NHS

Eric Rooney, Deputy Chief Dental Officer England, bids farewell

England’s Deputy Chief Dental Officer, Eric Rooney, is retiring at the end of this month. In the latest NHS dentistry and oral health update, he bids farewell to the sector while reflecting on the last 12 months and his career as a whole.

“It hardly seems a year since I was working on minimising the disruption to the supply of our normal and routine dental face masks. All due to a new novel virus affecting China,” says Rooney. “As the year goes by, so come birthdays and anniversaries, and this week it’s my birthday. That’s the same, but it’s different. Not just because of social distancing and the impact of Coronavirus, but because I have reached the normal NHS retirement age!

“Just like last year, I can hardly believe how time has flown, from being a fresh faced 17 year-old entering Dundee Dental School, to this last tumultuous year. Throughout that time, the dental profession, it’s institutions, and the wider NHS have been a massive part of my work life. For the support and camaraderie of colleagues across dentistry, health and beyond, I will always be grateful, as I will for the longstanding support of my wife and family throughout my career.

“There is still much to be done to improve our NHS services, for the good of patients, the profession and the taxpayer and there will continue to be difficult times ahead, but I have every confidence in our profession and in the wider health system that together they can build a better future.”

Paying tribute to Rooney, CDO England Sara Hurley states: “It has been an incredible honour and a real pleasure to work alongside Eric Rooney as Deputy Chief Dental Officer for England. His wry, dry, humour and his humility and humanity have shaped not just the office of CDO but in the genuine warmth of his sharing of knowledge he inspires all those that have the good fortune to work alongside him. He truly cares and his quiet deliberate passion to do the right thing sets a benchmark that many aspire to, but few can claim to have achieved. Eric’s impressive CV, including an MBE for services to Dentistry in the 2015 New Year’s Honours and the plethora of national and regional achievements underline his clarity in advocacy for oral health and ensuring that patients receive the most effective dental care.  His contribution as co-author of the 2009 review of NHS Dentistry, known as “the Steele Report” and his clear thinking and evaluation of the Government’s Dental Contract Reform programme have shaped the intent for future service provision with an improved offer for patients and professionals alike.”

Eric Rooney’s career in dentistry began in 1983 and, in the words of the CDO, has seen him go from “clinical practice to public health, designing and delivering regional and national initiatives, shaping contract and commissioning policy in conjunction with the British Dental Association, Department of Health and latterly NHS England.”

New ADG report shows at least 8 million people will be waiting for an NHS dentist this Christmas

A new report from the Association of Dental Groups (ADG), published today, projects that around 8 million people will be waiting for NHS dental treatment this Christmas, but unable to access a dentist to perform it.

The findings point to an unprecedented proportion of people being unable to access the NHS at any one time – 8 million people represents around 14% of the English population, or around one in seven people.

The fear among dentists is that record numbers of mouth cancer cases are going undiagnosed while more than a million fillings may have been missed this year.

The analysis is published today by the Association of Dental Groups, who commissioned Matt Hancock’s former aide to conduct an independent ‘state of the nation’ report on access to dentistry.

The work shows London to be the worst region in the country to access a dentist, with around 1.5m people in the capital waiting at Christmas – equivalent to around 17% of its population, or one in six people. The Midlands will have 1.3m waiting; around one in eight people.

Region Patients waiting at Christmas

  • London 1,500,000
  • Midlands 1,300,000
  • North East and Yorkshire 1,200,000
  • South East 1,200,000
  • North West 1,000,000
  • East of England 950,000
  • South West 800,000

In the report, titled “30 years of hurt”, Mr Sloggett notes that restrictions on the flow of people that can be seen in dental surgeries due to the pandemic are quickly making access a huge problem. He points out that the root cause is that the system has been underfunded and neglected for decades.

“For 30 years, dentistry in England has been the forgotten service of the NHS. It is time for that to change.”

