government

BAPD seeks new guidance from government to help to screen for oral cancer

The British Association of Private Dentistry (BAPD) has advised the government that it needs to change its guidance in order to help dental practices successfully screen for oral cancer.

The Association recently conducted a straw poll of its members in order to find out whether dental professionals were encountering problems in referring patients who were suspected of having mouth cancer. The results found that 676 out of the 755 respondents had experienced referral problems when seeking secondary care.

The poll comes following research, which has suggested that more than 24,000 cases of cancer have gone undiagnosed due to the Covid-19 pandemic.

Jason Smithson, Co-founder of the BAPD, said: “The comments would suggest a multi-factorial problem; however, there would seem to be some common themes. Clearly, this is a serious problem for the profession. Therefore, we have compiled a survey that we hope to present to PHE and NHSE and may impact fallow and PPE.”

Examining what the Chancellor’s Summer Statement 2020 means for dentistry

Michael Lansdell is a founding partner at specialist dental and medical accountants Lansdell & Rose and a chartered accountant. Here, he discusses the main points from the Chancellor’s Summer Statement delivered on 8 July, which outlined new measures to support business and workers.

Rishi Sunak’s Spring Budget was on 11 March, just two weeks before large parts of the economy were shut down completely. Now, four months later, your practice may have reopened and hopefully you are feeling positive, proactive, and prepared for whatever might come your way. Here’s a brief guide to the Summer Statement and which of the interventions could be of particular interest to practice owners and dental professionals.

Furloughed workers

If you are a dental practice owner who has furloughed staff, you will probably already know that the Coronavirus Job Retention Scheme (CJRS) is being phased down starting from August, when more of the cost of furloughing will be passed onto the employer. The CJRS has already been extended twice, but the Chancellor confirmed he still intends for it to finish in October, as planned.

What is new is a Job Retention Bonus in the form of a one-off £1,000 payment, for every employee you bring back and who remains continuously employed until the end of January 2021 (you’ll get your bonus from February onwards). Any furloughed individual you return to work must earn more than £520 a month, on average between the end of the CJRS and the 31 January.

Work placements, trainees, and apprentices

There are to be new payment bonuses attached to employers who offer the above, which could all certainly be of interest to practice owners and enrich your workplace for a multitude of reasons. First is the Kickstart Scheme, which aims to provide new, six-month, quality work placements for young people aged 16-24. Government funding for each job will cover employers’ costs, including 100% of the relevant National Minimum Wage for 25 hours a week, plus employer NICs and minimum automatic enrolment contributions.

There will also be bonuses for employers who offer traineeships/work placements for 16-24-year olds and for those who hire new apprentices – for every new apprenticeship, you could receive up to £2,000.

A Stamp Duty showstopper

This announcement was the headline grabber; the UK housing market had – unsurprisingly – ground to a near-halt in the first half of the year. So, as had been widely expected, from 8 July – 31 March 2021, there is to be a temporary cut on Stamp Duty Land Tax (SDLT) on residential property in England and Northern Ireland, increasing the zero-rate band to £500,000 with all bands being revised. For additional properties, or corporate residential properties of over £40,000 though, you’ll still need to add 3% to the relevant SDLT rates.

To sum up…

Generally, we’re all now wanting to regain lost ground from lockdown and, of course, the current picture will also look different from wherever you are in the UK. We might feel that we’re facing the great unknown, but although things might “seem” different, a successful business is always one that has been built on sensible and solid practises, protocols and processes, and is able to adapt and respond intelligently to changing and challenging circumstances.

What I do know is that at Lansdell & Rose, our dental clients are very happy to be back at work! We offer a full portfolio of accountancy services and will also give you specialist, quality advice with business support and planning for now and the future.

From the very start of the pandemic, those who adopted a confident and decisive approach have stood out from the rest and this is what every dental practice owner and dental professional who wants to gain the maximum benefit from their business and optimise their personal finance, should be aiming to achieve.

For more information please visit www.lansdellrose.co.uk.

Deliver consistency on NHS pensions, or open the floodgates to legal challenges

The British Dental Association (BDA) has called on the government to ensure all members of the NHS Pension scheme benefit from new pledges made to senior medics offering full flexibility over the amount they can put into their pension pots.  

The Association confirmed that dentists are also being hit with tax charges, which have been forcing colleagues to reduce their level of NHS dental activity in the face of growing access problems. Almost 1 in 4 new patients have tried and failed to secure an NHS dental appointment according to government surveys.

The BDA first raised this issue with the DHSC back in 2017 and has suggested pension flexibilities ever since. Dentist leaders have now written to Matt Hancock urging him to take a consistent approach and extend flexibilities to all NHS Pension Scheme members. They warn that targeting the availability of flexibilities would likely expose Government to challenge from groups that are prohibited from using them.

