On Thursday 25 March 2021 NASDAL (National Association of Specialist Dental Accountants and Lawyers) held its annual press conference, this year virtually at BDIA Dental Showcase, and many Principals, Associates and team members, along with the dental media, joined what was an enlightening event with 5 presentations and then an interactive Question & Answer session. Heidi Marshall, partner at Dodd & Co was a member of the panel.
It has been an unusual twelve months and this year’s event reflected this by being billed as a ‘State of the Nation’ conference dealing as it did with a wide variety of dentally related financial and legal matters.
The conference heard the latest goodwill value statistics which are normally produced on a quarterly basis but due to the pandemic, the latest figures covered the four months that ended 31 January 2021.
Against what many may expect, the latest period showed very little price reduction due to the pandemic. As with the last survey (which covered the period from 1 April to 30 September 2020), in our experience, there have been only limited price reductions but considerable lengthening of the process.
Benchmarking Statistics – “continued fall in NHS practice profits but better news for Associates”
The NASDAL benchmarking statistics are published annually in March and reflect the finances of dental practices and dentists for the most recent tax year (2019/2020). The NASDAL figures provide a detailed picture of dental practice finances, sourced directly from dentists working privately and in the NHS. They are immensely useful but this year, as the period in question only ran until March 2020, they have limited information to share about the effect of the pandemic. However, they do make interesting reading. Some of the key points from this year were:
- A continued fall in NHS practice profits – this is perhaps as NHS practices tend to be more Associate led
- A slight fall in net profit across the market as a whole
- Better news for Associates with an increase in fee income of 3% and increase in net profit of 2%
- Practice expense ratios stayed very consistent with previous years
Overall, we have seen results similar to the previous year with a small impact of COVID-19 in Feb/Mar 2020. Net profit of a typical dental practice fell back to £129,178 from £134,387 in 2019 and both NHS and Private practices saw a reduction in profit (NHS – £116,284 in 19/20 down from £124,475 in 18/19; Private – £133,192 in 19/20 down from £140,591 in 18/19). Only mixed practices bucked this trend with a small rise from £132,940 in 18/19 to £134,342. What the figures will show for the year of the pandemic is conjecture at this point, but we certainly find ourselves in a very different landscape now from a little over a year ago.
NHS Quarter 4 – meeting the targets
Since the beginning of January in terms of Q4 targets (in England) need to achieve 45% of pre-pandemic activity measures to avoid any financial penalties by way of ‘clawback’. There are 2 key issues that were affecting practices.
First and foremost, there is a small but significant number of practices that will be unable to hit the threshold of 45% of UDA contract amounts and how that ‘cliff edge’ will affect them. The fact that many NHS practices are already hitting this target is great but irrelevant to those that cannot.
Another unconsidered consequence of the Q4 rules is pay cuts of more than 65% for some self-employed dental associates who carry out NHS work. During the COVID 19 crisis a very important measure of financial protection has been given to NHS associates as so far they have been paid in full. Q4 rules brought this to an end for those associates who work in practices which cannot hit the 45% UDA threshold.
We believe that a fair compromise is quite simple – remove the ‘cliff edge’ at 36%. Without this change, a small percentage of the total NHS contract holders could be in real trouble. In addition, the associates who work in those practices could suffer a pay cut in excess of 65%.
As to what might happen as of 1 April, suffice to say that there will be no material change in circumstance between 31 March and the following day and therefore we would be surprised to see any movement from the 45% figure.
Practice sales market – “still buoyant”
Practice Sales were then discussed over the last year which were a whole lot busier than many might expect. What the pandemic did do was slow the entire sales process. From March 2020 until June 2020 there was a hiatus as society was locked down. Then, volumes of practice sales picked up quickly and NASDAL members saw a particular surge earlier this year as many sought to avoid a potential Capital Gains Tax increase in the Budget that as it turned out, didn’t materialise.
To illustrate the added time now involved, it can take up to 20 weeks for the CQC to register a new partnership allocation! As we move forward, it seems that those buying practices are having to do so in more of a ‘blind’ fashion than in is traditional. Even though a practice has been successful in the past, the new world that we find ourselves in, means it is no guarantee of future prosperity.”
The Future – “the reckoning of the end of furlough”
The final presentation was delivered by Heidi Marshall, who is NASDAL Secretary and is a Partner at Dodd & Co Chartered Accountants. Heidi had the unenviable task, even more so in these times, of considering what may happen in the coming months.
Heidi covered a wide range of areas including Q1 percentages, clawback and the ‘Zoom Boom’ of dentistry. She also shared evidence of mixed practices taking the decision to leave the NHS as they are finding that the numbers no longer add up.
Heidi particularly focused on the end of furlough and that September will see a real reckoning in many sectors. “I think that we will see the true impact of what the end of furlough will mean for our economy. Potentially hundreds of thousands of people could find themselves out of work and that will certainly mean a reduction in enquiries for elective dentistry but perhaps even the more regular care too?”
Overall we are pleased to see that the UK dental sector has reacted to the challenge that Covid has provided in a typically robust fashion, but it has been a tough 12 months for many and the future is still uncertain.
Now, more than ever, it is important that dental practices take specialist advice so that they can understand and react to changes in their business situation.
Filmed live from a COVID-secure TV studio, BDIA Dental Showcase On Demand (22 – 26 March 2021) will provide an experience for the profession like no other, bringing the lights and excitement of a physical show to your home or practice.
With 50 free seminars, 100 leading exhibitors and zero cost, BDIA Dental Showcase On Demand is not to be missed. Register now.
