NHS contractors have been waiting with bated breath for further details, following the Health Minister’s recent media announcement about a return to normal NHS dentistry from the 1st November. Most of us were taken aback by such little notice, compounded by comments from the Chief Dental officer. The R number is going up all over the UK like it has never done before and we don’t know what the future holds for us from the pandemic perspective. Many major cities in the UK are in Tier 3 and Central belt of Scotland is in severe restriction as we read the PCA.
Where should I start? As a group of committed and caring practice owners we have stood for a strong preventative approach in achieving excellent oral health for the Scottish population. But yet again the approach taken is disease centred…..more treatments rather than prevention.
They have set the period from November 20- February 21 as a monitoring period for the future level of support funding, to be applied going forward from April 2021. This will be measured against the backdrop of the NHS gross from April 19-March 20. Can they have chosen a worse period? With the R number rising in many areas, we enter the normal winter period, topped up by the Christmas holidays and the New year lull, the timing is concerning as it puts many practices in a disadvantageous position.
The average item of service and registration calculations period for historic calculations from April 2019- March 2020 is not clarified as the previous FSM (Financial Support measures) calculations were Feb 2019-March 2020. This needs clarity and the rationale for change.
The model based on a 3 tier system of support is potentially unfair as the level of activity is unpredictable at the best of times, and more so now with patients being extra cautious about making those extra journeys to health care environments unless they have a problem, and add on top the patient number restrictions (10 per day), fallow period , working in bubbles, the list goes on. This will have a direct impact on registrations and item of service activity. We do not know how the registration is measured for every practice during this period. The modelling is intended to provide good financial support to those who have good averages already, and practitioners need to show 20% of pre pandemic output to maintain the 85% of support funding in the longer term. Others will potentially struggle.
What happens to Associates, who are moving or starting new positions, in this period? They need a few months before they find their feet in a new workplace. It would be too much to expect them to walk into the ultra-threatening environment of a new surgery with Covid restrictions, PPE etc, and to have a moderate to high output of work straight away.
We do not know yet anything about GP234 and the impact of the skewed NHS/private mix of these unpredictable times. Will this have an impact on what payment models will be implemented come April 2021.Many practices were providing significant levels of private treatment during Phase 3.
Overall, this appears nice in the short term with practices receiving secure increased payments, approximately 7.8% on top of what they are being paid at present, and thank you SG for sending Santa early. SG must ensure practitioners don’t lose 85% funding through circumstances out with their control and will have to demonstrate continued goodwill to NHS dentists for the service to survive. in a country with one of poorest Oral health outcomes in Western Europe and amongst OECD nations, I hope the future model will be based on prevention and not numbers, am I dreaming?