BDA Chair Mick Armstrong said: “Dentists hit by five-figure pension tax charges face exactly the same choices as medical colleagues. With access problems to NHS dentistry mounting, government should not be giving colleagues any reason to do less.  

“It’s great Ministers have recognised the need for flexibility, but no healthcare professionals should be left behind. Failure to take a consistent approach risks opening the floodgates to legal challenges.”

Dentists challenge Jeremy Hunt to prove his mettle by investing in prevention

The British Dental Association has challenged Jeremy Hunt to put prevention at the heart of government’s NHS ‘birthday funding’ pledge, as dentists warn that a rush to reduce political pressure on hospital targets will fail to tackle the pressures facing the wider service.

In an open letter to the Health Secretary the dentists’ union has demanded clarity on investment in primary care and public health services, which appear conspicuous by their absence, stating that any settlement geared purely around chasing targets for acute care stands entirely at odds with the preventive philosophy set out in the Five Year Forward View.

It has sought clarity on issues around the government’s successive manifesto commitments to reform dental primary care services, its increasing over-reliance on patient charges, threats to training budgets, and its unwillingness to engage meaningfully on public health programmes.

The BDA has stressed that a new prevention-focused NHS contract will only now be viable if ministerial contributions taken out of service since 2012 are restored, to boost quality, access and time spent with patients. Recent figures have shown spending per head has fallen £41 to £36 per person in just five years. Recent evaluation reports have demonstrated prototypes currently being tested are not financially sustainable.

Dentist leaders have also urged the government to engage with modelling from Public Health England on the huge returns of investment yielded by spending on prevention, and requested details on plans for public health budgets for cash strapped local authorities. £1 spent on early years prevention programmes of supervised brushing yield £3.06 in savings after just five years.

Tooth decay remains the number one reason for child hospital admissions in the UK, with a growing number of children facing more than six-month waiting lists. The BDA has documented the multi-million-pound costs hospitals are now facing for failure to tackle tooth decay, a wholly preventable disease, on GP services, emergency and secondary care.

BDA Chair, Mick Armstrong, said: “If Ministers fail to invest in prevention in primary care and public health services they will be on the wrong side of their own strategy for the health service.

“It is wrongheaded to focus on cure over prevention, treating the symptoms but not the causes of the pressure on our NHS. More and more children face six-month waits for tooth extractions in hospital, but the solution cannot be throwing cash at the surgical workforce.

“This is about targeted investment. Reform of the failed NHS contract has reached an impasse, and the government’s stated goals of improving both access and prevention simply cannot be delivered on a standstill budget. To make this work all we need is the cash Ministers have quietly siphoned out of the service since 2012.

“The government’s own figures show a pound spent on preventing decay can yield three back in savings. Reducing exposure on hospital and emergency targets is politically useful, but it isn’t a sustainable or cost-effective basis for a healthcare strategy.”

Oral Health Foundation: “Decision to finally offer boys a HPV vaccination is one which will save many lives”

The decision to offer boys a vaccination against the Human Papilloma Virus (HPV) by the Joint Committee on Vaccination and Immunisation (JCVI), announced yesterday by Health Secretary, Jeremy Hunt, has been hailed by the Oral Health Foundation as a decision that will save thousands of lives every year.

The charity believes the decision, which has been under consideration since 2013, will lead to many lives being saved due to the vaccination’s ability to prevent HPV related mouth cancer, as well as other life-threatening diseases.

Under the current programme almost 400,000 boys go unvaccinated every year, which has millions at risk of developing HPV related cancers later in life – cancers which are on the increase.

Dr Nigel Carter, CEO of the Oral Health Foundation, discussed this momentous ruling: “This decision has been an incredibly long time coming and one we firmly believe it will be a significant moment in the ongoing battle against many types of cancer in the UK.

“This decision brings to and end what has been a dangerously discriminatory and unfair HPV vaccination programme in Britain, which has left millions of boys and men unprotected from the biggest sexually transmitted infection in the world.

“HPV is one of the leading causes of mouth cancer; but now we hope that with the swift implementation of the vaccination programme we will see a significant reduction in these numbers.

“Since 2008, girls have been offered a HPV vaccination through a school based programme to protect against cervical cancer, but this has been proven to offer little protection for men from life-threatening diseases caused by HPV; including mouth, penile and anal cancers as well as genital warts.”

Every year more than 7,500 Brits are diagnosed with mouth cancer, with the disease claiming in excess of 2,000 lives – more than testicular and cervical cancer combined.

“There has also been overwhelming support for the vaccine from health professionals and public alike,” added Dr Carter.

“A recent poll from campaign group HPV Action discovered that 97 per cent of dentists and 94 per cent of GPs believe that the national HPV vaccination programme should cover both boys and girls, we have also seen roughly 84 per cent of the public support an extended vaccination programme.

