hospital

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.”

CQC Board appoints Ian Trenholm as new Chief Executive

Ian Trenholm has been appointed as the Care Quality Commission’s new Chief Executive and will take over the role from Sir David Behan when he leaves in July.

Ian has been Chief Executive of NHS Blood and Transplant since 2014. Having started his career in the police service, his previous roles include Chief Operating Officer at the Department of Environment Food and Rural Affairs (Defra) and Chief Executive of the Royal Borough of Windsor and Maidenhead.

Peter Wyman, Chair of CQC, said: “I am delighted that CQC has been able to make such a strong appointment to the role of Chief Executive. Ian was chosen from an outstanding field for his significant leadership experience coupled with his commitment to making a difference to people’s lives. His track record of delivering technological innovation at scale in order to deliver benefits for people was the deciding factor – given both CQC’s strategic focus on delivering an intelligence-driven approach to regulation, and the increasingly central role that technology has in transforming outcomes across the health and care system.

“Under Sir David Behan’s leadership, CQC has become a catalyst for improvement, inspecting every hospital, adult social care provider and GP practice in the country – over 28,000 services and providers – and in the process developing a baseline on quality that is unique anywhere in the world. I’m confident that in Ian, we have found the right person to lead delivery on the next stage of our strategy – using new technology and new ways of working with the public and providers to continuously improve how we assess performance, encourage improvement and check that people get safe, high quality care.”

Ian Trenholm said: “I am really pleased to be joining the Care Quality Commission at a time of challenge for both health and social care. I look forward to working with the CQC team to build on the strong foundations already in place, creating innovative methods of assuring safe and effective care for all.”

Sir David Behan will remain in post until July. The appointment of Ian Trenholm was made by the non-executive members of CQC’s Board following open competition.

Peter Dyer re-elected as BDA Chair of hospital dentists

Peter Dyer, oral and maxillofacial surgeon, has been re-elected as the Chair of the British Dental Association’s Central Committee for Hospital Dental Services (CCHDS) for the 2018/2020 triennium, having first being elected in 2015.

Peter was appointed consultant in oral and maxillofacial surgery to the University Hospitals of Morecambe Bay NHS Foundation Trust in 1998 with a special interest in trauma and orthognathics. He has worked as the medical director for the Trust and is the responsible officer for overseeing the appraisal and revalidation of medical staff.

He was closely involved in the development of the new dental school at the University of Central Lancashire and also with the new medical school at Lancaster University. He co-edited the Handbook of Immediate Care and has contributed chapters about dento-facial trauma in a number of textbooks. As hospital dentists are employed on the same terms of service as doctors, Peter led the BDA’s response to the junior doctors’ contract dispute and was determined to secure a contract that is both safe for patients and practitioners alike.

In recognition of his major contribution to dentistry, the BDA and in reducing artificial barriers between primary and secondary care, Peter was appointed as the union’s president whose term expires next month.

Thanking CCHDS members for electing him to the office of chair, Peter said: “The profession is currently facing significant challenges, not least the new trainee contract needs to be implemented fairly, and ditto any changes to the consultant contract.

“It’s frustrating too that the long-recognised need to create a no-blame culture in hospitals, akin to the airline industry, has been undermined by the questionable handling by all those involved in the Bawa Garba case.

“How long more do we have to wait for a culture that promotes learning from mistakes rather than penalising individuals for systemic failures that place patients at risk? Let us hope that this sad case will be a tipping point and we will start to see a paradigm shift in attitudes and behaviours of regulators.

“It’s also unclear how hospital dental departments will be affected when the latest model for commissioning services – Integrated Care Systems [formerly called the Sustainability and Transformation Plans] – comes into play.

“Health Education England’s proposals to radically change the way dentists are trained have not only set alarm bells ringing in the dental community, they also fail to consider the knock-on effects to hospital dental services and the patients we serve.

“Our committee will also be working hard to address the anomalous routes for entry to the GDC’s specialist register for clinicians who have not undertaken formal training. The regulator’s current process is not as transparent as the GMC’s for the medical and surgical specialties.”

The Vice-Chair, Pete Brotherton, was also re-elected, having been elected himself in 2015.