THE VIRTUAL EXHIBITION
Browse the virtual exhibition and hold face-to-face meetings with 100 leading suppliers over video to discuss your needs and discover new solutions.
Find out more information about exhibitors via the instant chat and make the most of show-only special offers to find new products and resources at the best price.
View the full exhibitor list to see who’s at the show.
THE CONFERENCE PROGRAMME
The BDIA Dental Showcase On Demand programme will provide a new channel for learning with CPD-certified panel discussions, lectures and more.
Tune in to hear the latest policy updates, business advice and clinical techniques the biggest names in dentistry. Already confirmed are:
- Sara Hurley, Chief Dental Officer for England
- Eddie Crouch, British Dental Association
- Osama Ammar, General Dental Council
Joining Sara, Eddie and Osama are more than 70 dental experts, bringing you 50+ studio-produced CPD talks. You’ll take away best-practice tips to help guide your practice through these challenging times.
The conference programme is designed for the whole practice team so there’s something for everyone.
Make sure to join your peers at this brand-new virtual experience for the dental profession. Register free here.
The Practice Manager of the Year Award at the 2021 Dental Awards, the original and most respected awards programme in UK dentistry, has gained added prestige as it will now be presented by ADAM (The Association of Dental Administrators and Managers).
The Practice Manager of the Year Award is open for entries to all practice managers, regardless of their status as an ADAM member. For an entry brochure, visit https://the-probe.co.uk/awards/the-dental-awards-2021/.
The entry deadline is 28th February 2021.
Lisa Bainham, ADAM President, commented: “The Dental Awards are a great way to recognise and celebrate individual and team achievements. I, myself, am honoured to have received several accolades during my career in dentistry, and The Dental Awards truly inspire and give you the confidence to become the very best you can in your field. The recognition provides reassurance to your teams and patients of your standards.
“I would recommend entering the awards to anyone who goes above and beyond in the dental field, they deserve to have their dedication awarded and recognised. It is an honour for me to have judged these awards for the last few years and would urge individuals and practices to stand up and be counted, for increased team morale and much more.”
“Over the course of more than two decades, The Dental Awards has established itself as the most highly regarded awards honour in the profession,” said James Cooke, managing editor of the dental portfolio at Purple Media Solutions, including The Probe. “It is with great excitement that we announce a new partnership with ADAM that will see the Practice Manager of the Year Award held in even higher esteem.
“While we highly encourage Practice Managers to stand up and be counted for the tireless work they’ve put in over the course of an extremely challenging year, don’t forget that you can also ensure other members of your team – or even your entire practice – can be nominated for recognition in their own respective categories.”
ADAM provides its member Practice Managers with tailored advice, access to management development and regional events at preferential rates, free legal consultation, access to industry pay scales and more. For further information, visit https://www.adam-aspire.co.uk/.
2021 marks the 22nd edition of the Dental Awards. Over the years, this prestigious event has recognised the outstanding individuals and teams whose commitment and drive continues to raise standards throughout the UK dentistry profession.
The Dental Awards is supported by the UK’s leading dental magazine publisher, Purple Media Solutions, and is unquestionably the premier awards programme for UK dentistry.
Winning or being a finalist is a tremendous accolade and provides a massive publicity boost to the profile of your practice and your team. After all, who wouldn’t want to be treated by the Dentist or the Dental Team of the Year?
For more information, call 01732 371570 or contact email@example.com.
The British Association of Dental Nurses (BADN), the UK’s professional association for dental nurses, has today launched its 2020 Salary Survey.
The Survey is open to all dental nurses, non-members as well as BADN members, to find out how much dental nurses in the UK are being paid, as well as whether they were paid during lockdown. The Survey will provide data to support the BADN’s campaign for recognition of dental nurses’ contribution to oral healthcare in the UK, and for dental nurses working in general dental practice to be paid NHS rates, instead of minimum wage.
BADN invites all dental nurses, but particularly those working in practice, to complete the survey – which is anonymous. Dental nurses completing the Survey will need their P60 for the tax year ending April 2020 – all employees should have received this in April 2020 from their employer.
The Survey can be accessed from the BADN website www.badn.org.uk or via https://cutt.ly/SalarySurvey2020. Closing date is 31 December 2020.
The Association of Dental Administrators and Managers (ADAM) has chosen WestWon Limited as its preferred finance partner to support its members.
Lisa Bainham, president of ADAM comments “WestWon have bought some really exciting changes to the Dental Profession with their innovative products and services. WestWon has recently launched a new Dental Finance App for the dental sector to give everyone total transparency, and we felt their approach and professionalism would benefit our existing and new members.”
WestWon Services include low rate equipment finance, business loans, refurbishment loans, tax and VAT loans, vehicle finance and IT finance.
“Speaking on behalf of WestWon, CEO Jeremy Hall noted, “We have arranged hundreds of equipment leases and practice loans for dentists during my 30-year term in the leasing and asset finance business. We have no doubt that our experience and dedicated friendly team will give you a positive customer experience.”
Richard Porter, Divisional Director, comments “This is an exciting time for everyone, the additional value that WestWon will bring will change the way dental practices use finance. Our credit approvals are simple and fast, documentation is via digital signatures and straight-forward, and with our dental finance app you will always be getting the transparency you deserve!”
ADAM members represent over 600 dental practice members throughout the UK. Lisa adds “This is a wonderful opportunity to provide ADAM members with an outstanding, professional and friendly finance service.”