“It has become very apparent that the only certain way to protect boys effectively from HPV is through a national vaccination programme and now this has finally come to fruition we will push for it to be implemented swiftly and effectively so we can ensure that it is most effective in saving lives in the future.”

BDA heralds potential breakthrough on GDPR

Following months of lobbying the British Dental Association has welcomed news that Lib Dem MP Christine Jardine has tabled its suggested amendments [1] to the Data Protection Bill to save primary care providers from needless financial burdens.

The simple change would specifically exempt small NHS providers from the costly burden of appointing a dedicated Data Protection Officer (DPO). The BDA has been working closely with partners at the Optical Confederation, the National Pharmacy Association and the Pharmaceutical Services Negotiating Committee, urging both government and opposition MPs to exempt dentists, pharmacists and opticians from this expensive and unnecessary new requirement.

Primary care leaders have argued that the current draft Bill goes well beyond the requirements of the General Data Protection Regulation (GDPR), which does not require health providers to appoint a DPO unless they process healthcare data “on a large scale”.

Most high street NHS primary care providers do not process data on a large scale, but are set to be covered by this onerous new duty by virtue of being defined by UK legislation as “public bodies”. The BDA has estimated that outsourcing this service may well cost even the smallest practices in excess of £5,000, with some members reporting quotes from potential contractors of over £10,000 a year. Amendments will be considered at the Bill’s Report Stage, which is likely to take place in the second week of May [2].

News comes as primary care leaders have written again to the Department for Culture Media and Sport, urging Secretary of State Matt Hancock to change tack.

BDA Chair, Mick Armstrong, said: “We have been making the argument for a simple amendment that would protect small NHS providers who were never meant to be captured by these regulations.

“We want to thank Christine Jardine MP for her support. This common sense move wouldn’t cost taxpayers a penny, is non-controversial and nonpartisan, and remains entirely consistent with the stated intentions of the GDPR.

“This small change can make a big difference, saving hard-pressed high street health providers from needless pain. Together with our partners across primary care we urge parliamentarians on both sides of the house to offer their support.”

[1] https://publications.parliament.uk/pa/bills/cbill/2017-2019/0190/amend/data_rm_rep_0424.8-14.html

Clause 7, page 5, line 24, after “subsections” insert “(1A),”.                                                  

Clause 7, page 5, line 24, at end insert—

“(1A)

A primary care service provider is not a “public authority” or “public body” for the purposes of the GDPR merely by virtue of the fact that it is defined as a public authority by either—

(a) any of paragraphs 43A to 45A or paragraph 51 of Schedule 1 to the Freedom of Information Act 2000, or

(b) any of paragraphs 33 to 35 of Schedule 1 to the Freedom of Information (Scotland) Act 2002 (asp 13).”

[2] https://services.parliament.uk/Bills/2017-19/dataprotection.html

Devolution, evolution and revolution? Dentists to debate the issues at LDCs’ conference

The looming crisis in recruiting NHS dentists and the need for a level playing field for all dentists competing for NHS contracts, are among the topical issues that will be debated at this year’s annual conference of Local Dental Committees (LDCs) in Belfast on 7-8 June.

Some of the 200 delegates in attendance will also be calling on the government to commit a portion of the tax raised from sugary drinks to be spent on oral health schemes for children, and to improve funding of community dental services.

There will be a timely discussion on whether devolution improves dental care or takes the ‘N’ out of the NHS. This will include presentations from Michael Donaldson (responsible for commissioning health service dentistry in Northern Ireland) and Ben Squires (with similar responsibility for Greater Manchester). Ben will share his experience of DevoManc and where commissioning dentistry fits in the health and social care framework.

A Question Time debate will explore the benefits of devolved commissioning of dental care, and ask whether, in fact, this creates more barriers to healthcare. The panel will include all the chief dental officers in the UK: Sara Hurley (England), Colette Bridgeman (Wales), Margie Taylor (Scotland) and Simon Reid (Northern Ireland).

Professor Stephen Fayle, consultant in paediatric dentistry (Leeds Dental Institute), will discuss the importance of prevention for everyone, while general dental practitioner Claudia Peace will share her experience as an associate in a prototype practice in Wiltshire.

John Milne, the Care Quality Commission’s senior national dental adviser, will provide an update on developments around the Practitioners Advice and Support Scheme, which is also the subject of several motions.

Joe Hendron, Chair of the 2018 LDCs Annual Conference, said: “Since we’re having our annual conference in Belfast, it seems fitting to look at the impact of devolution on dentistry.

“This is no longer confined to countries, as the government continues to push its traditional responsibilities out to the regions, look at DevoManc.

“Is this a way of taking the ‘national’ out of our health service and blaming the ‘outposts’ if they’re poorly funded by central government, or genuinely the best way of addressing local differences?

“Whatever the answers, I am looking forward to hearing the debates and the first-hand accounts of our expert speakers in dental commissioning.”