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January 16th Lincolnshire LDC Update number 62
Dear all ……………….
Welcome to the first LDC update of 2022. On behalf of the LDC, may I wish you all a belated happy and healthy New Year.
2022 brings much uncertainty. For Q4, NHS practices have been set an 85 % target for UDA activity and 90% target for Orthodontic activity. The outbreak of the Omicron variant has meant staff absences and short notice patient cancellations. Something I’m sure private practices are also experiencing.
It may be very difficult or indeed impossible for some practices to reach these targets before March 31st, especially those practices where dentists have left and they are having difficulty with recruitment. There is an anomaly that overachievement greater than 100% in Q4 can be carried back to the first 9 months of the year, yet overachievement in Quarters 1-3 cannot be carried forward to Q4. Covid cases are still high, but hopefully the signs suggest the peak may have been reached and we could be over the worse.
Let’s stop and reflect
Not unreasonably, most NHS Practices are concerned with reaching targets before the end of March. For some practitioners, the effects of the pandemic and a target driven system has focused their attention on whether they should remain in the NHS or even consider selling their practice. Both will be considerations.
What is often missed, however, is the support NHS practices has have received. There have been significant furlough payments. Practices continue to receive free PPE. This offer of free PPE to frontline health care providers in England has been extended until 31 March 2023, or until infection prevention and control (IPC) guidance is withdrawn or significantly amended.
Yes there are targets and if these were met (or will be met) at 20%, 45%, 60% or 85 %, then 100% of contract value was/will be paid. The overall NHS offer has been a good one and a very interesting figure to know would be the actual amount in monetary terms that each practice has received by way of subsidy since the start of the pandemic.
What should practices do if they have concerns with staff absentees / short notice cancellations?
The most important thing we can all do is keep a weekly log of the above and also include any special circumstances, perhaps not necessarily connected with Covid.
Enclosed below is an example of a template that could be used to record this information. If you cannot make the NHS targets, then this data could be crucial in future discussions with NHSE.
You may remember the LDC recently sent out a short survey regarding the impact of Covid on staff absenteeism etc. Thank you to the practices who contributed and enclosed are the results. Please remember the relatively small sample size. This number equates to approximately 40% of practices in Lincolnshire
A patient’s perspective
The focus on targets and all that goes with being a dentist and running a practice means that often the patient’s perspective is forgotten. I will be attending a Healthwatch meeting in 10 days and I thought it would be interesting for you to see a sample of some of the recent responses sent to Healthwatch which we will try to answer.
Can you explain why they don’t accept NHS patients but you can get a private appointment within days, or is it fact it’s all about them making more money, and people without the means to pay just have to suffer. I was talking to a fellow pensioner who told me he takes a load of pain killers then pulls out his own teeth when in pain, is this really 2021 or 1821, and what about the children no dental treatment available unless you pay, when my children were young it was always a case to take them every six months, the NHS dentist system is failing these children.
Why is it I will lose 2 teeth because NHS dentists could not drill but if I go private I can get the work done??? NHS second rate service
Pre COVID, I was registered with a dentist. I was able to have regular check-ups. They used to be every 6 months, but around 5 years before COVID, my appointments were becoming longer in between check-ups. My last check-up was due in March 2020 and obviously with COVID hitting the country, it was cancelled and was rescheduled for about 6 months later (Sept 2020). However, this appointment was also cancelled and rebooked for another 6 months later (March 2021). However, yet again this appointment was cancelled and then not automatically rebooked. When I queries this with the receptionist, I was informed that as I had not seen a dentist at the practice in over 2 years (at that point) I was no longer registered with the practice even though it was not my fault. I was informed that I would have to find another NHS dentist as they were not taking on any new NHS patients. Can someone please explain to me why a practice is allowed to do this? I now cannot get another NHS Dentist and although I do not have any issues with my teeth – probably due to having regular check-ups and following advice, I am very angry that the practice can do this to patients. How many other patients has this happen to and are now experiencing similar issues?
Why in my area (Mablethorpe) we have a perfect dental surgery in the Marisco surgery but no dentist to run a practice …………….no excuses for this!
My dentist has left my practice so I can only access emergency treatment which is more expensive than regular appointments. Myself and my children cannot have check-ups. Is there any way we can be seen elsewhere whilst waiting for a new dentist? I am needing regular antibiotics whilst waiting for a tooth removed.
I’ve been living in Lincolnshire for over 13 years my teeth are getting bad due to illness and meds. Why can I not get to see a dentist? I’ve tried but same old answer we’re only taking private patients.
I have tried to get an NHS dentist for myself and my husband but nowhere is taking on new patients and the feeling is it will 12 to 24 months WHY!!!!
Why no NHS dentists available, I've been trying to get registered for years no. I resorted to buying antibiotics. Third World Service.
I moved to Lincolnshire in October 2020. I was waiting to go into hospital to have 5 teeth removed and treatment done as I have a sprained TMJ, so unable to keep jaw open pain free. I still haven't been able to register with a NHS Dentist. Have a HC2 form as I cannot afford private care. Consequently now have even more broken teeth which keep getting infection under them. I suffer with depression and this is affecting me, as front teeth affected. When oh when will I be able to register with a dentist so that I can get my smile back, mental health improved?
There are many more questions sent in but the recurrent theme is lack of NHS access, a workforce issue ie lack of dentists and why are you not offering solutions.
We are awaiting feed-back from NHSE regarding the recent expressions of interest for increased UDA and UOA activity and successful practices will be informed in due course. Historically interest from Lincolnshire has been low,so let’s see if there is any change this time?
Vaccination for Practice Teams
Now that the government has brought in mandatory COVID-19 vaccination for healthcare workers in England, some practices are reporting difficulties. It is estimated we could lose some 6-8% of our workforce at a time where staff shortages are acute.
The overwhelming majority of dentists and dental teams are in favour of vaccination. However, a proportion of dental staff are against the COVID-19 vaccination, some decidedly so. The BDA advice to practices is to have open and constructive discussions with staff on this issue, and they have provided resources to help, below. However, discussing the efficacy and safety of vaccination, with those who are decidedly against it, may prove difficult.
Mandatory vaccination for healthcare staff is now law in England. From 1 April 2022, staff without medical exemption will need to be vaccinated or the practice will be in breach of regulations and will face enforcement action. As things stand, patients may feel unwilling to attend practices where some members of staff are unvaccinated. A fact often overlooked.
Ultimately, you should not feel obliged to argue with staff on the rights or wrongs of a law which govern dental practice. Members can see BDA advice on the compulsory COVID vaccination and staff management, which includes:
Advice on compulsory vaccination and exemptions (All members can access)
Recruitment guidance (All members can access).
And finally …..
NHSE/ OCDO and the LDN are now producing excellent and informative bulletins and newsletters. The LDC is aware of information overload but our updates endeavour to take a slightly different slant on current affairs, which we hope you find helpful. If you wish to contribute in any way or require any assistance, please contact us at lincsldc@gmail.com
Have a good month.
Best wishes
Kenny Hume Chair Lincolnshire LDC
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