CODE has completed the acquisition of Isopharm which brings together the market leading compliance platform with the largest provider of online CPD for dental practitioners into a single entity.
Established for over 20 years, Isopharm is the leading provider of online CPD with over 60% of all dental practitioners using their innovative solutions to meet the mandatory requirements for continuous development. The business also provides software and services for validation and testing to a broad range of healthcare providers.
Neil Laycock, COO of the CODE Group, highlighted the significance of the acquisition saying “The addition of Isopharm represents the next step in creating the dental industry’s leading solution for practice operations. The breadth and reach of the combined company is unmatched in the industry and creates an exciting platform for innovative services”.
Karen Penfold, Managing Director of CODE, who will head up the new combined business said “CODE’s iComply is already the most widely used solution for compliance management for dental practices in the UK. The acquisition of Isopharm will be a major addition to our recently launched solutions for people management in dental practices. The integrated solution will bring major benefits to our clients; from attracting new staff, improving staff engagement and retention, and ensuring skills and process compliance in a single solution”.
Founder of Isopharm Andrew Kemp joins the CODE management team and said “CODE is the perfect platform for the next stage of innovative solutions we had planned at Isopharm, we are delighted to be joining forces”.
August Equity invested in CODE in 2019 and have been instrumental in the acquisition of Isopharm. “August Equity’s market knowledge, broad network in the dental and healthcare sector and prior experience in creating industry leaders has been very important in getting to this stage of CODE’s development, we continue to be excited about building on this start and extending the reach of the Group into more healthcare segments” said Dr Sati Sian, Chairman CODE Group.
To find out more about the businesses visit codeuk.com, training.isopharm.co.uk, email firstname.lastname@example.org or call 01409 254 354
The Association of Dental Administrators and Managers, (ADAM) would like to offer their congratulations to Jason Wong MBE who has been appointed Deputy Chief Dental Officer for England, in succession to Janet Clarke who retired last year.
Jason will work alongside CDO Sara Hurley and Deputy CDO Eric Rooney in collaboration with local and regional teams to deliver improved outcomes for patients, and champion the role of dentists and dentistry within the health system.
Jason is a general dental practitioner in Grantham Lincolnshire, who qualified from the University of Birmingham in 1995 and also holds a Diploma in Postgraduate Dental Studies from the University of Bristol. He was appointed MBE for services to Dentistry and Oral Health in the New Year Honours in 2020 and received his insignia from the Prince of Wales at Buckingham Palace earlier this year. Jason was the inaugural winner of the NASDAL DCby1 award in 2018 and has since become a judge on the awards.
Responding to COVID-19: providing treatment in uncertain times
As the COVID-19 crisis continues to develop, the challenges facing dental professionals are changing. The importance of effective infection control within dental primary care settings remains, but that is leading to a rapid reduction in the treatment being offered, reinforced by guidance to practices operating within the NHS, which non-NHS practitioners will also want to take into account.
This note updates and clarifies GDC guidance in three areas:
- Dental professionals working in non-dental settings.
- Remote advice and prescribing.
- Treatment in dental primary care settings.
In all these areas, the GDC has no interest in second guessing clinical judgements which take account of this guidance and are based on an appropriate assessment of the risks involved.
Dental professionals working in non-dental settings
The NHS is increasingly asking dental professionals to be ready to support the wider COVID-19 response by using their professional skills and experience outside the normal range of dental and oral health activities. As a regulator, we want to support that activity and our registrants taking part in it, while of course keeping to the fundamental need to do so in ways which support patient safety.
When a dental professional is providing support to the wider NHS, the same basic principles apply as in any other situation: the test is whether they are trained, competent and indemnified for the tasks they undertake.
There are many tasks in the wider health service which can be performed by dental professionals drawing on their existing professional skills and experience. Registrants should satisfy themselves that they are competent to perform the tasks being asked of them, or are given the training necessary to equip them to do so. We understand that the health services are preparing guidance on the mapping between dental skills and wider medical tasks, which registrants will want to take into account.
We expect registrants to make a considered judgement about whether they are trained and competent; we do not expect them to limit themselves to the specific activities set out in their scope of practice. That doesn’t make scope of practice irrelevant: it will be a useful starting point for considering what wider tasks are appropriate, but it does not in itself constrain dental professionals’ ability to support the COVID-19 response.
Indemnity should not be an issue where support of this kind is being provided to the NHS, since the Coronavirus Act provides cover for any liabilities beyond the scope of existing cover. We understand that some indemnifiers may choose to offer extended cover; registrants should ensure that they check with their indemnity provider and, if appropriate, with the relevant NHS authority that coverage is in place by one route or the other.
Remote advice and prescribing
Where patients cannot come to a dental surgery, dental professionals may be asked to provide advice remotely and to work with patients to defer the need for active treatment through the use of pain control and antimicrobial treatment. The basic principles of our guidance on remote consultation and prescribing continue to apply, but in the specific circumstances of COVID-19, the key requirement is to make an appropriate risk assessment. That risk assessment should be recorded and should take into account the infection risk of COVID-19, both from and to the patient, as well the apparent seriousness of the need for treatment and the extent to which it has been possible to make a clinical assessment. Where appropriate, it should also take account of NHS guidance on treatment which should and should not be offered in a primary care setting.
Treatment in dental primary care settings
For the duration of the COVID-19 epidemic, infection control is of paramount importance and even greater than normal care will need to be taken to minimise the risk of infection to, from, or between patients and between members of the dental team. In many cases, the right approach will be to stop providing treatment altogether.
