UK

Dental industry’s reaction to the GDC’s unchanged ARF

After the GDC released a statement stating that the ARF for 2019 would remain the same, leading associations in the profession had some responses to contribute…

BDA:

The British Dental Association (BDA) has responded to the news that the GDC’s Chief Executive, Ian Brack, has revealed the Annual Retention Fee (ARF) will remain unchanged at £890 in 2019. 

The regulator has offered no detailed rationale for the move, offering instead a series of claims on uncertainty and future risk.  

Dentist leaders have slammed the lack of transparency over the process. Fee levels should be debated and determined in a Council meeting open to the public, linked to a budget and business plan. The BDA had already told the regulator in response to its consultation Clear and certain: A new framework for fee-setting, that not consulting registrants on fee levels again was unacceptable. 

The Council has not yet published its evaluation and response to the consultation. The profession’s trust in the regulator remains as low as ever due to its approach to fee setting and handling – and continuing lack of transparency.

Fees remain the highest of all the UK health regulators and continue to be used to top-up reserves, well beyond the regulator’s own stated requirements. 

 BDA Chair Mick Armstrong said: “The £890 ARF symbolises the GDC’s cavalier disregard for the profession it regulates, offering new excuses when the old ones have worn thin.

“We require a regulator prepared to live within its means, willing to approach upstreaming and contingency planning with a cool head. Instead we have a body that puts padding out war chests above all else.

“We have long argued that the GDC’s approach to its reserves is fundamentally flawed, but even by their own measure, they now exceed their required need. The levels of uncertainty are the same for all the regulators, yet nobody else seems to be arguing in this way.

“The Overseas Registration Exam  – and any new approach to registering EU nationals if necessary – should be self-financing. Yes, there may be overheads, but the bottom line is existing registrants should not have to fund registration costs for new registrants. It is simply not a good enough excuse to hoard our cash.

“When the budget for 2019 hasn’t even been formally agreed by the Council, it is not a good look for the GDC’s Chief Executive to unveil the figures in this manner. The serious concerns about transparency that we keep raising continue and increase. The ARF hasn’t changed, and neither has this profession’s trust or confidence in its regulator. The case for a significant fee cut remains, a coherent argument for a freeze has not been offered.”

BADN:

The British Association of Dental Nurses, the UK’s professional association for dental nurses – the largest professional group on the GDC Register –  today condemned the GDC decision not to lower the Annual Retention Fee (ARF) for dental nurses.

“We made it very clear, in our response to the GDC consultation, that the current ARF of £116 per year is an unreasonable financial burden on dental nurses, the majority of whom are earning minimum wage” said BADN President Hazel Coey.  “Our salary surveys show that a qualified, registered dental nurse with more than 10 years’ experience and working 40 hours per week is earning, on average, around £15,000 a year – compared to hygienists and therapists, who can earn up to three times that much.

“A one-size-fits-all approach to the ARF for DCPs is not acceptable – and we call upon the GDC to recognise this fact and lower the ARF for dental nurses.  BADN also recommends a reduction in the ARF for those registrants – not just dental nurses but all registrants – who work part time.

“Mr Brack states that “protecting the public and maintaining public confidence in dentistry” will always be the GDC’s first priority. BADN would suggest Mr. Brack remembers that without registered dental professionals there would be no dentistry; and pays a little more attention to the needs of registrants – who, after all, are funding the GDC through their ARF!”

A spokesperson for the GDC told The Probe:

“The GDC is facing specific external risks at a time when it is making significant investment for long-term improvement and efficiency. It’s disappointing because real improvements have been made but the risks are real, and they must be planned for. In the first half of next year, we are consulting on our three-year costed corporate strategy. The activity we propose there will tell us what the ARF level will need to be to carry out that work and we look forward to the debate that will bring.”

Dentists: Heatwave resulting in spike in sugar consumption among kids

The British Dental Association has urged restraint as new figures show kids are eating five times their recommended daily sugar intake during the summer, with the heat pushing them to ice creams, lollies and soft drinks.

A poll of 1,000 parents with children aged two to 17-years-old conducted by mydentist found sugar intake will be hugely boosted during the break from school. 24.5 per cent of parents estimated they gave their children twice as much sugar over summer compared to other times of year. 15.6 per cent said three times as much, with 11.5 per cent suggesting more than five times.

The BDA has been a leading advocate of action on sugar, including the soft drinks industry levy. It has called on parents to take responsibility over sugar consumption, and on Ministers to deliver an ambitious follow up to its landmark Obesity Strategy, with measures to restrict the marketing, sale and formulation of sugary products.

