Kenny's Update October 2022

October 12 nd 2022 Lincolnshire LDC Update Number 68

Dear all …………… it feels as if it has been a while.

In Lincolnshire we have over 90 practices. 70 plus practices have NHS contracts with the

remainder fully private. It is hoped that when our Update goes out practice managers /

owners forward this to all staff members. If this is the case, we estimate our circulation list

should be over 1000 contacts. You may remember at the end of our most recent Update we

asked you to complete a very short doodle poll. Thank you to everyone who completed this.

The disappointment, however, was that that we had only 19 replies.

With this in mind, the question has to be asked regarding the value of our Updates. It has

been mentioned several times that we are conscious of information overload, and as such

we try and keep our content short, to the point and in a way that relates to the issues dental

teams face in general practice. We will therefore continue producing our Updates but less

frequently. The monthly LDN newsletter is excellent and informative and conveys much

information.

The LDC however is always available if you have a concern and we can be contacted at

lincsldc@gmail.com

Two Week Wait Patients in Secondary Care

Secondary Care are informing us that they are receiving a significant number of

inappropriate referrals under this pathway. The two-week wait is specifically for patients

who the referring practitioner thinks may have cancer. There can of course be uncertainties.

Is it Lichen Planus or Squamous -Cell Carcinoma? OMFS can understand such a referral on a

two week wait but not a draining sinus from a heavily restored molar tooth or prolonged

anaesthesia following an ID block as examples. Please remember, a second opinion from

another dentist in your practice is always worthwhile.

Update your NHS Choices Page

Patients searching for an NHS Dentist, will check the NHS Choices Page. Please ensure you

are displaying the correct information and keep this updated. Healthwatch, in particular,

have been very critical of incorrect information being displayed on the NHS Choices page as

well as practice websites. It may be an appropriate time to revisit your answerphone

message and update this as well.

Aspiring Dentists Event

The LDC hosted this event at Lincoln County Hospital in early September and thank you to

all LDC members who helped on the night. The event was very well attended and encouraging that so many local students feel dentistry could offer them a career. Not all see

themselves as dentists, but several were enquiring about DCP roles. We have to encourage

these students and offering job experience may go a long way to help them on a career

path. One that hopefully means they could return to Lincolnshire.

Phased Courses of Treatment / Avoidance of Doubt

With the recent change of the contract, it is worth revisiting this document. The key is to

have records which clearly demonstrate why the clinician can justify this approach. We

understand why individuals may be reluctant to consider phased courses of treatment (red

flags etc at NHSBSA) but for new patients with high dental needs, this could be a way to plan their treatment. Ctrl and click to follow the link

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What will be important in the future are recall intervals. It looks as if these will be closely monitored and so be prepared to be able to justify why you set your time interval when recalling patients. As regards the changes made on October 1 st , premolar and molar endodontics started before this date count as band 2 and therefore 3 UDAs.

At present, our understanding, is that if molar endo is carried out post October 1 st followed by a crown (and because you are following restorative guidelines you place the crown within 12 weeks) you will only get 12 UDAs not 7 plus 12.

Lincolnshire Dental Workforce Strategy

In response to a request by the ICS, NHSE have set up a working group to look at the issues

we face in Lincolnshire. Key stakeholders, including the LDC, have been invited onto this

group which meets every 2 weeks. 2 separate workshops, which stimulated many ideas,

have also taken place. A face-to-face meeting is being proposed for November and as soon

as dates and times are known, we will send out details.

Peer Review

The LDC, led by Vice-Chairs, Andy Fenn and Sandy Gemmell are aiming to re – start the Peer Review initiative. It will be open to all members of the dental team, not just dentists. DCPSs will be very welcome. The scheme is not limited to practices with NHS contracts. Private practices offer much, and we want them to be involved as well.

Work is ongoing with this and after or next LDC Meeting in November we will hopefully be

able to send out information on how you can get involved.

And finally ………………

We are aware of large contracts being handed back, not just in Lincolnshire but Midlands

wide and also a drop off in NHS activity in this financial year. The impact in an area like ours

however, where there are fewer dentists and already an acute lack of access, is much more

significant. The country faces hard economic times and the majority of the public in

Lincolnshire may struggle to finance whole family dentistry on a private basis. Something to

consider as business decisions are made for the future

Best wishes

Kenny Hume Chair Lincolnshire LDC