Practitioners providing NHS services will of course need to adhere to the directions given by their nation’s Chief Dental Officer; other practitioners will want to take that into account in making decisions. From a regulatory perspective, the central question is again whether an appropriate risk assessment has been made. If treatment is offered, it will be important to record the specific precautions in place to ensure that the risk is appropriately managed for the particular treatment envisaged.
Executive Director, Strategy, GDC
Responding to COVID-19: regulating in uncertain times
The central role which GDC has as a regulator is to protect patient safety and to maintain public confidence in dental services. The onset of COVID-19 doesn’t change that, but it is changing – and will continue to change – how we do it in practice.
We know the impact this is having on the profession and the level of challenge and uncertainty involved. Many questions and concerns still remain unanswered, not least on the level of support which may be provided by government. We don’t want to add to that uncertainty and concern, and hope that the information provided here helps you understand what actions we are taking to provide help and clarity where we are able to.
Our approach is based on two core principles:
- Minimising the burden of time and attention we impose on registrants.
- Maximising the flexibility of registrants to manage their professional activities in response to the challenges of COVID-19.
That doesn’t mean that we can withdraw completely. There is still a vital role for regulation, and we are in any case limited in our ability to be flexible in some areas because of the constraints of the legislation under which we operate.
As we all know, circumstances are continuing to change rapidly. Our approaches will need to adapt as the situation changes, but we want to be as clear as we can be about how we are approaching the different areas of our work. So, the information below is as complete as we can currently make it, but it will inevitably need to be updated as the epidemic and its consequences unfold.
This sets out the position of the GDC as at Monday 23 March 2020.
Expert advice on the clinical aspects of COVID-19 will continue to come from the health authorities of the four nations. We cannot create that advice – our role will be limited to providing clear signposting to all the current guidance we are aware of. That guidance inevitably doesn’t cover every possible set of circumstances, so professional judgement remains key when making decisions about providing – or not providing – treatment. We do not expect any dental professional to provide treatment unless, in their professional opinion, it is safe to do so for both patients and the dental team.
For our part, we will expect dental professionals to keep themselves aware of current guidance and to make decisions informed by it, but we won’t be looking to second guess judgements made on that basis.
Continuing professional development (CPD)
As a result of the restrictions in place, we share the concern we have heard about potential difficulties in meeting CPD requirements for this cycle year. We know that many face-to-face CPD activities have already been cancelled and that will no doubt continue over the coming months.
The five-year CPD cycle already offers a lot of flexibility. There is no requirement for CPD to take a particular form and perhaps more usefully in the current context, it’s perfectly acceptable to submit a return of zero hours, if 10 or more hours have been recorded the previous year. Our records suggest that over two thirds of dental care professionals (DCPs) who are due to make a declaration this summer will meet the requirement on that basis. So, a good starting point is to check what’s already recorded on eGDC to see if there is an immediate shortfall.
We will look sympathetically at the circumstances of anybody who is still left with a shortfall for the declaration they are due to make this year. Of course, there are options other than face to face CPD and the CPD Provider Guidance is available on our website for anyone wishing to know what is required for a CPD activity to meet the verifiable criteria. But to be absolutely clear: nobody will be removed from the register because of a lack of access to CPD during the crisis period.
Please email us with any queries or concerns about this to email@example.com.
Joining the register
Thousands of students will have been due to complete their professional training over the coming months and then to register with GDC. Teaching and assessment are being severely disrupted, but we have been working with education providers to ensure that as many students as possible can still have a smooth transition into practice. We, and they, have prepared a joint statement setting out our shared approach, which has now been published on our website. This statement includes relevant contact details.
Returning to the register
Many will have seen the appeals to doctors, nurses and other healthcare professionals whose registration has lapsed to return to work, and we have been asked whether similar arrangements will be made for dental professionals.
The GMC has long had powers to give temporary registration in emergencies. The NMC, the HCPC and the social work regulators are being given similar powers in the emergency Coronavirus Bill, which is expected to pass through the House of Commons today. But the GDC doesn’t have – and is not currently in line to get – such a power, so as things currently stand the only route back onto the register which we can legally offer is by individual restoration.
We have been exchanging information with the Department of Health and Social Care on this, and it’s possible that that might change for the future, but that’s in their gift, not ours. We are though looking – within the constraints of the legislation – at whether we can streamline any of our processes and requirements.
Fitness to practise
With the exception of the small number of cases, where there is an immediate perceived risk to patient safety, almost all fitness to practise hearings have now been postponed. We aim to run the urgent hearings remotely whenever possible so that we do not require participants to travel. We will contact all parties involved directly with information about how they participate.
Because we list substantive hearings up to nine months in advance, we will continue to schedule new referrals from Case Examiners. We will look to relist the postponed hearings once we are confident that we will be able to hold them in a safe and appropriate way.
This is not a time for fitness to practise cases to be a distraction – but even in current circumstances, people may have legitimate concerns, and it is important that they are able to raise them with us. If they do, the GDC is under a legal duty to investigate them. We will continue to record and make a risk assessment of new fitness to practise concerns and we will continue to progress new and existing cases as far as we can. As always, it’s worth remembering that a clear majority of cases are closed in the early stages of an investigation and only 15% of concerns are eventually referred to a practice committee for a hearing – so it’s in everybody’s interest not to leave cases hanging over registrants any longer than they have to.
Nevertheless, as far we can, we will keep requests for information to a minimum and in particular will avoid asking for information from the NHS unless there is an urgent, risk-based, need to do so. We appreciate that many people will have difficulty providing information to us for various reasons, and we will take a pragmatic and reasonable approach. If that’s likely to delay progress on a particular case, we will let all parties know and offer appropriate support.
