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February 28 th Lincolnshire LDC Update number 47
Dear all ……………….
Thank you to everyone who took part in the last Tuesday’s LDC Meeting.
I hope you found the discussion informative and worthwhile. We had a record number
attending and my thanks go to Emily, Shawn and Jason who presented on the evening. We
felt it was important to give you an up to date view on what is happening at a local level ie
the vaccination programme, orthodontic provision in Lincolnshire, the new LDC Website and
referrals to Secondary Care. The national picture is of equal importance, particularly with
regards to abatement for NHS practices, likely targets for Q1 and proposed changes in the
contract with flexible commissioning now a reality.
Referrals to Secondary Care
You will be aware there was a concern raised regarding the algorithm on FDS for
orthodontic referrals. It would appear that Overjets of 9 mm or more are referred directly to
Secondary Care. These referrals are then automatically rejected because they do not meet
the acceptance criterion and bounced back to the referring practitioner. In other words, a
waste of everyone’s time. I have contacted FDS and await a reply.
Orthodontic Referrals
As the astronauts on Apollo 13 famously said … Houston we have a problem! Castle
Orthodontics closed on Friday 26 th February and Treeline have taken on their cases to close-down, plus a small number of new case starts. These are additional cases who were already assessed by Castle Orthodontics.
However a large number of patients have been referred to Castle Orthodontics who have
not been assessed and I believe these will be returned to the referring GDP. It would appear
that no other orthodontic providers / performers are currently taking on new patients, so
the question I have asked NHSE is where can GDPs send their patients for treatment?
A new procurement is still some time away we think, and so what happens in the short and
medium term? The LDC recognises the serious nature of this problem and this lack of service
provision in Lincolnshire. It was suggested that colleagues write to your constituency MP
highlighting the lack of service, the impact on the patient and family and the inequality in
health care. ie children whose parents can justify private treatment get their children seen,
those who can’t …. Don’t.
Safeguarding
Another topic discussed on Tuesday.
Enclosed is an email with links from Catriona (Cat) Brown from Special Care Dental Services.
This is very helpful and please give it your consideration.
“Jason sent the link for the CDO’s letter which focused on Domestic Abuse
http://createsend.com/t/d-336A07743A38DF552540EF23F30FEDED at the LDC meeting in
the chat. This was something I shared with my team when it came out and I thought it might
me a good thing to share in your LDC update.
Safeguarding is my “thing” and I have been the Lincolnshire Dental Safeguarding Lead for
the past 15 years, and since going to CDS I have been training Safeguarding in Dentistry to
the other Counties in CDS, as I didn’t realised other people didn’t have over 50 hours of CPD
on the subject!
I receive the Lincolnshire Safeguarding updates, as well as the Domestic Abuse updates and Iam also on the mailing list which sends out update emails to the GMP’s. In those they do
monthly 7-minute bulletins, the idea being you have a short sharp message to share with
your team. The one on Domestic Abuse was really well received by my team and I have
added it here, along with the poster and referral form for EDAN Lincs. which we have on
display in our toilets. We made an organisation decision to do this as we felt that having it in
a main waiting area only wasn’t ideal, that someone who is experiencing domestic abuse
may not like to show they are taking notice, however in the privacy of a toilet they can read
it / take a photo without anyone knowing. Also there is a video done by EDAN Lincs. and
Lincolnshire Police which is available in 7 different languages which can be found at
I am not sure how many incidents GDP’s have on their safeguarding logs, we have about
30/year. A lot are was-not-brought (WNB) situations where we have shared that
information with the family doctor or health visitor (if they are under 6) but I am concerned
with the amount of adults who have rung our phone line during COVID and mentioned how
down they are, and how they have considered taking their own lives, we have added 2
people to our list over the past week because of that. What is frustrating is that when we
contacted the Adult Services and the Single Point of Access for one of these, they wouldn’t
accept a referral from us and said it had to come from the GMP, I will be taking this further.
I also encourage my employees to do the free e-learning training which can be accessed
through the Lincolnshire Safeguarding Children’s Partnership found at
https://www.lincolnshire.gov.uk/safeguarding/lscp/3 Once registered the trainings on there
are brilliant, though quite intense, and there are 2 domestic abuse e-learning courses
currently available through that route
I may be teaching Dentists to suck eggs, and if like us, Safeguarding is mentioned in every
team meeting then people are probably aware of these resources, but if not then I thought I
would share.”
7 Minute briefing
Domestic Abuse in covid (002).pdf
7 minute session
Domestic abuse and COVID.pptx
EDAN referral.docxEDAN poster.docx
How to calculate abatement in NHS Contracts.
There is a lot of confusion over the abatement amount which will be payable at the end of
the quarter. Below are a couple of examples as to how this can be calculated and my thanks
go to David Hornsby at West Parade Dental Care for providing this information. This is only
one of many scenarios and shows, for a practice achieving their exact, reduced, target for
Quarter 4 (and assuming they had met all the other criteria for the previous quarters), how
the abatement calculation could be worked out:
The abatement is 16.75% of the element of UDAs or UOAs that the practice doesn’t fulfil.
For UDAs, where you need to get 45% of the “normal” target therefore, the element that
you haven’t achieved would be 55% which is equivalent to a percentage of 9.2125% of your
total UDAs (the 55 percent you don’t achieve x 16.75% = 9.2125%). For example, a practice
with a target of 10,000 UDAs, paid at £20 per UDA actually achieves 4500 UDAs (which
when multiplied up by 2.22 per UDA means they exactly reach their target). The abatement
would be calculated on the 5500 UDAs that they didn’t actually do. So, the total abatement
for the practice would be 5500 x £20 x 16.75% = £18,425.00. (or in other words, the total
quarter’s contract value of £200,000 x 9.2125%)
With regards to UOAs, where you need to get 70% of the “normal” target, the element you
haven’t achieved would be 30%, which is equivalent to 5.025% of the total target. So, for
example, a practice with a UDA target of 1,000 UOAs for the final quarter, paid at £75 per
UOA, achieves 700 UOAs (which when multiplied up by 1.43 gives them the required total).
The abatement would be calculated on the 300 UOAs which weren’t actually achieved x £75
x 16.75% = £3,768.75 (or in other words the total quarter’s contract value of £75,000 x
5.025%).
Further examples can be found by selecting one of the webinars, dependant on your type
of contract at: https://www.pcc-cic.org.uk/dental-year-end-2020-21-webinars/
If you need any further help in this matter please contact me at lincsldc@gmail.com
And finally ………………….We have been made aware that there appears to be an increasing number of inappropriate referrals are being sent to OMFS via the 2 week referral pathway. We will cover this in more detail next week but please remember this pathway is for suspected oral cancer patients only.
Keep safe and well and enjoy the sunshine
Best wishes
Kenny Hume Chair Lincolnshire LDC
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