BDA challenges GDC to explain unchanged registration fees

 

The British Dental Association (BDA) has challenged the General Dental Council (GDC) to explain its failure to reduce registration fees levels for 2018, which remain unchanged at £890 – the highest cost of any UK health regulator. 

The Council agreed a budget, which was not shared in advance, and the Annual Retention Fee (ARF)  levels at last week’s Council meeting. The BDA had already demanded clarity from GDC chair Bill Moyes after noting the ARF for dentists was listed for 2018 at the same level on the regulator’s website ahead of the gathering, while public papers also outlined an ambitious and seemingly uncosted Business Plan.

The BDA has now expressed its alarm that the decision for fee levels to remain at the current level was made secretly, with no formal announcement and no discussion with the profession. The budget paper, made available after the meeting and citing a number of savings and underspends against 2017 forecasts, refers to many ‘uncertainties’ for 2018, including a potential reduction in registration numbers and the costs of implementing projects linked to Shifting the Balance.

In its response to that consultation earlier in the year, the BDA highlighted its concerns that some of the proposals would be costly and that a reduction in the ARF and a focus on core aspects of regulation were paramount to ensure a rise in confidence in the regulator. Yet the GDC has not found it necessary to gauge further views on its budget plans for next year from the profession. The BDA has argued that keeping the fee at the extortionate level of £890 can only be seen as a money-grab.  

Given projected complaint levels have not materialised, the BDA has repeatedly demanded that the fee be reduced. Increases in complaints were cited for the fee rise in 2014, in a consultation process that was deemed unlawful in the High Court. The Association has long criticised both the regulator’s designs to expand its remit beyond its statutory duties, and its preference for holding excessive financial reserves which, for 2017, are expected to reach around £6m and forecast to be over £7m in 2019.  

The GDC’s finance report including figures to June 2017 showed the regulator was running a surplus of £3.9 million above budget. 

BDA Chair Mick Armstrong said:
“As long as the ARF level stays unchanged it will remain the clearest illustration of the GDC’s failure to deliver on needed reforms. Our regulator will struggle to regain the confidence of this profession as long as it seems more concerned with funding pet projects than improving the efficiency or effectiveness of its statutory functions.

“The rationale for the ARF hike was a projected rise in complaint levels and Fitness to Practise cases which have not materialised. The GDC has used registration fees to improve Fitness to Practise processes, some of which have already borne fruit and demonstrably reduced costs. Registrants now have a right to know what their fees are paying for. 
“Yes, we expect the GDC to take reasonable and proportionate steps to manage its finances as Britain prepares to depart from the European Union. But not to repay the profession the ‘caution’ rating from last year when admitting that the expected reduction in registrants has not taken place is not acceptable, especially while it maintains the most extortionate fee levels of any UK health regulator.
“We have already been asked to pick up the tab for the GDC’s financial mismanagement. In 2018 dentists should not be expected to subsidise our regulator’s fondness for mission creep or its obsession with holding vast and unnecessary reserves of our money.”

New method for extracting tooth root pulp means richer stem-cell harvest

Researchers at the University of Nevada, Las Vegas (UNLV) have developed a new method for extracting tooth root pulp that quadruples the number of stem cells that can be harvested and replicated to treat a variety of medical conditions. Read the full report here

Orthodontic legal challenge: Update

 

A legal challenge by the BDA over concerns about the procurement of £1/2 billion orthodontic services in the south of England has been suspended while NHS England undertakes preparatory work for the procurement of such services. The services procured will commence after March 2019.

In the interim, NHS England has announced that existing providers, whose orthodontic contracts were due to expire next spring, will have their contracts extended until March 2019.

The preparatory work that NHS England South is undertaking before progressing to procurement includes needs assessments, impact assessments, public consultation and engagement with the profession.

NHS England South will run a series of evening events in October and November for all providers who are interested in delivering NHS orthodontic services. Dentists who want to attend these events should email: scwcsu.orthosouth@nhs.net

The BDA launched legal proceedings in March against the NHS England South procurement, and in the meantime commissioners in Cheshire and Merseyside suspended their orthodontic procurement, which was also based on a similar procurement approach.

BDA Chair of General Dental Practice, Henrik OvergaardNielsen, said:

“We hope the extra time that bidders have to apply for a new contract will increase their prospects of success and at least provide existing contract holders and their patients with some certainty in the interim.

“The final outcome of this legal challenge is uncertain and legal proceedings are on hold until at least the end of the year. The BDA remains determined to stand up for members and to ensure that they are all treated fairly.”