Annual Retention Fee (ARF)
We are not yet clear on the government’s plans to support the sector and so it remains a real possibility that dental professionals will be under severe financial pressure in the coming months. Understandably, there are calls for us to waive the ARF payments which will be due from DCPs in July and from dentists in December.
We understand that dental professions are facing the likelihood of financial distress – however, that is not an issue that we able to solve by unilateral action. A solution to the financial pressure registrants are facing will require financial support from the government. Some of the provisions already announced by government to support businesses will have value for dental practices, and in some parts of the UK direct support has been given to NHS contract holders, but where appropriate we will join the discussion with government to help ensure that the particular needs and circumstances of all dental professionals, across both NHS and private practice, are understood.
What we can do and absolutely will do is continue to apply the rigour to our planning processes which allowed us to reduce the ARF for dentists last year by 24%. We will be looking again at our plans for the remainder of the year, with a view to delaying expenditure and stripping out cost.
Executive Director, Strategy, GDC
Our main objective during the period of the COVID-19 pandemic is to ensure our people are kept safe and that everyone in the dental profession is aware of and understands the latest advice.
We are very aware that the situation is very fluid at present, however we wanted to remind you that our position and advice is that you continue to follow the latest NHS and government guidance. Specifically, this advises that if you have any symptoms of the coronavirus infection, however mild, then if you live on your own you should stay at home for seven days from when your symptoms started, and if you live with others, then all household members must stay at home and not leave the house for 14 days. The latest information can be found from Public Health England.
In recent weeks we have had the appropriate level of contact with the Department of Health and Social Care (DHSC) regarding COVID-19. However, it’s important to say that this has not been at the same level as other health regulators such as the GMC and NMC. This is completely understandable as doctors and nurses are engaged in the direct treatment of patients displaying COVID-19 symptoms, in a way that’s different from dental professionals. Should this situation change then we would expect to increase our engagement with DHSC, but at this stage we feel that it remains appropriate and at the right level.
The Chair has made the decision to cancel the public session of the Council meeting that was due to take place on Thursday 19 March in Birmingham. It’s not a decision we took lightly, but we strongly believe it is the correct and prudent decision in the current climate, and in line with government guidance about avoiding unnecessary travel. Council will instead carry out its responsibilities by meeting virtually.
We are also reviewing, on a case by case basis, our planned Education Quality Assurance inspections and we will be contacting the education establishments who have planned inspections individually to agree the most appropriate course of action.
As we stated earlier ensuring that we have a safe working environment is of paramount importance to us. So, following confirmation that one of our staff in our London offices has been off work with coronavirus symptoms we made the decision to close the offices on Tuesday 17 March and undertake a full deep clean. We don’t believe there is any immediate cause for concern, but felt it was prudent to take precautions.
In addition, we are asking all staff in both Birmingham and London to work from home on Wednesday 18 March to test how well we can manage the organisation if we were all working remotely. As a result of both above, we have postponed our hearings that were scheduled on both these days in London. At this stage we anticipate they will resume on Thursday 19 March.
These are fast changing and uncertain time for all of us, so please be assured that we will update you again should things change significantly. You can read the latest news on our COVID-19 web pages, which include links to the updates from all four governments and departments of health.
Chief Executive and Registrar
As part of our statutory objective to protect the public, we continually monitor new developments in the dental sector. We are aware of a number of organisations offering services remotely which could constitute dentistry as defined in law, including the growth in ‘direct-to-consumer orthodontics’.
Orthodontic work is a sub-speciality of dentistry, primarily concerned with disturbances of the positions of the teeth (malocclusion) and the jaws that support them. Orthodontic treatment is how these problems are managed.
This work falls within the practice of dentistry (as defined by the Dentists Act 1984
) which, amongst other things, requires individual dentists and dental care professionals to be registered with the GDC, to act within their Scope of Practice
and to adhere to the GDC’s Standards for the Dental Team
. Registered dental professionals who do not comply with these standards put their registration at risk. Anybody practising dentistry while not registered with the GDC could be subject to prosecution for illegal practice.
We have received reports that providers of ‘direct-to-consumer orthodontics’ are offering services which may not include face to face patient contact with a registrant authorised to provide direct services to patients. Our view is that for all dental interventions, this important interaction between clinician and patient should take place at the beginning of the patient consultation. This enables the clinician to carry out the assessments necessary for making clinical judgements that ensure the suitability of the proposed course of treatment, that support the prescribed course of treatment, and that address any underlying oral health problems. It also gives patients the opportunity to ask questions, provide valid and informed consent and be satisfied that that the course of treatment proposed is likely to meet their needs and expectations.
We are continuing to gather evidence about the potential risk of harm to patients from ‘direct-to-consumer orthodontics’ and other forms of dental care offered remotely. We have contacted providers of these services to seek clarification on the procedures they follow and how GDC registrants may be involved. In parallel, we continue to welcome further advice and information from the dental professions.
We will issue a further statement when we have evaluated the evidence we are gathering. Until further guidance is available, dental professionals are reminded that they must consult their indemnity providers should they need further advice. Complaints received relating to these matters will continue to be addressed through our existing processes.
Registration for the British Dental Conference and Dentistry Show 2020 is officially
Now you can secure your place at the event to make sure you don’t miss out on the extensive education and networking opportunities available. A world-class speaker line-up has been accrued, with industry-leading professionals sharing their colossal collective experience and expertise.