Every 10 minutes a child in England has a tooth removed in hospital due to preventable decay according to figures from Public Health England. Tooth extraction also remains the most common reason for hospital admissions in five to nine-year-olds.

Russ Ladwa, Chair of the BDA’s Health and Science Committee, said: “It is tempting to beat the heat with soft drinks and ice cream, but parents must recognise the damage these sugar-laced confections can do.

“Tooth decay is now a wholly preventable epidemic, and the number one reason a child will be admitted to hospital. Yes, we need parents to take responsibility over what they buy, but Ministers also need to force industry to change the way they formulate and market these products.

“Added sugar is cheap, addictive and nutrient free. Ultimately if you want to keep the kids cool and hydrated reach for the water.”

Are your customers right at the heart of your business?

By Les Jones, Creative Director at Practice Plan

In this highly competitive consumer world where customers are like gold dust, it never ceases to amaze me how many times I find myself in a situation where I’m ready to part with my money, but my supplier of choice is unable to take it.

It seems the art of grabbing defeat from the jaws of success is alive, and thriving, on the high street.

Here are two recent examples of how my desire to part with my hard-earned cash was thwarted by the very people I was trying to give it to.

One size does not fit all

I’m off on holiday in the next few weeks and, as is traditional, I thought I’d treat myself to a few new items of clothing to boost my holiday image. So, I pop into French Connection (I know what style is all about!) and I find a few pairs of trousers that seem to fit the bill. Yet, as I flick through them on the rack, something strange emerges – every single pair, in every colour are a 32-inch leg.

Now, despite the fact that I’d like to think I’m a strapping six-footer, I am, in fact, 5 ft 8 and not much more than a 29-inch leg. I ask the sales assistant if she has any of the trousers in a different length to which she says ‘no, sorry, we only do them in a 32-inch leg, you’d need to roll them up or get them shortened.’

I can only assume that the decision to restrict the trousers to just one length somehow makes the production run easier and more cost-effectively. But it’s also a sales barrier – because I don’t want to roll the trousers up and I can’t be bothered to get them shortened. So, I decide to take my business elsewhere and FCUK lose out on a £100 sale.

The breakfast deadline

I’ve written before about my cycling exploits and how every good cycle ride has a great coffee stop at the halfway point. A recent ride out was no exception. I cycled out one morning, got 25 miles under my belt and then decided it was time for breakfast. I was looking forward to an egg and bacon bagel and a great cup of coffee. I stopped at a cafe I’d not tried before and when the waitress arrived I put my order in. However, I was immediately knocked back by being informed that the bagels were part of the breakfast menu, which finished at 11am. It was now 11.20am and the lunchtime menu had kicked in – I could choose from a list of sandwiches.

Lunchtime! Who has their lunch at 11.20am?

I don’t know about you, but when you have visions of a bacon and egg bagel in your head, a cheese and pickle sandwich is not going to cut it! So, I decide to leave it and I cycle a further five miles to another cafe that is able to satisfy my growing need for breakfast.

Again, there’s probably a perfectly good reason why the cafe has organised its menu availability that way – but, I’m guessing it’s all about making things easier for them, not better for their customers.

They lost my business that day, and they’ve probably lost it for the foreseeable future. When you factor in the lifetime value, that could represent a reasonable amount of income lost.

The amazing thing is the bagel, bacon and eggs were in the building, as were the tools to cook them, as was my money – we just couldn’t do the exchange!

Barriers in your practice

I could also drone on about the car hire company that wouldn’t hire me a pre-booked car because I didn’t have a credit card – even though I had the money and the paperwork! Or the shoe shops that entice me in with their lovely displays but eight times out of ten can’t sell me a pair of shoes as they don’t have my size (7) in stock. The list goes on.

So, the question is – is any of this happening in your dental practice, are there barriers that you are inadvertently erecting which are costing you much needed income? Are you really putting the customer right at the heart of your business and responding positively to their wants and needs…or do they just have to fit in with your way of doing things?

Keeping a note of how many times patients don’t go ahead with an appointment or a treatment plan might give you some valuable insights into how you could change the way you do things to ensure the pendulum swings back in your favour.

I’m guessing that none of the examples I’ve given are isolated ones, I bet they happen every day – what wasted opportunities for those businesses involved.

Make sure you don’t fall into the same trap.

