Kenny's Update October 2024

Lincolnshire LDC Update October 2024 

Rather than send the update in the previous form, I enclose my Chair’s report which was delivered at last month’s LDC Meeting. There is so much going on at present and I hope you find this report informative.  

Dental Strategy   

• Workforce – a wide-ranging discussion ensued which linked to the Lincolnshire Dental Strategy  

• Access – despite the positive feedback from previous fellows, there were no applications for Leadership Fellows for this year. 

Dental Recovery Plan   

• New Patient Premium –The aim for this initiative was to increase activity, but this increase does not appear to have materialised to date. The initiative is currently time limited to March 31st.  

• UDA rate- The UDA rate was uplifted to £28, and this has affected 43% of practices within Lincolnshire.  

• Golden Hellos- There are 4 Golden Hellos allocated to Lincolnshire.  Although there have been expressions of interest, at present I am unaware of any uptake on this. 

• Supervised tooth brushing – Work is ongoing with Lincolnshire County Council and CDS. I have been advised that the funding has now been obtained. So far there are 25 schools on board, with the hope of further uptake from special needs schools.  

• Dental vans – This initiative was part of the previous Government’s Dental Plan. Interest seems to be tailing off and the benefits of such a capital-intensive project are not proven.  

• Water Fluoridation a Public Consultation has now closed, and we await an outcome.  The Northeast of England is likely to be the first area to be considered in a bid to increase the provision of fluoride in water. 

Lincolnshire Institute for Dental and Oral Health    

• Project manager- This post is held by Susie MacPherson. I can confirm that so far, she has done a great job. 

• Focus groups – Over the last few months there have been focus groups held (2 online, 2 face to face) One group was for associates, DCPs, therapists, hygienists, nurses and technicians and a second group for practice owners, providers and corporates. For the project to be a success for the University / ICB and Practices, it is vital there is collaborative working between everyone. Further focus groups will follow. We value everyone’s input … please come along.     

• Sites – There have been 2 sites identified, both locations are in Lincoln. 

• Next steps – A presentation to the ICB Board which will include a Business Plan, will take place in November. Currently, work is ongoing to determine costs to re purpose existing buildings, equipment costs and running costs. 

•  Momentum with this project is building and what has been particularly encouraging is the number of local practitioners who have come forward offering clinical support. There is an excellent base of clinicians in Lincolnshire with a wide and varied skill set. We want to use this expertise for teaching and mentoring  

Leadership Groups   

• Role of LDC / involvement / support – I refer to the LDC Lecture held last April. Whilst it was great to see such good numbers of attendees, those who came were largely those who regularly support the LDC / BDA. We are committed to LDC support and engagement with all local practices. LDC member Taf Shuro attended a Leadership Day in Nottingham recently, and improvement of integration in the different spheres of health within the Midlands was discussed. All the 4 medical professions were represented by regional heads, along with the regional CDO. The outcome showed that at present, the professions work in silos, with the challenge being better communication between the professions and to move forwards with integration.  Taf felt that help from a national level would also be key. Issues within Lincolnshire were discussed and where dental is concerned, communications and IT links between the professions is a big issue. It was also suggested that a directory of Lincolnshire dentists and GP practices could be set up for clinicians.   

• We have a highly proactive LDC, and it is essential that there is a good succession plan. 

NHS Choices – Practices are contractually bound to keep their NHS Choices profile up to date and information displayed should be accurate. If Practices have mixed contracts ie adult and children, they should not be advising they can take on children only, when capacity allows.  Furthermore, messaging which gives the impression that patients are / or have been registered can be misleading, and practices are asked to try and avoid this terminology.    

Projects   

• CVD Pilot – I attend a weekly meeting for this project, and although funding has not been confirmed as yet, it is expected to be delivered. *NB details of the forthcoming hypertension pilot have now been sent to you. Time scales are short, and Expressions of Interest must be registered by Friday 25th October at 5pm. The likelihood is that this project will be DCP led. In Lincolnshire areas of deprivation will be targeted and these include Lincoln, Gainsborough, Boston, Sutton Bridge area and Skegness/ Mablethorpe. Full details, including eligible criterion, patient type, as well as expression of interest, will be sent out to everyone in due course. This pilot is open only to practices providing NHS Services.   

• Diabetes -   There is a forthcoming diabetes pilot. This is in addition to the proposed CVD Pilot. The expectation is that 3 practices in Lincolnshire will take part. The study follows on from a previous pilot, funded by the NIHR/Diabetes UK, which looked at utilising dental practices to risk-assess patients for non-diabetic hyperglycaemia and type 2 diabetes. In line with the NICE Guidelines and Commissioning Standard “dental care for those with diabetes”, this study wants to explore the links and barriers to implementation of the commissioning standard as well as identifying the prevalence of undiagnosed NDH/T2 diabetes amongst dental cohorts. 

• Clinical Research Network -I can confirm that there is funding in Primary Care for clinical research. We have previously been in liaison with this team and will be meeting with them in November.  We will send you information on how you can apply for this funding post meeting. 

• NHS Clinical Entrepreneur Programme – This is an interesting programme, and details will be sent out when further information is known 

Recruitment 

• Therapists – BSA reporting shows that percentage wise, clinical output from Therapists in Lincolnshire is the highest in the Midlands. This may be a reflection of the number of Overseas Dentists currently working as Therapists    

• Overseas –The Lincolnshire Institute for Dental and Oral Health (formerly the name for the proposed Centre of Dental Development) very much wishes to encourage dentists who have graduated overseas to become involved in this project. The numbers taking ORE are increasing although I have been advised that there are still people dealing with delays.   

• Secondary Care –Lincolnshire is compromised by the lack of a Restorative Consultant. This has an impact when it comes to patient care, but also professional support for the Dental Team countywide. An Orthodontic Consultant needs a Restorative Consultant to work alongside for case planning and support.  In my capacity as an LDN chair, I will be involved with the new Restorative MCN. The first meeting of this group takes place on Wednesday 27th November on Teams  

• Paul O’Malley, who was a co-opted LDC Member and full time Orthodontic Consultant at ULHT, has left his post and is now working at Sheffield Dental Hospital 

Flexible Commissioning 

There is nothing definite to report at the moment, but I will keep you posted when we know developments  

Gerodontology  

• I have been advised by Catriona Brown, Associate Operations Director Special Care Dental Service for Lincolnshire that the next year’s CDS national dental survey is over 65’s in care homes which includes 100 people per local authority in 6 – 10 care homes.  The patients must have capacity and not be end of life.  This will start in February 2025 due to winter pressures. 

Practices referring patients to IMOS 

As more patients become private, band 2 charges may not be collected by the referring practice. The IMOS provider does not necessarily know that no charge has been taken and potentially, through no fault of the referring practice or IMOS provider, the patient may not be charged, as there is no notification that the person is private. The option to identify a patient as NHS or private could be added via a new tick box on FDS. I will see that this topic is brought up at the next Oral surgery MCN.