There will also be an extensive trade floor with dental manufacturers and suppliers demonstrating their latest innovations. Whether you’re looking for digital technologies, restorative materials, software programmes or training courses, there will be something for you.
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The British Dental Conference and Dentistry Show 2020 – 15th and 16th May –Birmingham NEC, co-located with DTS.
For all the latest information, visit www.thedentistryshow.co.uk, call 020 73485270 or email firstname.lastname@example.org
National Smile Month sees the launch of a new campaign aimed at highlighting and supporting the
dental profession’s greatest ‘achievements for good’.
The ‘beproud’ hashtag will come into force in the coming weeks as the dental profession and
industry celebrate the daily good work of colleagues, customers and friends whose actions they
think are worthy and provoke the feeling of being proud.
Mark Topley, Founder of Dental CSR Certification, the business behind the #beproud campaign,
“It’s humbling to know our profession is achieving and doing so much for others and the
environment but also a great shame to see these same individuals holding back from sharing their
stories, as if by highlighting this it somehow undermines the original intention. This campaign is a
way to break down this barrier, to create a safe space to recognise the good and selfless decisions
being made in dentistry and to encourage and inspire more goodness in turn. At a time where the
news is breeding negativity, it’s about time we heard about more of the good. It’s what people want
to see – did you know that 90% of your patients and team now expect you to do good as part of
running the business?”
Dental CSR Certification encourage all practices to #beproud of their good decisions and to share
their positive stories on social media, celebrating everyday heroes. For example, it could be
recognising the efforts of a team member who consistently goes above and beyond with their
patients, the impact of the money your practice has raised so far this year for charity or recognising
someone who works in your local community.
We want you to share your stories and we want to feel the pride behind your words − because all
good work, in whatever format, should be celebrated and this is the time to shine the light on the
people you respect and admire. Everyone loves a pat on the back – be an encourager.
The #beproud campaign kicks off an exciting month for Dental CSR Certification as the company
gets set to launch a new set of standards that recognises dental practices’ commitment to doing
good – for their people, their community, and the environment. This is achieved via three levels of
certification (Bronze, Silver and Gold) depending on the level you are at in your Corporate Social
Responsibility (CSR), while motivating teams to aspire to that next stage of recognition.
The #beproud campaign sits at the heart of Dental CSR Certification, where the daily good work of
the dental profession and their pride in sharing it is celebrated.
To take part, all you need to do is share your story on Facebook, Instagram, twitter or LinkedIN
with #beproud and link to the Dental CSR social media accounts – @dentalcsr. This may be via
one dedicated post or through a six week social media campaign, giving you the option to post
weekly or even daily providing the freedom to recognise all those individuals who should #beproud
of their achievements. At the end of August, Dental CSR will select one practice for a free CSR
consultation, during which Mark Topley and his team will be on hand to advise and support you in
your journey to CSR certification.
For more information on Dental CSR and the certification that will become available very soon to
dental practices in the UK, visit www.dentalcsr.co.uk.
The results of a Freedom of Information (FOI) request to the General Dental Council (GDC) by Dental Protection demonstrate how important it is for dental professionals to have comprehensive indemnity cover and dentolegal support when faced with GDC proceedings.
Nearly one third (29%) of the warnings issued by the GDC in the past five years relate to personal conduct matters. Three quarters of these were given as a result of a driving offence.
This data supports the importance for dentists to maintain their membership of a dental defence organisation that will safeguard their interests and reputation before the regulator.
Dental Protection regularly defends members on a wide range of matters – including personal conduct matters. However, not all organisations provide protection against GDC investigations that relate to personal conduct, and so the dentist would have to personally pay for this legal support when faced by the regulator. When choosing their indemnity provider, it is important for dentists to consider whether their indemnity in GDC cases is limited to ‘the practice of dentistry’.
Having effective legal representation may also help a dentist to eliminate the risk of a warning altogether. In late 2018, Dental Protection brought Judicial Review proceedings against the GDC’s decision to issue a warning to a member who had committed a minor driving offence. In this case, Dental Protection successfully argued that a warning would be an excessive and unjust sanction by the regulator.
The FOI request to the GDC also revealed that nearly one-third (27%) of warnings issued to dentists related to record keeping. Dental Protection provides advice and has a wide range of workshops and education modules to help dentists with a variety of topics including record keeping.
Raj Rattan, Dental Director at Dental Protection, said:
“The GDC investigation process can be very unsettling for dentists who fear that their reputation is at stake. If you receive a warning you will have to disclose details of the sanction in any future job applications. Any dentist who receives a published warning will also find that details of the warning are put on the GDC website.
“While many healthcare professionals may feel that personal conduct issues do not necessarily make you unfit to practise, the GDC are clear that dental professionals have a responsibility in their personal life to behave appropriately.
“Unlike others, Dental Protection supports our members when they face allegations related to personal conduct in front of the regulator.
“Dental Protection continues to support dentists throughout all stages of a GDC investigation by providing the best possible support from our experienced team.”
Throughout the past years, Dental Protection has been contacted by an increasing number of dentists who have failed to pay their Annual Retention Fee (ARF) to the General Dental Council (GDC) by the 31 December 2018. Any dentist who has not paid their ARF by this deadline is removed by the GDC from the register and cannot practice in the UK until they have successfully been restored to the register.
