Kenny's Update 10th of January 2021

Dear All,

It was encouraging to see both the OCDO and the BDA responding very quickly to the Prime Minister’s announcement last week regarding lockdown. Practices remain open but for

those with NHS Contracts, there is a significant difference in that activity levels have to

increase to ensure payment are made at previous levels. More of this later.

Thank you to all the practices who responded to our request for staff numbers eligible for

the Covid immunisation programme. Our figures show there is circa 1400 employed in

Primary Care dental practices in Lincolnshire.

It has been very encouraging to have practices not on our mailing list making contact and

reporting figures to us. We are sorry you have not been receiving our updates in the past

and if you are aware of any other practices who may wish to receive information from the

LDC, please let us know at lincsldc@gmail.com

The OCDO have given the following guidelines

Vaccination Programme

If you work in NHS primary care dentistry

The NHS will contact you. You do not need to contact the NHS, such as a GP surgery.

Your practice will be contacted via its registered email address and asked to confirm the

number of people eligible for the vaccine. Hospitals and local vaccination centres will then

begin contacting you to come forward for the vaccine.

NHSE & I will update you as more information becomes available.

If you work in NHS secondary care dentistry

The NHS trust that employs you will organise your vaccine. Please speak to your line

manager if you have any questions.

If you work in private dentistry

Providers must update their contact details, including email address, with the Care Quality

Commission (CQC) as a matter of urgency.

This is because if you work in private sector dentistry and you or the practice you work in

do not have a NHS contract, then the NHS does not hold any contact details for you. We will

get your contact details, or that of your practice, from the CQC.

If you are a locum and not currently clinically active, or between employment, NHSE & I will update you as soon as possible.

So the question everyone wants to know is when will our practice be immunised?

…………………..

We understand the anxiety and frustration among dental teams. The infection rate is rising

and we work in the danger zone of mouth /oropharynx.

What I can tell you is that a huge amount of work is going on behind the scenes with the

LDC/ CCG & NHSE. The way the immunisation programme works in our area is that some of the distribution of the vaccine will be via Hospital Hubs and also via the PCNs (Primary Care Networks). These are distributed on a geographical basis through the County. (See below)

The dental profession is in Group 2 b in terms of priority, so those in Care Homes and their

Carers and the over 80’s come first. Lincolnshire has also prioritised East Midlands

Ambulance service and St Barnabas Hospice and I’m sure we call can agree on why this is

necessary.

Compared to other counties, Lincolnshire has a significantly higher proportion of over 80’s

and those in Care Homes which means vaccinations of dental teams will follow once this

programme is completed. Dental Staff working in ULHT have already been offered the

vaccine.

For Primary Care in Lincolnshire, it is planned that Mass Sites will be used to support the

vaccination of Dental Teams. These will be spread throughout the County and local IT

systems will be in place to support these teams. For your information, the large vaccination

centres/ hospital hubs are at Lincoln County Hospital and Pilgrim Hospital, Boston.

Lincoln are currently offering the Pfizer vaccine. Boston, the Astra Zeneca vaccine.

As regards PCN Local Vaccination Services – these are community facing local vaccination

services led by GPs working together in PCN groups – there are 8 up and running and a

further 5 scheduled to come on line this week.

Both systems will provide ways of vaccinations – their priority has to be the 80+ but where

there is capacity or DNAs, people will be booked in. To support this however, the CCG will

need a mechanism with local dentists to be able to link with them at short notice.

The CCG will share with us the basic information that people need to have available so that

these systems can be mobilised quickly. It does require a responsive approach as often

there will little notice and quick adjustments to our diaries will be required.

I know there are further meetings taking place before a full CCG meeting on Tuesday

morning.

Northampton and Derbyshire have started offering the vaccine to dental teams and I am

sure you know for fact, or anecdotally, dentists in primary care or non-clinical staff who

have now been vaccinated. This only adds to the frustration of the majority. The whole

vaccination programme is a massive mobilisation which involves many varied challenges in

terms of logistics and manpower. We cannot give out a starting date as yet but I am sure we

are only days away and whilst I know it’s difficult, please be patient.