The BDA urges members who are interested in bidding for an orthodontic contract to use this time to input into the engagement process and to convey any concerns they have about the procurement process to NHS England.

Hospital denture loss costs in so many ways, says study

A study by Jessica Mann and Mili Doshi, leading figures in the Mouth Care Matters initiative, has revealed that lost dentures during hospital stays are costing the NHS thousands of pounds, and threatening the dignity and comfort of patients. The study, published in the British Dental Journal (22 September) has investigated the loss of dentures in hospital trusts in Kent, Surrey and Sussex over a five-year period (2011-16) and the cost of replacing these. Of the 11 hospital trusts in the three counties that provided data, a total of 695 dentures were lost. Seven of the trusts reported that – between them – the NHS paid out £357,672 to replace these: it works out as an average of £51,096 per trust over five years.

There are 152 hospital trusts in England and, basing its estimates on the study’s findings, the BDA believes that the overall cost could be at least £1,100,000. This does not even include mental health trusts, where denture loss may still be a significant issue.

The authors of the BDJ study point out that losing a denture in hospital can have a profound impact on a patient’s wellbeing, self-respect and dignity. They say that many people choose not to tell their family and friends that they wear dentures, but when the absence of teeth becomes obvious it can cause considerable distress and embarrassment. They give an account of a patient whose dentures went missing in hospital, who subsequently refused all visitors and couldn’t bear to see her grandchildren without teeth – as she felt her appearance would scare them.

Speaking to The Times newspaper, Jessica Mann explained, “People wrap [dentures] in tissue after a meal and then they get taken away with the meal tray, some people put them under their pillow and then they get taken away when the linen is changed, some are just mistaken for rubbish or get lost in transit.

“A lot of hearing aids and glasses go missing as well but the thing about dentures is that they take so much longer to make and are so personal.”

Jessica Mann also talked about the effects of denture loss on patients. “We’re very worried about the nutrition of people who can’t manage to eat and so they stay in hospital longer. You might not be able to speak if you’re used to having dentures in your mouth. And then there’s the loss of dignity.”

BDA President, Peter Dyer, said:

“It’s all too easy to underestimate the devastating impact that losing dentures can have on patients, but this study brings those issues to light.

“We know it can make patients feel depressed about their appearance, when they are at their most vulnerable, and it hinders their ability to eat and communicate with staff and friends.

“These difficulties are often compounded by the fact that it can take several weeks –  if not months –  to get these replaced, particularly if a patient remains in hospital and there is no access to dental care.

“It can be a struggle for patients to adjust to a new denture, when they may have had their old ones for years.”

“More needs to be done to raise awareness of denture loss with both patients and staff.

“Some simple care and attention will save a lot of money and make life more comfortable for a huge number of patients.”

Mouth Care Matters is suggesting that staff are trained to find misplaced dentures and wards provide labelled denture pots for those patients who wear them. For more information see www.mouthcarematters.hee.nhs.uk. n

Income protection – because you never know

By Richard T Lishman

Every year, millions of working days are lost across the UK due to sickness and injury averaging out at about 16 days per person – and dentists are no exception.[i] If anything, dentists are at greater risk of becoming ill or suffering from an injury than many other professionals, as dentistry is such a physically and mentally demanding occupation.

That is why you need income protection – a policy designed to pay you an income if you are unable to work due to sickness, injury or an accident. That way, if the worst were to happen, you can rest assured that your livelihood is protected regardless of how long you are off work.

Now, there are more than 50 income protection plans available at any given time, so be sure to examine all of the options available to you. Here’s what you’ll need to consider:

  1. Level of incapacity: All insurance companies base claims on how ill you have to be prior to any benefit being paid, but whether or not you receive a payout will all depend on which incapacity level you choose. Selecting ‘own occupation’ policy will provide you with the most comprehensive cover, as it ensures that your claim will be assessed on your ability to perform your duties as a dentist. ’Any occupation’ cover on the other hand will only pay out for as long as you’re unable to work, so if you were declared fit to work payments would be stopped – regardless of whether you could return to practice or not.
  2. How long can you afford to wait before making a claim? With income protection policies there is what is known as the ‘deferred period’, which means you can either choose to be paid from the first full day you are off sick or defer your claim to a later date. Generally, a shorter deferred period will increase the cost of your cover.
  3. Guaranteed or reviewable premiums: If you were to go for guaranteed rates, the amount that you would pay for your cover would remain the same for the duration of the plan, irrespective of how many claims you make. Alternatively you could select a reviewable premium, which is where your monthly payment would be reviewed after a set period of time and can be increased based on their overall claims experience.
  4. Exclusions: When choosing income protection cover be sure to check the policy for any potential limitations or exclusions. These may vary depending on the insurer that you opt for, but typical exclusions where you won’t receive a payout can include pre-existing medical conditions and illness or injury that is self-inflicted.