The report suggests there is no way at present to tackle the backlog due to a crippling lack of NHS dentists and proposes several urgent recommendations for boosting dentistry recruitment, including by:

  • Boosting training: increasing the number of placements in England along with incentives to work in areas with acute staff shortages;
  • Routes for overseas professionals to fill short term gaps: because it takes five years to train a dentist, for the short term, automatic recognition of EU dentistry qualifications should be maintained after Brexit and recognition of dental qualifications from good schools outside the EEA should be extended.
  • Boosting retention of NHS dentists: Many dentists are leaving the sector or moving from the NHS to private practice due to dissatisfaction with the current NHS dental contract. Government needs to look into this urgently and open up a process of reform.

Commenting on the report, Neil Carmichael, Chair of the Association of Dental Groups and former Conservative MP for Stroud said: “These figures represent real suffering, with hundreds of thousands – potentially over a million – fillings going unperformed, plus a host of other treatments piling up, as well as undiagnosed cases of mouth cancer. Even when the Covid restrictions are lifted, dealing with this will take months. We need urgent action now to draft in more dental professionals to tackle the crisis.”

The report can be found at https://www.theadg.co.uk/.

How NHS dental staff can join the Covid-19 vaccine team

Understanding that many NHS dental practitioners and dental healthcare staff want to support the Covid-19 Vaccination Programme, the Office of the Chief Dental Officer, England and NHSE have prepared an FAQ document to help clarify how indemnity arrangements will work with regards to participation in the COVID-19 vaccination programme.

Further guidance on recruitment into the Covid-19 vaccination programme is available at Join the Vaccine Team

New Covid-19 infection prevention and control dental guidance published

The Department of Health and Social Care (DHSC), along with Public Health Wales (PHW), Public Health Agency (PHA) Northern Ireland, Health Protection Scotland (HPS), Public Health Scotland, Public Health England and NHS England, has released new Covid-19 infection prevention and control dental guidance.

This newly published UK IPC Guidance has been developed for dental settings, and has been considered and incorporated into the latest revision of the office of CDO’s SOPs, which will be published imminently.

Whilst this guidance seeks to ensure a consistent and resilient UK wide approach, some differences in operational details and organisational responsibilities may apply in Northern Ireland, England, Wales and Scotland.

It is also noted that this guidance is of a general nature and that an employer should consider the specific conditions of each individual place of work and comply with all applicable legislation, including the Health and Safety at Work etc. Act 1974.

The guidance is available to read here.

NHS England: Contract uplifts confirmed

Following consultation with the BDA, the Department of Health and Social Care has confirmed that contracts will be uplifted by 2.5% in England. The uplift will be paid in November and backdated to 1 April.

The BDA stressed, when the Chancellor announced his deal back in July, that an above inflation award represents a bare minimum any government can offer NHS workers’, adding that the ‘uplift does not begin to cover the huge increases in expenses practices have faced with PPE and meeting new cross-infection guidelines’.

Foundation Dentist salaries will be updated by 2.8%, as will Educational Supervisors’ grants. FD service costs have been frozen, which the BDA has strongly objected to.

This is the second consecutive year of above-inflation pay awards for dentists. The BDA remains clear that this must now be built on, as part of wider plans to maintain the long-term integrity of the service.

The BDA continues to campaign on behalf of NHS dentists.

NHS pension discrimination case update

In April 2015, public sector pension schemes were reformed, with most members moved from what have become known as ‘legacy schemes’ into new, ‘reformed’ schemes. Transitional protections were put in place to protect those within 10 years of their normal retirement age, allowing them to remain on legacy schemes, rather than be moved automatically.

In December 2018, the Court of Appeal found that these transitional protections unlawfully discriminated against younger members of the judicial and firefighters’ schemes as transitional protection was only offered to older scheme members. In July 2019, the government accepted that the judgement applied to all public sector pension schemes, and is taking action to remedy the discrimination.

On 16 July 2020, the government launched a consultation seeking views on its suggested remediation measures.