Les Jones is the Creative Director at Practice Plan, the UK’s number one provider of practice-branded dental plans. He has over 30 years’ experience of working within the creative and dental sectors in the fields of design, marketing and strategic consultancy. If you are interested in finding out more about how we help practices to become more profitable, call 01691 684165 or visit building.practiceplan.co.uk

 

 

Dental Protection: Good record keeping key in phase-down of dental amalgam

Dental Protection is reminding dentists in the UK to maintain good clinical records and obtain full consent if a decision is made to use amalgam as a restorative material, ahead of changes to EU Regulations on its use.

The EU Mercury Regulation is intended to protect the environment from the adverse effects of mercury pollution. It reflects the aims of the Minamata Treaty to reduce the use of dental amalgam in the medium to long term, and to eventually phase it out altogether.

From 1 July 2018 amalgam is not to be used in primary teeth, children under 15 years and during pregnancy/breastfeeding – except if deemed necessary on the ground of ‘specific medical needs’. This should be interpreted as including the specific dental needs of the patient.

By 1 July 2019 the UK and other EU member states will be required to have a national plan on the phasing down of the use of dental amalgam.

Dental Protection advises members to take extra care in obtaining consent and record keeping, to help in defending any future claims, complaints or regulatory investigations that may arise from the use of amalgam in the restricted groups.

Dr Raj Rattan, Dental Director at Dental Protection, said: “Complaints and claims may arise despite a dentist’s efforts to ensure that patients are satisfied with their treatment. Therefore, in situations such as these extra care needs to be taken.

“If a dentist deems it appropriate to use amalgam in a patient in one of the restricted groups, they must communicate the rationale to the patient, or the person who has parental responsibility for them, explain why the decision is in the patient’s best interest, and provide information about the material risks and benefits of amalgam in that particular situation. Valid consent must then be obtained ensuring they are aware of the restriction in specific patient groups.

“In order for the patient or their guardian‘s consent to be valid, they should be given the opportunity and time to ask questions about the proposed treatment to make an informed shared decision.

“Once the decision has been agreed, the justification for placing the amalgam should then be recorded in the patient’s clinical records, along with any discussions about the options, risks, benefits and costs as part of the consent process.

“Records should state clearly on what basis the decision to use amalgam in one of the restricted groups was taken, and that it was made with the patient or guardian’s full knowledge and understanding.”

The use of amalgam is so far not restricted in patients who do not fall into the identified groups. However, patients with knowledge of the restriction may express anxieties about the use of dental amalgam in their own mouths.

In these circumstances Dental Protection advises members to discuss the position of the EU Regulation with the patient, explain the risks and benefits, discuss any alternatives and ensure proper consent is obtained before proceeding with the treatment. Details of this discussion should be recorded in the patient’s records.

Dr Raj Rattan added: “Without proper consent and comprehensive, well-kept records, a dentist will be heavily disadvantaged in defending any allegations made down the line. Detailed records of treatment will influence whether a case can be defended or whether it will need to be settled. Dental Protection can provide members with further advice and guidance.”

Dental neglect: Children falling through the cracks in “siloed health service”

The BDA has renewed its call for a joined-up strategy on children’s oral health, as new research reveals that GPs are not given the time or training to spot the tell-tale signs of dental neglect.1

The study, published in the British Dental Journal, surveyed all GPs in the Isle of Wight about their awareness and perceptions of dental health care in the identification of abuse. Among these family doctors, usually the first point of contact with the NHS, the majority had never liaised with a dentist. 96 per cent of respondents had never received any formal dental training and some did not perceive dental health to be important. Only five GPs mentioned a link between a lack of dental registration and childhood neglect and no GPs worked at clinics where child dental registration status was recorded.

Dental neglect is a marker of child neglect. It was defined in 2009 in the UK as “the persistent failure to meet a child’s basic oral health needs, likely to result in the serious impairment of a child’s oral or general health or development.” The research demonstrates that GPs lack time, training and confidence to identify dental neglect during routine examination of the oropharynx, and lack awareness of dental neglect as a potential marker of wider systemic neglect.

The study also notes that the sheer ubiquity of dental neglect within the general population may have desensitised many health practitioners to its wider social and health consequences, and blurred the lines between neglect and economic deprivation.

Official data shows that 41.8 per cent of children in England had not been to see a dentist for a check-up in the 12 months up to June 2017. Tooth decay remains the number one reason for hospital admissions among children across the UK. The BDA believes that progress can only be achieved by breaking down silos across the health service, along with co-ordinated and properly funded public health interventions.