To find out more about income protection or for expert help and guidance with finding a suitable policy, contact the Independent Financial Advisers at money4dentists today.

For more information please call 0845 345 5060 or 0754DENTIST.

Email info@money4dentists.com or visit www.money4dentists.com

About the author
Richard T Lishman is Managing Director of money4dentists, a firm of specialist Independent Financial Advisers who help dentists across the UK manage their money and achieve their financial and lifestyle goals

[i] Health and safety executive: Working days lost. Accessed online 2 May 2017 at http://www.hse.gov.uk/statistics/dayslost.htm

A tighter tax squeeze on higher incomes – don’t get caught out!

 

The government’s tough stance on the tax affairs of the very wealthy has been the focus of a specially designated team since 2009. These taxpayers, or High Net Worth Individuals (HNWIs), are people whose investible assets exceed £10m.

The Public Accounts Committee (PAC) has been critical of how HMRC handles HNWIs, however, and in a report issued in January claimed that not enough is being done to deal with tax evasion and avoidance within this group. Between 2009 and 2016, there were 72 completed investigations for tax fraud, but just one successful prosecution in a criminal case.[i] This is significant because HNWIs have the potential to make a healthy contribution to government finances.

The HNWI population in the UK currently stands at 552,800. In 2014/5, this growing club paid over £535,000 a head in income and capital gains tax (CGT).[ii] At the last count, London had the most HNWIs for a city worldwide, with New York and Tokyo in second and third place.

If this all sounds a million miles away from anything that dental practice owners should concern themselves with, don’t be fooled because there have been clear indications that HMRC wants to get more money out of a wider group of taxpayers. It is now starting to look closer at those who are just inside the upper tax bracket, which will include many dental professionals and entrepreneurs. Indeed, the number of Brits paying income tax at the higher or additional rate hit record levels in 2016.[iii]

In 2011, two years after the HNWIs team was established, the Affluent Unit was set up to look at individuals with incomes over £150,000 and/or a net worth between £1m and £20m. The Unit has almost doubled in size since it began, increasing its numbers of employees by 20 per cent. The Affluent Unit’s prime targets commonly include those who have property portfolios/bank accounts that are based offshore. You will also come under the scrutiny of the Unit if you habitually file self-assessment returns late and use (or have used) tax avoidance schemes.

An affluent individual is likely to have more complex tax affairs, so it is common sense that HMRC will want to take a closer look to ensure that everything is above board. The fact is that even if you are a higher or additional rate taxpayer, there are perfectly legitimate ways to reduce your tax bill while staying fully compliant with the rules. The services of a specialist accountant are essential to help with tax planning and regular tax check-ups so you can be confident that you are doing everything by the book. Lansdell & Rose has an expert team with extensive experience in advising dental practice owners on money matters. Saving tax while remaining legally compliant is not only possible, but will help you get the most out of your business.

If HMRC is being criticised for not having taken a tough enough stance on its wealthiest clients, then you don’t want to be caught out as it starts to ramp up the scrutiny on those who are slightly lower on the income scale. As it expands its operations to monitor the affluent more closely, we can predict a tighter inspection of everyone’s tax affairs in a few years’ time, as the government seeks to squeeze more tax out of more of the population. Don’t give yourself the headache of non-compliance; work with the experts now and you will stay in control.

 

To find out more, call Lansdell & Rose on 020 7376 9333,

Or visit www.lansdellrose.co.uk

[i] https://www.parliament.uk/business/committees/committees-a-z/commons-select/public-accounts-committee/news-parliament-2015/high-net-worth-individuals-hmrc-report-published-16-17/

[ii] www.worldwealthreport.com

[iii] Higher-rate taxpayers hit record levels. Financial Times, 20 May 2016.

We are what we eat

 

By Rachel Pointer

In early 2016, data from UK households who took part in a survey that documented food and drink habits between 1974-2000 was published.[i] We now eat less white bread, offal and fewer varieties of fish, but more pasta, pizza and chips. The purchase of ready meals went up fivefold between 1974 and 2000, with consumption of canned vegetables dropping by over a third in the same period.