The government has proposed giving public sector scheme members a choice on which pension scheme they accrue benefits in for what is being called the ‘remedy period’ – the time between the 1 April 2015 and 31 March 2022. For this period, affected members can choose to have their benefits accrue in a legacy scheme or a post-2015 reformed scheme.

It has also proposed two possible methods for making this decision – members will either have to decide on their scheme within 12 or 24 months after 31 March 2022, or they will be asked to decide when they access their benefits.

In either case, those who have already drawn on their pensions will be asked to choose as soon as possible after 31 March 2022 – their choice will then be applied to their pensions retroactively. The government is also proposing that all active members are moved into the reformed schemes on 1 April 2022.

Wesleyan is a specialist financial mutual for dentists, and therefore has considerable experience advising people on public sector pensions.

Parminder Gill, advice policy consultant at Wesleyan, said: “Sunday saw the closure of the government’s consultation into its suggested approach to remedying discrimination in public sector pension schemes. This is shaping up to be the biggest change to public sector pensions in the past five years.

“Affected members are now eagerly awaiting further information on the government’s next steps.

“The proposed measures will have an impact on the retirement savings of millions – with potential implications for the size of their pensions pots and the amount of tax they will need to pay.

“Under the government’s proposed solution, members will be asked to choose on how they want their pension accruals to be calculated.  The ‘right’ answer will very much depend on the individual, but almost everyone affected will have a complex decision to make factoring in projected pension benefits, planned retirement age, their life expectancy and any impact on their Lifetime Allowance or Annual Allowance of moving from one scheme to another.

“The process of resolving this will take some time, and the final proposal to members could look very different. However, an update on the government’s intended way forward will provide those affected with more clarity around what this will mean for them and enable them to start factoring it into their retirement plans.”

BADN welcomes BSA survey on pay concerns

The British Association of Dental Nurses, the UK’s professional association for dental nurses, welcomes the survey by the NHS Business Services Authority on pay concerns during the Covid-19 pandemic in England.

As the introduction to the survey states “The expectation from NHS England & NHS Improvement (NHSE&I) during the Covid-19 pandemic is practice owners are required to ensure that all staff including associates, non-clinical and others are continued to be paid at previous levels prior to the pandemic.”

This expectation was also made clear in the various Letters published by the Office of the CDO England during the lockdown period.

However, many dental nurses were not paid at all during the March-July lockdown period; many were forced by their employers to take annual or unpaid leave for the whole period; and some who were paid are now being told they have to pay it back or work unpaid.  “There are innumerable variations on employers not having paid their dental nurses ‘at previous levels prior to the pandemic’” said BADN President Jacqui Elsden.  “Many decent employers, who have done the right thing by their dental nurse employees, find it hard to believe that some employers have behaved in such an unethical and unprofessional manner towards the lowest paid members of the dental team.  We are delighted that, after much lobbying of the OCDO and NHS England by BADN, the BSA is conducting this survey to discover the extent of the problem.  We hope that similar steps will be taken by the other three home nations.”

Dental nurses working in NHS or mixed practices who have not been paid their usual salaries during the pandemic can complete the survey here.

Mixed practices were able to furlough an appropriate number of staff proportionate to their private practice.  This survey is for those dental nurses working in mixed practices who were not furloughed.

NHS England updates Urgent Dental Care Guidance and Standard Operating Procedure

NHS England and NHS Improvement have issued updates to the Urgent dental care guidance and standard operating procedure and Dental standard operating procedure: Transition to recovery documents, along with a letter from Chief Dental Officer Sara Hurley.

“It is 12 weeks since dental practices in England were able to resume face to face dental care,” Sara Hurley begins in her latest communication. “Thank you for all your efforts in broadening access to dental care and supporting the collective NHS focus on a return to full operating capability across the whole of healthcare.”

