Your NHS dentistry and oral health update

29 September 2022 (Issue 53)

An update from Sara Hurley and Ursula Montgomery 

Dear colleague,

Since we announced the contract changes for 2022/23 in our letter of 19^th July 2022 we have been working with DHSC, regional commissioners and NHSBSA to make the necessary legislative and administrative changes to bring these into effect.

From 1st October, several contractual changes will come into place including a minimum indicative UDA value of £23, updates to support enhanced UDAs for higher needs patients and personalisation of recall intervals, promoting more effective use of skill mix and other changes requiring regulatory amendments. Further details of these changes are set out in this bulletin in the items below. 

As we approach winter, influenza vaccination should be offered, as part of an employer’s occupational health responsibilities, to frontline health care workers. This includes both clinical and non-clinical staff who have contact with patients and is to protect the staff and those they care for.

Where a frontline healthcare worker falls into an eligible NHS flu programme cohort either due to age or being in a clinical risk group, then a flu vaccination can be accessed through the NHS Flu Scheme, for example at the person’s registered practice, from a community pharmacy. Further information is available at https://www.gov.uk/government/publications/national-flu-immunisation-programme-plan/national-flu-immunisation-programme-2022-to-2023-letter

With best wishes,

Sara and Ursula

Minimum indicative UDA value of £23

All contractors with an indicative UDA value of less than £23 should have received a letter from their local area team confirming whether this will be implemented through either a reduction in required annual activity or an increase in their annual contract value (with activity requirements remaining the same). This will come into effect from 1^st October 2023 and should be reflected in Compass by the end of October.

FP17 updates to support enhanced UDAs for higher needs patients and personalisation of recall intervals

We have been working with the NHSBSA and dental system suppliers to make the necessary changes to the FP17 to support these proposals. These will come into effect on your clinical systems from 1^st October 2022. Specifically, we have introduced new fields to the Clinical Data Set to capture the provision of molar and non-molar endodontic treatments to support the appropriate allocation of 5 and 7 UDAs to qualifying Band 2 Courses of Treatment, in preparation for the planned regulations amendment. 

To support the personalisation of recall intervals we have amended the FP17 to collect data on the highest BPE sextant score and the number of untreated decayed teeth at the beginning of the examination. Completion of the NICE guidance recommended recall interval field will become mandatory on adult claims for Band 1,2 and 3 Courses of Treatment from 1^st October 2022. We continue to work with NHS BSA and others on the optimal presentation of this information to support benchmarking, personal reflection and peer review.

NHS BSA have updated their Guidance for the completion of FP17 activity submissions in England to reflect these changes.  This will be available on the BSA website from 1st October 2022. Dental system suppliers are also providing training for their clients and we would like to thank them for working with us to make these changes as promptly as possible. 

Promoting the more effective use of skill mix

The existing GDS Regulations (Schedule 3, Part 4, paragraph 22) identify dental hygienists, dental therapists and professionals specified under section 36A of the Dentists Act as being able to provide services under the contract provided that they are a dental care professional and their registration is not subject to suspension. These staff are therefore able to provide care under the contract in accordance with their scope of practice and competence. Contractors are advised that any changes to current working practices should be preceded by an individual conversation with the DCP concerned to ascertain current levels of competence and confidence and any support required to work to their full scope of practice. We have amended the FP17 so that we can collect data on the care being provided by DCPs from 1^st October 2022. There will be a check box to indicate which DCP fully or partially provided care (therapist, hygienist, nurse, clinical technician) together with a space for their GDC number. 

Additional guidance on how to facilitate dental team working will be published in October 2022.

Changes requiring regulatory amendments

The amendment to the UDAs awarded to the filling and /or extraction of three or more teeth, non-molar and molar endodontics requires regulatory change before it can be enacted. The changes to the FP17 described above will ensure that we are collecting the information required to support this change from 1^st October. We anticipate that the regulatory changes will be in place by the end of November and will be implemented with immediate effect. We also anticipate that this will include the regulatory changes necessary to require updating of the Directory of Services. We will provide further updates on both of these changes as they progress through the parliamentary process. 

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

Special focus bulletins 

Chief Dental Officer Sara Hurley and the NHS team regularly produce 'special focus bulletins' on clinical priorities and key aspects of patient care. These bulletins summarise the key information dental teams need to know and act as a refresher, combining best practice, expert opinion and useful resources. If you would like to suggest a topic for a future special focus bulletin please email the CDO's team at England.CDOExecutive@nhs.net 

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Key advice, guidance and resources for NHS dental teams

NHS updates to the profession 

Key letters from the Chief Dental Officer and the NHS dentistry and oral health team are online here. 

Infection prevention control (IPC) 

NHS practices should refer to the NHS England Infection Prevention and Control Manual which details the principles NHS dental practices should now follow to deliver care. The accompanying dental framework identifies hazards and risks with guidance on measures that should be maintained as we move to new, improved and safer ways of working. 

Dental recall priorities for children: implementation tool

Children are a clinical priority group for all NHS dental teams. Practices are encouraged to use the NHS implementation tool which assists dental professionals in the recall of children for a dental appointment, in line with NICE guidelines. You can view the tool online.

Avoidance of doubt note: provision of phased treatments

This document is to support dental professionals, and to clarify where it might be appropriate to provide phased treatment spanning over several courses of treatment (CoT). You can read it online here.

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