There have also been huge shifts in how we eat. Whereas a hearty breakfast, lunch and dinner at defined times was the norm not too long ago, nowadays the rules are looser. We don’t always stop to eat. Snacking or eating between meals used to be frowned on; biscuits or cake were often only bought out for guests or for a treat.

A snack is generally defined a bar or packet of something that is cheap, requires no preparation and can be consumed anywhere. Brits love to snack and savoury snacks are the most popular choice; we eat more crisps than any other country in Europe.[ii] But snacks are no longer something small to keep us going until mealtime. Crisps and chocolate bars are available in super-sized packets and the calorie content of many popular snacks is higher than we think. So-called ‘healthy’ snacks, such as cereal bars, are often full of sugar. We must not forget calorific and high-fat beverages, either. Energy or sports drinks are massively popular and we have a thriving coffee shop culture that did not exist in the 1970s.

If size matters, should certain snacks be upgraded to ‘meal’ status instead? Although some health professionals advocate grazing on five or six mini meals as alternative to three big ones for a range of health benefits “in relation to appetite control, bodyweight management and improved blood glucose control in diabetics and pre-diabetics”[iii], this only works if people know what an appropriate portion size is.[iv]

Dental professionals must address the needs and changing habits of the modern patient and help them think about what they are eating. If snacks or mini meals are the reality of how they eat, help them make healthier choices. Cheese or unsalted nuts are better than crisps and chocolate for teeth (although not so good for waistlines). Get them to think about portion size and remind them that it is OK to stop when they are full! Alongside nutrition advice, teaching them how to brush using the correct technique and the best tools will keep their mouth clean and remove debris left over from regular meals and snacks. The comprehensive range from Tandex, including interdental brushes, is suitable for all ages and dental needs and supported by adjunctive products, including a mouthwash containing fluoride and chlorhexidine.

Going out to eat frequently, snacking more, bigger portions – the way we eat has changed drastically in the last 40 years. Reiterating nutritional advice alongside good brushing technique will help us fight the snack attack and encourage patients to think about their teeth as well as their waistlines.

For more information on Tandex’s range of products,
visit www.tandex.dk or visit the facebook page:

www.facebook.com/pages/Tandex-UK/234855250044190?fref=ts

 

 

Author Rachel Pointer qualified from Guys Hospital as a dental hygienist and began work in general dental practice in Hertfordshire.  After working as staff hygienist for Professor Naylor she was appointed tutor dental hygienist at Guys Hospital before working in Australia.  Rachel has experience in hospital, specialist periodontal practice and in the private sector as well as setting up a PDU within a cerebral palsy home in Essex.  Working for 10 years for the British Dental Hygienists Association as their information officer plus membership and careers co-ordinator she presently works at Addenbrookes Hospital and in general dental practice and a few year ago branched out to teach in a Montessori school setting.

 

 

The real cost of insufficient protection during sports

The cost of a good quality mouth guard is nothing compared to the cost of loosing a tooth. Every sporting situation where a player’s face might come into contact with a hard object – whether that be another person, their fist, a bat, racket or stick, ball or the concrete / tarmac ground – presents a risk to the teeth and gums.

While mouth guards are mandatory in competitive contact sports, many people don’t appreciate the full importance of the devices and so will often choose not to wear them. The dental team has the ideal opportunity to help educate patients and their parents on the dangers of sports and the benefits of effective protection for the teeth and gums.

One of the major barriers to mouth guards – especially for parents buying devices for their children ad young adults perhaps living on their own for the first time – is cost. Many will select the cheapest option in order to comply with the rules of their sport, but give little consideration to what they are actually purchasing.

When talking to these patients, it’s important to demonstrate the full potential cost of not wearing a mouth guard. For example, if a player has a tooth knocked out during a game, they will require dental treatment to replace it. This might involve simply reinserting the avulsed tooth – or more extensive treatment could be required such as dental implant therapy and or further restoration, the cost of which would be significantly higher than purchasing an effective mouth guard in the first place! Further still, there would be the cost of on-going maintenance of any treatment delivered, in some cases, lasting a lifetime.

If such treatment is not financially viable for the patient or their parents, the subsequent emotional or psychological considerations for someone left without a tooth could be considerable. One study found that 47% of those surveyed needed more than a year to accept their tooth loss, with 6.3% still coming to terms with it after this time.[i] The research also suggested feelings of sadness and depression were fairly common among this group of respondents. Such emotions could have a knock-on effect on the person’s social life, especially if the missing tooth is in the anterior region – low self-esteem could cause them to shy away from public interactions, having an impact on their everyday lives.

