Your NHS dentistry and oral health update

Monday 29th March 2021

An update from Gabi Darby and Sara Hurley

Dear colleague,

Today, NHS England has written to practices on the next steps for contractual arrangements and with an important update on our approach to dental reform.

NHS England has made the following joint statement with the British Dental Association about the work we are initiating on dental system reform:

“Today’s letter on NHS dental contract arrangements, issued jointly by Minister Jo Churchill, NHS England and the Chief Dental Officer represents an important new chapter in progressing contract reform in England.

The commitment to pursue rapid meaningful change across the next year will be particularly valued by those working in NHS dentistry. All parties have recognised the profession is seeking faster progress on contract reform. NHS England and the British Dental Association are optimistic that the commitments given represent a new start for system reform, with DHSC having asked NHS England to lead in moving the process forward over the next 12 months and beyond.

NHS England and the BDA look forward to working together immediately and at pace to take forward system reform, exploring how we can make the joint principles set out in today’s letter work for the profession and patients. Whilst we know that contract reform is not straightforward, we hope and expect that the 6 aims will offer a transparent framework to enable us to develop a reformed NHS system that provides high quality patient care and an environment where professionals can work to their full potential.

We will now begin the process of developing reform and will report back progress as soon as we can.”

Issued jointly by Gabi Darby (NHS England) and Shawn Charlwood (British Dental Association)

As NHS England takes a lead on this process, we're sharing the following 6 aims which will apply to contract changes. These will bring focus and transparency to our work.

Contract changes must:

1. Be designed with and enjoy the support of the profession
2. Improve oral health outcomes (or, where sufficient data are not yet available, credibly be on track to do so)
3. Increase incentives to undertake preventive dentistry, prioritise evidence-based care for patients with the most needs and reduce incentives to deliver care that is of low clinical value
4. Improve patient access to NHS care, with a specific focus on addressing inequalities, particularly deprivation and ethnicity
5. Demonstrate that patients are not having to pay privately for dental care that was previously commissioned NHS dental care
6. Be affordable within NHS resources made available by Government, including taking account of dental charge income. 

We've also announced the contractual arrangements for Q1 and Q2. You can find the full detail in this letter. In February mean performance was 59% of contracted Units of Dental Activity (UDAs), so to maximise patient access we are only asking practices to keep up this momentum. Contracts remain in place for normal levels of activity but claw-back will not be applied to practices delivering at least 60% of contracted UDAs and 80% of UOAs (with normal tolerances applying in addition). We understand it is hard for dental teams to plan ahead with only three months’ notice. For this reason, the arrangements are expected to last for the first six months of 2021/22.

The Chief Dental Officer's Clinical Fellow Scheme 2021 is accepting applications. The scheme helps dentists to develop their skills in leadership, management, strategy, project management, and health policy. It's an excellent initiative to help the future leaders of dentistry develop, so if this might be for you please do apply. 

Thank you for your continued dedication and hard work,

Gabi & Sara

Inequalities in oral health in England - a new report from Public Health England

Public Health England has published "Inequalities in oral health in England". This detailed report is important reading for dentists, their teams and the NHS on the challenge ahead. The NHS will study this report carefully as we look at how to improve NHS dentistry. 

Chief Dental Officer's Clinical Fellow Scheme 2021/2022 - run in conjunction with Faculty of Medical Leadership and Management

The Chief Dental Officer's Clinical Fellow Scheme was established in 2017 by Sara Hurley. It currently provides dentists who have had limited dental leadership opportunities and have not held a senior leadership role in dentistry, with a unique opportunity to spend 12 months in a national healthcare-affiliated organisation outside of dental practice to develop their skills in leadership, management, strategy, project management, and health policy.

The scheme is ideal for aspiring future leaders who have had limited leadership opportunities and have not held a senior leadership role in dentistry such as hospital consultant or LDN/LDC Chair or equivalent.

Applications are now open, you can apply using the 'Apply today' button on this page. The deadline for applications is this Wednesday 10am, 31 March 2021. 

Click here for more information and to apply

"We can rise to emerging challenges of the 21st century by fostering talent and prepare a cadre of capable and motivated dental leaders who can confidently take their seat alongside their healthcare peers in the key national and regional forums"

Sara Hurley, Chief Dental Officer England 

Every action counts’: Supporting excellence in infection prevention and control behaviours

The pandemic has thrust infection prevention and control (IPC) into the spotlight like never before, and huge efforts have been made locally, regionally and nationally to maintain the highest level of excellence, instilling confidence in our local communities.

Compliance with IPC measures will be critical in healthcare settings, including dental services, as restrictions ease and more people become vaccinated. To support trusts, NHSE/I has led a project to better understand the complex drivers of behaviours that influence how people act and what support can be offered to improve compliance.

Guided by behavioural science, research was undertaken to gather insight from frontline staff, patients, professional bodies, and clinical and IPC experts to understand what factors influence compliance and co-design interventions and solutions.

The ‘Every action counts’ products suite was developed to address the key themes of the research. The suite includes an implementation toolkit supported by communication and operational resources to strengthen IPC leadership and culture, staff and patient engagement, training, and operational management.

These resources have been developed as a framework, but should be adapted to make relevant for the dental setting. If you need support with adapting the resources, please contact ashley.langton1@nhs.net. The toolkit and suite of resources is now available online.

General Dental Council introduces option to pay Annual Retention Fee by installments

The GDC has announced a new pay by installments option for the Annual Retention Fee (ARF), designed to support dental professionals who pay their own fee by enabling them to spread the cost over the year with quarterly Direct Debits. For dental care professionals (DCP) this works out as four payments of £28.50 and for dentists it is four payments of £170.

More information is available on the GDC's website. 

By word of mouth ... the colleagues we're all talking about!

The NHS Clinical Entrepreneur Programme is a workforce development programme for clinical and non-clinical NHS staff. To find out more click here.

Well done Natalie and the whole team!

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Previous NHS dentistry and oral health updates 

Previous bulletins can be accessed by clicking on the links below:

NHS primary care bulletin

The NHS primary care bulletin provides resources on health policy and practice and we encourage you to sign up for this, too. It is aimed at teams across general practice, dentistry, community pharmacy and optometry. 

A reminder of the latest COVID-19 advice and guidance 

Letters of preparedness to the profession 

During the course of the pandemic, we have regularly written formal letters to the NHS dental profession with important updates and information. They are online here. 

Transition to Recovery: Dentistry's standard operating procedure

This document is the essential guidance for all dental teams in England. In it, we detail all the key things dental teams need to know about how to run their services safely, for patients and themselves. The latest version was published on Wednesday 3 February 2021. Changes to the previous SOP are in yellow. You can read the SOP online here. 

Urgent Dental Centres: Standard Operating Procedure 

If you work in an urgent dental centre or are responsible for one as a provider, or as a commissioner, then the Urgent Dental Centre SOP should be your guide. Changes to the previous SOP are in yellow. It was updated on Wednesday 3 February 2021 and is online here.

COVID-19: infection prevention and control dental guidance

The guidance is an appendix to and should be read in conjunction with the national guidance on infection prevention and control for COVID-19 . You can read the general guidance and the specialist dental appendix online here.