The BDA’s Chair of General Dental Practice, Henrik Overgaard-Nielsen, said: “Tooth decay can be a tell-tale sign of abuse or neglect, and many children are falling through the cracks in a siloed health service. GPs bear an enormous burden and it cannot fall to them to ‘multitask’, when government is failing to deal with the problem.

“Tooth decay is the number one reason for child hospital admissions, but dentists are not seeing those at most risk early enough to make a difference. Poverty, neglect or ignorance can be huge barriers to good oral health, and we desperately need joined-up policymaking to tackle them.

“Oral health has such a low profile that it is not surprising that awareness of its importance is low in other parts of the NHS. When we face an epidemic of decay, dentistry can’t be left in a corner. Without meaningful engagement in education, in media and across the health service we simply cannot expect progress.”

  1. See: Colgan, S.M et al (2018). ‘Bridging the gap’ – A survey of medical GPs’ awareness of child dental neglect as a marker of potential systemic child neglect, The British Dental Journal, published 11 May 2018

Mission (Im)possible

Five dental business consultants are taking on their ultimate challenge, cycling almost 1,000 miles in fifteen days to raise funds for three wonderful charities – Cancer Research, Bridge2Aid and BrushUpUK. Chris Barrow, Les Jones, Sheila Scott, Simon Tucker and Ashley Latter have set themselves an ambitious target; between them they’re hoping to raise £50,000. The team has been sponsored by four industry stalwarts – Practice Plan, Dental Sky, Wesleyan and Dental Focus.

Explaining why they chose these three charities, Ashley commented, “We will all be touched in some way by cancer in our lives, so supporting the work of Cancer Research is something everyone can get behind.  We’ve also chosen two special charities within the dental sector.  Bridge2Aid does amazing work in Africa training local medical officers to carry out basic dentistry and, as a result, helps thousands of people out of pain and suffering.  BrushUpUK is a charity that believes that everyone should have the knowledge and skills to access and maintain a good standard of oral health and works with professionals within the sector to provide education and guidance to vulnerable groups in society”.

A fundraising page has been created for anyone who would like to support the challenge. 

Additionally, you may like to challenge yourself and join the five for a leg or a day of the journey. Dust off your cleats, dab on your chamois cream and join the team! There are five places available for each day. For more information, or to make a donation, visit www.fivegoforth.co.uk.

 

New BOS survey reveals a rise in the number of adults seeking orthodontic treatment in the UK

New figures released by The British Orthodontic Society (BOS) to coincide with National Smile Month, which kicked-off yesterday (14 May), has revealed the number of adults seeking orthodontic treatment in the UK continues to rise.

This survey, conducted in March 2018 among BOS members, was designed to gather new data about orthodontics and patient choices in the UK compared to two years ago.

Asked if they were seeing an increase in private adult treatment, 80 per cent said yes. This figure compares to 75 per cent in 2016. When asked what kind of braces they provide to their patients, orthodontists revealed a cross section of approaches:

  • Over 75 per cent supply fixed braces with clear aesthetic brackets
  • Over 35 per cent supply lingual braces (fixed behind the teeth)
  • Over 75 per cent supply clear aligners

The survey showed that adult patients are most likely to be female and in the 26 to 40 age bracket. However, the number of men seeking treatment appears to be on the rise. 19 per cent of the respondents to the survey estimate that half of their adult patients are male. This compares to 13 per cent in 2016.

The most popular system, provided by more than 98 per cent of orthodontists, is fixed braces on the front of the teeth, often referred to as ‘train tracks’. This figure reflects the high number of young people treated as NHS patients for whom fixed braces is the most appropriate option.

A quarter of BOS members responded to the survey. Of those who answered the survey, 27 per cent see only NHS patients while 67 per cent see both private and NHS patients.

Richard George, BOS Director of External Relations, commented: “It’s gratifying to see the number of adults interested in orthodontic treatment continuing to rise. If you are interested in treatment for yourself, it’s important to seek an opinion from a professional who has the training and skill to diagnose and treat a variety of orthodontic issues. Our members, specialists and dentists with a special interest, offer a range of options for adults, enabling them to provide a solution to any kind of orthodontic problem. The value of choice cannot be over-estimated.”