Further still, it’s important that patients realise the importance of a high quality device. A cheaply-made, poorly-fitting mouth guard might do little better than no mouth guard at all in protecting the teeth and gums during sports. Solutions such as the Saber Protect custom-made mouth guards from CosTech Dental Laboratory offer outstanding protection for patients – regardless of their age, the type of sport they play and the competition level they play at.

When it comes to safety in sports, quality protective equipment is essential. In many sports, this includes a well-fitting, quality mouth guard, which will promote comfort and facilitate communication while also protecting the teeth and gums. Help your patients appreciate the cost of not wearing the right mouth guard to keep them safe on the sportsfield.

 

Saber Protect custom-made mouth guards are fabricated by CosTech Dental Laboratory. For more information, please visit

www.custom-mouth-guards.com.

[i] Okoje VN, Dosumu OO, Alonge TO, Onyeaso C. Tooth loss: are patients prepared? Niger J Clin Pract. 2012 Apr-Jun;15(2):172-5. doi: 10.4103/1119-3077.97305.

 

Asthma found to increase the likelihood of gum disease by a fifth

Asthma sufferers have been found to be at a much higher risk of developing gum disease, according to the findings of an innovative new piece of research. The study, which looked at a selection of 21 papers published between 1979 and 20171, analysed the relationship between asthma and oral health in more than 120,000 people, with the most recent results from 2017 confirming that people with asthma were almost one fifth (18.8%) more likely to suffer from periodontitis. 

In response, leading charity, the Oral Health Foundation is encouraging asthma sufferers to ensure they pay close attention to their oral health in order reduce their risk of developing gum disease.

Speaking on this important new research, Dr Nigel Carter OBE, CEO of the Oral Health Foundation said: “We have known for some time that there are close links between oral health and systemic disease, such as heart disease and diabetes. This new study is hugely significant as it could help many millions of asthma sufferers from having to deal with further significant health problems.

“The good news is that avoiding gum disease can be as simple as brushing your teeth twice a day with a fluoride toothpaste, using interdental brushes daily and regular visits to the dentist. While gum disease can be treated very effectively, the best approach is certainly prevention and making sure we do not fall foul of it at all.

“When not caught and treated early enough gum disease can lead to tooth loss and further oral health complications.

“We are encouraging anybody who suffers from asthma to be especially alert to the early signs of gum disease; which include red inflamed gums, bleeding when brushing your teeth and persistent bad breath, and ensure that you visit your dentist as soon as possible to get checked out and avoid any further problems.

“We welcome more research on this topic, as a greater understanding could be a game-changer in stopping asthma suffers also developing gum disease.”

The findings, published in the journal of ‘Journal of Periodontology’, illustrate a close link between the two diseases and suggest that there is huge potential for millions more people to develop gum disease in the UK, gum disease is already one of the biggest non-communicable diseases (NCD) globally.

According to Asthma UK, 5.4 million people in the UK are currently receiving treatment for asthma. The UK has some of the highest rates of asthma across Europe.

Woman pleads guilty to illegal tooth whitening in Doncaster

A woman from Doncaster has pleaded guilty to practising dentistry illegally following a prosecution by the General Dental Council (GDC). Shelley Ann Starr, from Armthrope, Doncaster, was fined £110 and ordered to pay a £30 victim surcharge and a contribution of £880 towards costs, at Doncaster Magistrates’ Court.

Ms Starr practised dentistry illegally by providing tooth whitening to members of the public on 6 July 2017 at 18 Sailisbury Road, Doncaster, DN4 0HA. The Dentists Act 1984 outlines that to practise dentistry legally – which includes tooth whitening – an individual must be registered with the GDC.

The GDC’s role is to regulate the dental team in order to protect patients and help to maintain public confidence in dental services. One of the ways patients are protected and public confidence is maintained, is by prosecuting people who carry out dentistry illegally.

Shaun Round, Interim Head of Illegal Practice at the GDC, said: “It is imperative that dental professionals are registered to practise. Registration ensures that only those fully trained and qualified can practise dentistry legally. It also places a legal requirement on dental professionals to keep their skills and knowledge up to date through the completion of continued professional development (CPD) – this makes sure that patients receive the best possible treatment by a professional that is trained, competent and indemnified.

“Registration with the GDC is also required to purchase valid indemnity insurance, which is imperative as it allows patients to seek compensation if they are harmed as a consequence. By performing dentistry illegally, patients are placed at serious risk of harm.”