To support practices as they continue to expand the range of treatments offered, the latest Covid-19 dental guidance update incorporates validated evidence and expert consensus. These publications serve as a framework for identifying and mitigating the risks to dental staff and patients.

“Updates include: Covid-19 screening questions to be asked in line with the case definition for possible Covid-19 and isolation requirements including quarantine advice for those entering or returning to the UK,” says Hurley.

To read Sara Hurley’s letter in full, click here.

The Urgent dental care guidance and standard operating procedure can be accessed here.

The Dental standard operating procedure: Transition to recovery document can be found here.

ADG: New figures show ‘dentists are deserting the NHS and poorest patients are paying the price’

The Association of Dental Groups has responded to the recent publication of the NHS Dental Statistics for England 2019-2020. The statistics reveal that overall, the number of dentists with NHS activity in England went up slightly – from 24,545 in 2018/19 to 24,684 in 2019/20.

But they also reveal significant regional disparities – with 65 NHS clinical commissioning groups seeing dentist numbers go down over the past year. At seven NHS clinical commissioning groups, dentist numbers declined by 20% or more from 2018-19 to 2019-2020.

Neil Carmichael, Chair of the ADG, said: “The figures are just the latest proof that the number of dentists working in the NHS is plummeting in many of the areas where they are most needed. In large parts of the country, dentists are deserting the NHS and it is the poorest patients who are often paying the price. That’s why we urgently need to increase the pipeline of new dentists here in the UK while also making it easier for overseas professionals to enter UK dentistry.”

 

The NHS Dental Statistics for England 2019-2020 can be accessed here: https://digital.nhs.uk/data-and-information/publications/statistical/nhs-dental-statistics

Workforce figures are taken from Table B1 in Annex 2 – Geographical breakdown of dental data.

They show that NHS Fareham and Gosport CCG, NHS Isle of Wight CCG, NHS Portsmouth CCG, NHS South Eastern Hampshire CCG, Southampton CCG and NHS Bassetlaw CCG saw a percentage difference of 20% or more from 2018/19 to 2019/2020.

ADG members consist of group providers of NHS and private dentistry across England and Wales. Find more information about the ADG on their website here.

SDPO raises concerns over out-of-date PPE in Scotland

The Scottish Dental Practice Owners Group (SDPO) has raised serious concerns that NHS dental teams in Scotland have been issued face coverings that may not be “fit for use”. The organisation reported that when practices received their PPE to begin aerosol generating procedures from Monday 17th August, some discovered that the FFP3 masks they received were “significantly beyond their expiry dates, in some cases by almost a decade”.

The SDPO even claimed that, in some cases, the original expiry dates had been covered with a new date of expiry label. To top it off, those dates had also passed, with the most recent being in 2019.

The SPDO said: “Preliminary inquiries to the mask manufacturer 3M suggest that they do not consider masks beyond their expiry date to be fit for use. Practitioners have serious concerns about the safety of masks of this age. How can masks this old be passed as safe when the manufacturer suggests otherwise? SDPO members are practice owners and must consider patient and staff safety. We lack confidence that the masks issued to dental practice staff are fit for use, and we are very concerned that NHS dental teams across Scotland have been issued with masks that may compromise patient and staff safety.”

However, a spokesperson for the Scottish Government stated: “Revalidating stock and extending the shelf-life of masks is standard practice to maintain pandemic stock levels and this was used in relation to FFP3 respirator stocks as announced in March. Any PPE which has been issued to NHS boards for onward distribution to dental practices and may have passed its original expiry date has been re-tested to ensure it remains safe to use. Such testing has been approved and reviewed by the Health and Safety Executive and to standards relevant to the PPE being tested. Critically, this PPE – supplied free of charge by our NHS – enables dentists to carry out urgent and emergency care while ensuring the safety of patients, dentists and all dental staff. Each board has a proactive programme of fit-testing for FFP3 masks under way with each practice requiring a fit test for a dentist and dental nurse; this is a rolling programme of work, there are around 1000 dental practices in Scotland.”