What can you do in the meantime?

Please do not contact your GP. This is local and national advice. GP practices have been

totally overwhelmed by such calls, to the extent they are struggling to provide normal

services.

If you have personal contacts who are directly involved in the vaccination programme,

perhaps consider making them aware of your circumstances.

There are sometimes cancellations at the vaccination centres or unused vaccine left at the

end of the day, so perhaps use this as an opportunity.

If you have been lucky enough to have received a vaccine, please be sensitive and aware of

others who have not yet been immunised.

Activity Rates for NHS Practices

I think all NHS Practices are now aware of the new increased UDA targets starting from

January 1 st and I’m sure we have all worked out that perhaps the only realistic way for

practices to meet these targets, is to see more patients. With infection rates increasing, the

advice from the Chief Medical Officer is to treat each patient as if they have Covid and so

with more patients, we will be exposing ourselves and our teams to further risk. This is so

counter intuitive! It is also inevitable that some of these patients seen will be at the expense

of patients with problems. A situation no one wants at this time.

Furthermore, from what we are hearing, it is unlikely there will be any change in stance

from NHSE regarding activity levels, although the matter is being discussed this week in

Parliament.

So everyone is aware, if practices fall below 80% of the target, then UDAs will be paid only

on the basis that they are delivered, rather than at the enhanced rate. For example, if a

practice was to reach 32% of pro-rata UDAs, they would only receive credit for the UDAs

delivered on a 1:1 basis, which would represent 8% of their annual UDA total (32% delivered

during one quarter of the year). In effect, for the last quarter if a practice reaches the

threshold of 36% pro-rata UDA delivery, we expect each UDA delivered to be worth 2.2

UDAs. If the practice fails to reach 36% of pro-rata UDAs, each UDA is likely to be worth 1

UDA. A similar approach is likely to apply to orthodontic delivery in relation to the 70%

target.

Associates and Practice owners should be aware that individual payment to Associates may

therefore not depend on the individual performance of the Associate but the collective

performance of the practice. In other words, an Associate could achieve well over the 45 %

threshold but because other performers fall short of their respective targets, the practice

then fails to meet the 36% cut off point. The over performing Associate would therefore be

penalised financially and by a significant amount. This would be a difficult conversation

between the practice owner and Associate.

The BDA have published guides and contracts for this final quarter and I would urge

everyone to have these in place.

Failure to meet your individual target can be down to many factors. However some of those

can be out of the individual’s control. For example, patients cancelling at short notice

because they have Covid or need to self-isolate. Similarly with yourselves and your own

staff. Patients simply refusing to attend for routine appointments because of a perceived

risk to themselves .There could also be unexpected child care issues. The Best from the East

could return and bad weather prevents patients from attending.

We would therefore strongly encourage all practices to keep full and contemporary records

from January 1 st detailing such scenarios. This will be vitally important information if

evidence for mitigation is required at a later date.

Nigel Bourne

Here is the link for Nigel

https://nigelbourne.muchloved.com/

The arrangements for his funeral are as follows:

Private funeral service to be held at St Nicholas Church on Monday 1st February 2021 at

11:30 am followed by committal at Lincoln Crematorium. Due to Covid restrictions this is

limited to family only, but it is hoped we can remember him together with family and

friends when restrictions are lifted.

It is hoped to live stream or record Nigel’s funeral service to be shared with those who wish.

Nigel’s page will be updated as soon as there are more details.

And Finally …………………..

I am sorry you are receiving this update later than normal, but I have been holding back

waiting for up to date information from the CCG regarding the vaccination programme. This

came through late this afternoon. Look out for more information in the next couple of days and please be assured we do understand how everyone is feeling and we are working hard

with the CCG to roll out the programme for all dental team members, as soon as possible.

Stay safe and well

Best wishes

Kenny Hume Chair Lincolnshire LDC