG will investigate the complaint and decides whether practitioners require support or a disciplinary referral to the PLDP.
•The PDLP has been told that it cannot have LDC observers, only a trained disciplinary practitioner. Tim Hogen (Kent) is currently trained. / PM
MB
Secretary’s Report
1. National Conference
•Approval given to permit AT, MB and E Lazanakis (EL) to attend National Conference in June 2015.
•TH will attend National Conference as GDPC Representative.
•LDC will fund.
•Will report back after National Conference in September 2015 LDC Meeting.
2. LPN Report
•3rd Meeting now.
•The membership has now been finalised.
•The Secondary Care Representative is Jeremy Collier. He is the program lead for HEKSS as well.
•The work around MCNs and pathways has not yet not been published.
•NHS Outcomes Framework has 2 dental outcome measures; (1) Decayed teeth and (2) Extractions of teeth in children in secondary care (i.e. GA extractions). In West Sussex, we have one of lower DMFT scores. In contrast, in East Sussex (Conquest Hospital) there is a considerable number of GAs for the extraction of teeth in children.
•A link is to be placed on our website for LPN’s website minutes.
•Prescribing fluoride - CCGs are blocking fluoride on repeat prescription from GPs because they believe GPs are not competent in re-prescribing this.
•We are waiting for national direction on this matter.
•DCP post on the LPN will be rolled out soon but will not be funded. / AT
AT
Treasurer’s Report
Funding for Channel
•Channel meets 3 times a year.
•It includes the Chairs and Secretaries of Kent, Surrey and Sussex LDCs.
•They have spent just under £2000, whilst keeping £1300 in reserve.
•A request for £2000 has been made this year, £500 each (West Sussex, East sussex, Kent and Surrey).
•TH proposed to pay this levy. AT seconded. Passed with no objections.
•Conference subscriptions: the LDC contributes £1825 towards conferences.
•It is currrently based on the number of performers in our area, the agenda committee were proposing moving to a percentage of the performer’s gross.
•Committee did not approve of this.
•PM confirmed we are within budget this year.
•Good achievement considering we ran the CORE CPD day. / PM
GDPC Report
•The first meeting back was in April 2015 - 68 practitioners. 3 from Surrey and Sussex; Richard from Surrey, Dianne (Surrey) but reports to East Sussex, and TH from West Sussex (reporting to us).
•The new Chair (Henrik) will be negotiating with the DOH on behalf of the GDPC. The new chair will serve for 3 years.
•John Milne has stood down after 6 years as chair.
•The 2 blended contracts were discussed. Clinical Practice Reform on hold.
•Community Providers (Polyclinic Idea) discussed - central funding is being implemented now for pilots. Polyclinic’s to include dentist, GP, podiatrist (for example) in one building. It is felt that small dental practice may come under threat because large corporates may take control due to the economy of scale. AP currently works in a polyclinic setup with dentist, GP and pharmacy in same building, and reports it can be useful.
•The GDC are now piloting the sending patient complaints back to the NHS area teams. It was felt that ideally, patient complaints should be firstly referred back to the practice to address in house.
•Contractor Loss Exercise (BSA) –in the top 300 practices; if 2 or more COTs are submitted to BSA within 28 days of each other, then the dental record card will be requested. After this the top 800 practices will be asked to self-audit their claims for band 3 to 3s. This is part of a greater clawback of funds felt to have been incorrectly claimed, on a national level.
•DAF reports cannot be accessed via portal which poses difficulties with providers monitoring performers claims.
•LDC agreed to fund loss of earning for GDPC attendance (TH). Travel is reimbursed by BDA. / TH
Channel
•The Channel Meeting was on 9th March 2015
•EL, AT and TH attended.
•Friends and Family Test in place now. Two questions are required. Data collection samples can be as low as 0 a month but not recommended because it will not give a sufficient overview.
•As soon as the submission is made, via the portal, the original papers can be shredded.
•Demographic information not required (as per templates sent to practices).
•Kent still have issues with the Practice Inspection Checklist. The CQC and Practice Inspection Checklists are different.
•NHS Mail (nhs.net) accounts are available to practitioners (includes performers) on request. If you send patient details on an un-secure network then it can be seen as a breach of information governance and subsequently a formal breach of NHS contract.
•To obtain a nhs.net account, practitioners need to contact Gisela Cox.
•Newsletters coming out from area teams discussing realignments.
•2015/2016 UDA Year - still there is a leeway of an over performance of 2%, and under-performance of within 4%. If providers under perform more than 4%, then a breach notice will be served and all the underperformance will be clawed back. / TH
EL
Any Other Business
•A Wilson (AW) stated that the MOS Contract has been accepted to start at St Richards, Chichester, in May 2015.
•There is a training element to this. It could possibly expand to Worthing.
Date and Venue of Next Meeting
The next full meeting is 17th June 2015 at the Roundabout Hotel, West Chiltington.
All meetings have been cancelled at Storrington.
Date and venues of 2015 meetings
Exec 4.30 pm LDC Main 6.30 pm
Wed 13th May 2015
Wed 15th July 2015 Wed 17th June 2015
Wed 14th October 2015 Wed 18th November

Agreed by the committee on 12th June 2015 and signed by the WSLDC Chair at the meeting.

…………………………. …………………..date

1