Chairman's report for AGM

This is a copy of Kenny Hume's report as delivered to the LDC AGM on the 25th of May

"Thank you for taking part in the second Teams AGM of Lincolnshire LDC. The novelty of virtual meetings has now passed as these have become the accepted norm. Virtual meetings confer many benefits but there will still be a place for face to face and the networking that goes with such meetings.

Normal house-keeping please …………….. Will you all go on mute. If anyone wants to ask questions there is a tool bar at the bottom of your screen and please put your hand up at the end. Please check the emergency exits in case of fire and know where the lavatories are in case of a real emergency.

This time last year we were in lockdown. Enjoying the sunshine, if you can remember, but being overloaded with much information and advice some of which was inconsistent. Our weekly updates continued and I hope over the year you found them informative, and the communication relative and not just aimed at NHS practice. With less new information, I have recently been sending these out every other week and sooner than later the frequency will reduce to monthly.

Whilst practitioners with NHS contracts received 1/12 of contract value every month for 20%, 45 % and now 60% of activity, this security was not available to private practices. We believe the role of the LDC is to be inclusive and support all dentists in our area. Compared to neighbouring counties, Lincolnshire has a higher proportion of solely private practices and it has been particularly pleasing and enlightening to help these practices. Most Private practices, however, do not contribute to the LDC levy and so we need to find a way to encourage them to do so. Our service is for everyone but currently only supported by mainly NHS Practitioners.

As a Standard Operating Procedure became established and PPE was sourced, practices went back to work from 8th June. It was a different world they went back to. Three letter acronyms and more were everywhere. As the two Ronnies might say ……….. What does NHSE, BDA say is the correct PPE, SOP & IPC when doing an AGP for an RCT? (I missed out OCDO and SDCEP because too difficult to say)

The Furlough scheme was a “life saver” for practices and ensured viability. The vast majority of practices adhered to the principle of paying staff as previously but it was concerning the small number of cases reported to us where this was not the case or involuntary redundancies were made.

Slowly and steadily a new normality returned, all be it with rules on social distancing. Car parks became waiting rooms. Ventilation meant open your windows… or to improve ventilation open wider still. The initial shortage of PPE is no longer. The emergency cases gradually gave way to less acute problems. Triaging still continues but I wonder what the long term cost might be of all the antibiotics prescribed. At present routine appointments are now being made and examinations once again being carried out.

It is clear however, that the capacity to treat patients within practice has decreased significantly, however this is something our fully private practices however may dispute. I know all our reception staff are overwhelmed by calls from prospective patients asking to be seen. It’s no coincidence that Healthwatch receive most complaints from patients unable to access NHS dental care. We are now seeing experienced practitioners retire and dentists leaving the area without replacement, worsening an already very difficult situation.

Unfortunately, the pandemic did not see off the UDA system. With clawback significantly reduced and patient charge revenue off a cliff, the influence of the Treasury prevailed. I know the GPDC Committee of the BDA have begun with negotiations over a new contract and this can’t come quick enough. Flexible commissioning may give opportunities in the immediate future, although with numbers at NHSE trimmed to a minimum, there has to be concerns on whether they have the will and the manpower to roll this out effectively.

As in previous years, recruitment and retention still remain major concerns. Recruitment to the County is challenging, both in primary care and secondary care. It is not just Lincolnshire, with other rural areas facing similar issues and whether it is uncertainties associated with Brexit or other reasons, the situation is becoming very acute. There has been much effort by the LDC, LDN, HHE, PHE and Local Authorities to promote Lincolnshire as an attractive place to live and work and only last month, Lincoln was voted the best city in England to bring up a family. The Talent Academy teamed up with us again and thanks to Millie’s organisational skills and help from Imogen, Helen Matt, Ed and Mary ………a successful Aspiring Dentist Evening took Place in March. Jessica who attended our first event in 2019 is on this call and I would like to welcome her. Let’s hope in several years-time Jessica and some of the other students come back to live and work in Lincolnshire.

Retention is equally as important. We are now seeing experienced practitioners with large list sizes retiring and dentists leaving the area without replacement.

In 2019, one of our specialist Orthodontic Practices went into close down and stopped taking on new NHS referrals. In February of this year, our remaining specialist practice in Lincoln closed. In Louth, the orthodontist left in March and has not been replaced. Furthermore, cases that were previously seen in Secondary Care have now been returned to primary care where there is insufficient manpower to treat these patients. With no replacement funding forthcoming from NHSE, the orthodontic service in primary care is in crisis.

The implications for our patients and referring dentists are significant and further widens the inequality in health care within our County. The LDC has escalated our concerns. Why should our patients have to accept such a woeful service? The newspaper headlines yesterday were all about waiting times in Practice. It’s time we made the public aware of why this is the case…………….the lack of funding and an NHS contract unfit for purpose. NHS Dentistry was already in a mess before Covid. Covid has only made matters worse.

A definite positive over the last year has been the continuing engagement with the CCG. Few other LDCs have this engagement and as the Integrated Care System develops the relationships already made will be key. Personally, I am hoping the development of the integrated Care System will be a positive for Lincolnshire.

Approval has given for the care home pilot and whilst I am delighted that our business case has been accepted, I have a major doubt as to whether there is an urgency amongst the commissioners to get this scheme up and running. Time will tell.

I would also like to pay tribute to work carried out by the Special care service in Lincolnshire over the last year. Not an easy gig this last year. In my updates, I have stressed that this service is not a dumping ground and yet I know those in the service have often felt it was. I cannot begin to imagine how frustrating it must have been not to have been able to carry out a GA for 14 months and yet they have carried on regardless. Thank you.

In national issues, Lincolnshire LDC continues to punch well above our weight. As well as having the Deputy Chief Dental officer in our committee in Jason, we now have the Chair of the General Dental Practitioners Committee of the BDA in Shawn. Congratulations to you both on these well-deserved appointments and thank you for what you do to help our profession at a national level.

Jason and Shawn will cover national issues in their reports and Jason will talk about Integrated Care Systems

As you all know, we lost a valued and well respected member of our committee this year with the death of Nigel Bourne. Nigel was one of us. A very talented dentist but above all a good man. He was Chair for 4 years and a long standing member of this committee. Nigel is very much missed by all of us.

Leaving the committee this year as they both retire is John Ogden and Roger Bayes. John has been our Chancellor… sorry Treasurer for ever and Roger is currently Vice-Chair. Both John and Roger engaged in debate, had their own opinions and have been the best of committee members. Lincolnshire LDC have been very lucky to have both on our committee for so long. You will both be greatly missed and thank you for all you have done for us. We have arranged a gift which will hopefully improve their respective golf games but obviously I cannot present this, this evening.

Throughout this last year, I would like to pay tribute to the LDC committee for all their help, support and friendship. Thank you in particular to Sharon for all her administrative support and keeping herself largely out of hospital this year. Over the last 2 years in particular, the role of the Chair has changed beyond recognition. The time spent on LDC matters means it has become a “proper job” I am very fortunate to chair such a good committee. Every one contributes and has an equal say and opinions are heard. It is very encouraging to see our younger members now stepping forward and coming onto the committee. You are our future and welcome to the LDC.

Words that are never said about me …………….. I wish he would speak for longer, There ends my report "