Failing to pay the ARF by the end of this year will result in dentists needing to apply for restoration to the register in the New Year. Restoration requires the completion of the GDC application form and submission of the relevant evidence. The GDC states that the process will take at least 10 working days during which the dentist must not work. Dental Protection has witnessed the enormous distress and inconvenience that this has caused to dentists as patient appointments have to be cancelled and cash flow is interrupted. Knowingly working when not registered is illegal and a fitness to practice issue which can result in sanctions from the GDC.
The end of the year is also the last day of the Continuing Professional Development (CPD) year. The Enhanced CPD scheme was introduced this year which has seen the implementation of new CPD regulations. Under the ECPD scheme, dentists will need to complete a minimum of 100 hours verifiable CPD over their five year cycle as well as ensuring they declare at least 10 hours during any two year period. It is important to remind all dentists that any CPD done after the 31 December 2018 will not count towards the previous year.
Raj Rattan Director at Dental Protection said:
“We would like to remind our members of the importance of complying with the CPD rules. This year, there are some new requirements including a change in the reporting system, which needs dentists to complete the key annual statement and have a Personal Development Plan (PDP) in place. As far as we are aware, the consequences of not having a PDP have not yet resulted in a case. Nevertheless, we urge all dentists to comply fully with the requirements to avoid a fitness to practise investigation.”
Three national dental organisations are supporting the World Health Organisation’s World Antibiotic Awareness Week by urging the dental profession to help keep antibiotics working.
The Faculty of General Dental Practice (FGDP(UK)), the British Association of Oral Surgeons (BAOS) and the Association of Clinical Oral Microbiologists (ACOM) say that while progress has been made in reducing the number of antibiotic prescriptions in dentistry, more needs to be done to further reduce inappropriate prescribing.
Antimicrobial resistance (AMR) is a worldwide problem, with the emergence of bacteria that are resistant to many classes of antibiotics constituting a major threat to public health as even simple infections may become untreatable. Inappropriate prescribing and misuse of antibiotics contribute to an increasing incidence of multi-drug-resistant infections, causing an estimated 700,000 deaths each year, including 25,000 in Europe. The health care gains for patients undergoing major surgery, and a wide range of critical treatments such as organ and stem cell transplants and chemotherapy, will be lost to the higher risk of mortality, and the UK government predicts the annual global toll could be 10 million by 2050.
Dentists issue approximately 5-7% of all antibiotic prescriptions in the NHS, and the three organisations are encouraging dental prescribers to use freely available resources to help ensure appropriate use.
FGDP(UK)’s Antimicrobial Prescribing for General Dental Practitioners is available on the Faculty’s website, and provides evidence-based guidance on when to prescribe antibiotics, what to prescribe, for how long and at what dosage.
The BAOS’s recently-launched Antimicrobial Stewardship (AMS) e-Learning Modules provide verified CPD enabling oral health professionals to demonstrate application of the principles of antimicrobial stewardship to common clinical scenarios. They are relevant to all GDPs, including those who place dental implants, undertake minor oral surgery or practise in specialist areas.
The FGDP(UK), BAOS and ACOM also highlight the free Dental AMS Toolkit, which is endorsed by Public Health England and available on the FGDP(UK) website at www.fgdp.org.uk/antimicrobial-prescribing. The toolkit includes patient information on the use of antibiotics for the management of dental infections, as well as the Antimicrobial Prescribing Self-Audit Tool which enables dental prescribers to audit their antimicrobial prescribing and management of dental infections against guidelines.
The profession is also encouraged to take the dental pledges at http://antibioticguardian.com/, and to use the hashtags #AntibioticGuardian and #keepantibioticsworking on social media.
Dr Nick Palmer, Editor and co-author of the Faculty’s guidance, said:
“The number of antibiotic prescriptions issued by NHS GDPs is now at its lowest level for 25 years. However dentists can do more to reduce inappropriate prescribing to help keep antibiotics working.”
Greg Gerrard, Council Member of the BAOS, added:
“Oral health professionals have a vital role to play in keeping antibiotics working by prescribing them only when necessary, and by educating patients to take and dispose of them responsibly.”
Dr Noha Seoudi, representing ACOM, commented:
“There is a clear link between inappropriately prescribed antibiotics and the increasing rates of antibiotic resistance, so it is vital that dentists ensure that their use of antibiotics is clinically justified and in line with the national guidelines.”
World Antibiotic Awareness Week is a joint initiative of the UN’s World Health Organisation, Food and Agriculture Organisation, and World Organisation for Animal Health. It runs until Sunday 18 November, which is also European Antibiotic Awareness Day, organised by the EU’s European Centre for Disease Control.
Group Captain Mark Richardson, Vice-Dean of the Faculty of General Dental Practice UK (FGDP(UK)), has been appointed Her Majesty The Queen’s Honorary Dental Surgeon.
The honour follows his recent promotion to Chief Dental Officer of the Royal Air Force (RAF), and caps off a successful year in which he was also elected to the Faculty Vice-Deanship. Two Queen’s Honorary Dental Surgeons are appointed from each of the three Armed Services, and while the role is honorary, they assume responsibility, on a rotation with the Queen’s Honorary Surgeons, Physicians and Nurses, for medical arrangements at Investitures at Buckingham Palace, Windsor Castle or the Palace of Holyroodhouse.
Mark joined the RAF in 1989 shortly after graduating from Dundee University, and has served as a dental officer in Afghanistan, Europe, the Far East and the UK. Based in Tidworth, Wiltshire, he is currently the Armed Forces’ Principal Dental Officer for Wessex Region, responsible for clinical delivery, governance and quality assurance across 16 tri-service dental centres which look after the oral health of around 30,000 service personnel. He is also the Armed Forces’ Clinical Adviser on Paedodontic Dentistry, in which he holds an MSc.