The UK welcomes its first pan-European dental provider, Colosseum Dental

One year after taking ownership of the UK’s third largest dental group, Zurich-based Colosseum Dental Group unveils a £5 million comprehensive modernisation programme focused on clinical excellence and best practice

“We’re really excited to be part of a pan-European group which is in the vanguard of best practice. We’re looking forward to sharing knowledge and outcomes, enabling us to push dental boundaries and enrich the dental experience for our patients.” – Ravi Rattan, Clinical Director, Colosseum Dental UK Ltd

Southern Dental, one of the nation’s largest chains of dentists, is now known as Colosseum Dental UK Ltd. The name change coincides with the first anniversary of Zurich-based Colosseum Dental’s acquisition of Southern Dental, which made it not only Europe’s fastest growing dental group, but also the only one with a network spanning the continent.

With a patient base in excess of 500,000, the majority of Colosseum’s 80 practices in the UK will undergo an extensive refurbishment programme, introducing a new look and feel to waiting rooms with upgraded treatment areas and clinical facilities as part of a £5 million investment in the company.

Peter Keegans, CEO, explained: “Our new owners have a long-term, 20-year vision which is enabling us to invest in upgrading our clinics to be state-of-the-art practices offering the highest standards.”

Local practices serving their community

Keegans continued: “We want to break with convention from other dental chains. Each of our 80 practices will be known by the local name patients have always referred to it. If, for example, ‘Hollybush Dental’ is how a practice has always been known colloquially, we’ve no intention of simply re-badging it as ‘Colosseum Dental’. In this way, each practice will retain its connection as an integral part of its community.

“Our name change marks a new era: a renewed energy and focus, an opportunity for cultural change and to align ourselves with the values of our European colleagues. Armed with a long-term vision, we can now invest in our practices and staff with confidence, knowing our patients will be the ultimate beneficiaries. Everyone wins.”

European scope for professional development and patient care

Being part of a European group means dentists have the chance to provide best practice based on the ability to observe long-term clinical outcomes in a huge, European-wide patient base. Treatment protocols, guidelines and KPIs are currently being developed across the group to provide highly informed patient care, and present the best possible treatment options to patients.

Ravi Rattan, Clinical Director at Colosseum Dental UK, who joined in 2016, is excited to be part of these changes: “At Colosseum Dental, we’re committed to raising clinical standards and offering more advanced treatment options and procedures to our patients. Our new specialist referral centres in Kettering and Kingston offer private as well as NHS treatments such as orthodontics, implants and facial aesthetics. Patients there will benefit from 3D CBCT scanners to enable better, safer treatment planning. Having new investment means we can continue to set up such centres: Our European colleagues are highly experienced in managing large referral centres, and we are learning from their success.”

The group’s aim is for no differences to exist between treatments available at, say, a practice in Switzlerand, and those available at one in Southern England. Lars Armbäck is Chief Dentist at Colosseum Dental Group. Armed with 30 years’ general practice and a special interest in prosthetics, implants, quality and treatment strategy, his focus is on best practice, dentist development and quality assurance. He’s excited by the addition of the 80 English clinics, noting, “Patients everywhere should be able to benefit from digital technologies that enable them to make informed choices about their care. Hence, as a group, we recently chose to invest in intraoral scanners for all patients, and our size means we can negotiate to help keep diagnostic and treatment prices affordable.”

Committed to professional development

Career choices at various levels are being made more flexible, in line with changing lifestyle requirements such as increased female and part time dentists in post. Samaneh Nezamivand-Chegini, a dentist who practises in Central London, having joined in 2012, now sits on the Clinical Board. She says, “It’s great to see my suggestions have been noted, despite my being relatively newly qualified. Peter [Keegans] and his team have listened and acted, which is in turn inspiring my clinical colleagues. On a personal level, I’m being supported to further my career and income via training in implantology.”

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.

New managing director for bredent subsidiary in the UK

bredent UK has appointed a new managing director, who comes from the dental industry.

Stephen Denman, an ex-dental technician who has spent the last 10 years leading sales teams across Europe, developing business strategies plus supporting country commercial organisations for Dentsply Sirona, will take up the position on 1 May 2018.

Stephen said: “I have always held bredent and its products in high regard, first as a customer then as a market peer and am very much looking forward to joining bredent UK. The bredent family is full of talented and enthusiastic individuals who will continue to deliver the excellent service and support customers have come to expect over the years, as well as providing some of the most innovative solutions in the dental field.”

Stephen will replace the current managing director of bredent UK Ltd, Maja Thompson, who co-founded the business in 2004. Maja Thompson has decided to explore new opportunities – a decision fully supported by the bredent family.

The company supplies the dental market with products from the German manufacturer bredent and bredent medical GmbH Co.KG located in Senden, south Germany. The bredent group is a family owned company and has been supplying the dental market for more than 40 years.