A holder of FGDP(UK)’s MGDS qualification, he became an examiner for the MFGDP in 2007 and then a Core Group MJDF examiner in 2013. He has been the elected Board Member for the Wessex and Oxford region since 2016, and is also a Facilitator for FGDP(UK) Fellowship.
He is also a Fellow both of the Faculty of Dental Surgery of the Royal College of Physicians and Surgeons of Glasgow, and of the Faculty of Dental Trainers at the Royal College of Surgeons of Edinburgh, where he recently became an examiner for the Membership in Advanced General Dental Surgery. He also holds an MSc in Medical Education and is a CQC Specialist Advisor.
On his new appointments, Group Captain Richardson commented:
“I feel very honoured and humbled to have been appointed Queen’s Honorary Dental Surgeon, and to have been chosen to be the Chief Dental Officer of the RAF. This represents the pinnacle of my military career.”
Ian Mills, Dean of FGDP(UK), said:
“On behalf of all members of the Faculty, I congratulate Mark on this significant achievement and career milestone. We are privileged to benefit from his immense knowledge and wide experience.”
Sara Hurley, the Chief Dental Officer for England, added:
“Mark’s appointments as CDO (RAF) and Queen’s Honorary Dental Surgeon are fitting recognition for a career dedicated to the delivery of exceptional care for an exceptional patient population, as well as his broader contribution to continuing excellence in training”.
ADAM and specialist dental accountants Hazlewoods are working in partnership to produce their annual survey looking at current pay rates. The aim is to gain a better understanding of current rates of pay within the dental sector and provide participants with a benchmark against others in their region.
One lucky respondent will win an iPad and one year’s subscription to ADAM. To be entered into the prize draw your survey must be received by 30 November 2018.
Take part here – https://www.surveymonkey.co.uk/r/G92TFBG
www.hazlewoods.co.uk / @Hazlewds_Dental
DPAS Dental Plans has welcomed a new member to the team, with Leanne Rose joining them as a Business Development Consultant.
Leanne, has six years’ experience in NHS and private practices with roles including Dental Nurse, Treatment Coordinator and Practice Manager. She has a wealth of practical experience in building the online presence of practices, increasing the number of patients on plan and training staff on the patient journey.
She has joined DPAS’s team of Business Development Consultants who are dedicated to providing personal support, training and encouragement to help practices grow their patient numbers.
Leanne, who is covering the North West region, said, “I am passionate about using my experience in dentistry to help practices grow their plan numbers and create a solid foundation to further build their business.
“I’m already beginning to feel like an extended member of the practices’ teams, and with my background I can relate to the challenges and opportunities they’re facing as I have been in the same situations so can share advice I know works.
“The opportunity to become part of the DPAS team was perfect for me. I have already begun to enjoy visiting our practices and learning about the different approaches they take and sharing that best practice with others. I’m looking forward to building long-term relationships with all the dental teams under my care.”
For more information about DPAS visit: http://www.dpas.co.uk/
FGDP(UK) rejects amalgamation of regulators
The Faculty of General Dental Practice UK (FGDP(UK)) has responded sceptically to proposals to cut costs by amalgamating the UKs health regulators.
In response to a consultation by the Department of Health, it says it is not convinced that combining dental regulation with that of other professions could save money while retaining the required understanding of the dental professions, and that in the absence of evidence to the contrary, the interests of patients and the profession will best be served by the continued existence of a regulator dedicated solely to dentistry.
The Faculty says that decisions on the regulation of health professions should instead be guided by the risk of patient harm, and that as such there can be no optimum number of healthcare regulators. It also suggests that as the UK has over 70 regulators, including four for social care, and six each for legal services, financial services and privatised utilities nine regulators for healthcare, covering 1.5 million professionals in 32 occupations, does not appear excessive.
FGDP(UK) also expresses concern over proposals to create a single adjudication body for fitness to practise, a single register of all health professionals, and a single set of standards in lieu of profession-specific ones, and rejects the suggested use of mediation in regulatory proceedings and proposals for employers to be represented on the General Dental Council (GDC).
However, FGDP(UK) agreed that the currently statutorily-regulated professions should be reassessed to determine the most appropriate level of oversight, and that the regulator should be accountable to the Scottish Parliament, National Assembly for Wales and Northern Irish Assembly in addition to the UK Parliament.
Dr Mick Horton, Dean of FGDP(UK), said:
While the GDC itself acknowledges that there are improvements to be made to the way in which it regulates, it has nonetheless developed specialist knowledge of dental patients and the professions that treat them, each of which exhibit characteristics and contextual factors which are not necessarily the same as those of other medical professions and their patients. In an amalgamated regulator, this sector-specific knowledge would either be maintained at additional cost, or, more likely, lost in a drive to harmonise procedures and cut costs. For these reasons, the onus is on the government to produce convincing evidence that its own stated objectives for regulation public protection, performance management, and professional development and support – would not be all the harder to meet if dental regulation were to be amalgamated with that of other professions.
ADAM and specialist dental accountants Hazlewoods are working in partnership to produce their annual survey looking at current pay rates. The aim is to gain a better understanding of current rates of pay within the dental sector and provide participants with a benchmark against others in their region.
One lucky respondent will win an iPad and one year's subscription to ADAM. To be entered into the prize draw your survey must be received by 31 December 2017.
Take part here – https://www.surveymonkey.co.uk/r/salary-survey-17
www.hazlewoods.co.uk / @Hazlewds_Dental