SCOTTISH DENTAL NEWS AUGUST 2006
Highlights in this edition:
STATEMENT OF DENTAL REMUNERATION - UPRATING
The uprated Statement of Dental Remuneration (SDR) was issued directly to general dental practitioners on 19 May 2006 and revised fees were backdated to 1 April 2006.
The revised definition of NHS commitment has resulted in around 69% of dental practices in Scotland being regarded as NHS committed. This, in turn, has enabled a substantial number of practices to access new measures of financial support which were set out in the dental action plan e.g. rent re-imbursement, increased general dental practice allowance. Along with the profession we are looking at the treatment of part-time dentists in respect of measuring NHS commitment. More information will be provided as soon as this issue has been resolved.
RENT RE-IMBURSEMENT - £7.3m paid
In the December (paid January) payment schedule and pending full premises valuations we made an interim payment of £3.4m in respect of nominal rent re-imbursement for the financial year 2005-06. Premises valuations have now been completed and a further £3.9m is due to be paid in the July (paid August) payment schedule to complete the payment reconciliation for 2005-06.
For the financial year 2006-07 we are currently finalising the statement of dental remuneration determination which will allow this year's payment to be made. These payments will be made on a quarterly basis.
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GENERAL DENTAL PRACTICE ALLOWANCE - £15m paid in 2005/06
In the financial year 2005/06 we paid over £15m for this allowance which demonstrates our commitment to support independent NHS dental practices.
DENTAL WASTE PROJECT
In the previous issue of the newsletter we advised that a letter would be issued to NHS Boards in the near future advising them of revised arrangements for the management of clinical and special dental wastes. On 12 May 2006 a circular NHS: 2006 PCA(D)5 was issued to NHS Boards advising of the revised arrangements. Details of the new arrangements can be found in the April 2006 newsletter.
DENTAL BURSARY
For the 2006/07 academic year a bursary will be introduced for dental undergraduates studying at the Dundee and Glasgow dental schools. The main provisions of the scheme are to provide £4000 per year of study to dental undergraduates starting in year 2 of the course. The bursary would be provided on the condition that recipients agree to carry out 5 years (or part time equivalent) of NHS dental work in Scotland, beginning within one year of graduation. There will also be a parallel scheme for current students in Year 3, Year 4 and Year 5 who will be eligible for a bursary of £4000 per year of study in return for a 4, 3 and 2 year NHS commitment respectively. The scheme will be administered by the Student Award Agency for Scotland.
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Registration of new dental care professionals
The General Dental Council (Professions Complementary to Dentistry) Regulations Order in Council was made in June 2006. It specifies professions complementary to dentistry which are to be regulated by the General Dental Council (GDC) from 31 July 2006. This will entail the registration of over 40,000 new dental professionals in the UK.
The professions to register with the GDC for the first time are dental nurses, orthodontic therapists, dental technicians and clinical dental technicians.
The exact numbers will be unknown until the new year (2007) but we estimate over 4000 new dental care professionals in Scotland will register.
A substantial number of potential registrants may not have formal qualifications but the Order of Council allows them two years from 31 July 2006 to register. It also allows potential registrants to register on the basis of their experience. The route to registration after this date will be through qualifications only.
Professionals who require further information should contact the GDC to clarify their position. If potential registrants require additional education and training they should register their interest in such courses through contacting one of the NHS Education Scotland regional education centres in Glasgow, Edinburgh, Dundee, Aberdeen or Inverness to ensure that they are undertaking appropriate recognised additional training to obtain registration status.
Courses leading to registration as a clinical dental technician are in preparation but we need potential students to register their interest with NHS Education for Scotland as soon as possible so that we can discuss demand with educational providers.
This is the largest change in regulatory status for dental care professions since the introduction of the Dentists Act. Registration will bring many benefits including improved patient safety and improved quality of care. Further benefits of this legislation will be to allow these professionals to considerably enhance their contribution to dental services and oral health improvement in Scotland in future years.
Dundee Dental Education Centre (DDEC)
Deputy Health Minister, Lewis Macdonald recently opened the Dundee Dental Education Centre. This "state of the art" facility is the first of the larger dental educational centres to open in Scotland. The facility is now fully operational and offers multi professional education for all dental professionals. It also offers undergraduate and pre registration educational support to students of all dental professions.
The clinical skills area provides an educational facility for both postgraduate and undergraduate training and is a focal point of the centre. There are 38 student workstations and one central tutor's station, all have audio and visual links to the tutor's station and can also be linked to the lecture/seminar rooms. A local decontamination centre has also been installed adjacent to the clinical skills unit.
The DDEC houses new state of the art conference and meeting facilities comprising 4 meeting/seminar rooms of varying sizes plus exhibition space, each with the latest audio visual equipment.
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IT
40 Practice Pilot
A questionnaire was issued a number of weeks ago to allow the pilot practices to provide feedback on their experiences of the pilot project. Responses are still being collated but those received to date have been very helpful and will be used to inform the Project Report.
N3 Rollout
Options for the achievement of the N3 Rollout were presented to the National IM&T Infrastructure Steering Group and a small subgroup formed to ensure that the way forward for GDS was aligned with current and emerging national IM&T strategies. The forum has recommended that the rollout be undertaken centrally with regular assessment in conjunction with the IM&T strategies as they develop. Planning of the rollout is continuing with the rollout aiming to commence in September. Detailed plans and schedules will be published once available.
Clinical System
Discussions with SEHD are on-going regarding the options for the procurement of clinical system(s), with various items requiring investigation and resolution before procurement can commence. The high-level requirements document for a clinical system is still under Quality Assurance review with sign-off expected within the next few weeks.
REMOTE AREAS ALLOWANCE
NHS Practitioner Services Division have now written to those practices entitled to the remote areas allowance under the revised definition based on the density of population within the post code sector.
REVISED ACCESS SCHEME
Information on the revised Scottish Dental Access Initiative (SDAI) scheme is still being worked on. However, information on the new scheme should be issued shortly. SDAI's should continue to be submitted under the existing process until further instructions are issued.
DEPRIVED AREA ALLOWANCE
Details of this allowance which will be backdated to 1 April 2006 are still being finalised and will be issued soon.
EMERGENCY DENTAL SERVICES
The Scottish Emergency Dental Services (SEDS) project continues to develop access to dental nurse triage and access to emergency and urgent treatment in partnership with NHS Boards.
The overall approach continues to be one which:
- Builds on existing services.
- Establishes a robust and comprehensive service prior to raising the profile of the national service.
- Stages the development of the service.
access to dental triage through the NHS 24 number.
a standard triage protocol based on Scottish Dental Clinical Effectiveness Programme triage guidelines.
the service through a virtual network, managed and call handled by NHS 24 with triage provided by Dental Nurses employed by local NHS boards in 3-4 centres with locally agreed referral arrangements for emergency and urgent cases.
local in-hours advice lines for routine NHS dental access.
a national network based on a common Information Computer Technology (ICT) platform.
The dental triage service based in Glasgow continues to develop, both in terms of operating hours and the population covered. The service is being extended to provide access to dental nurse triage in the evenings as well as weekend mornings. Following the incorporation of the Clyde element of the former NHS Argyll & Clyde into NHS Greater Glasgow the service has also been extended to patients in the Clyde area, and also the Helensburgh area of Argyll & Bute.
The Lanarkshire triage component also continues to develop and to support the extension of NHS Greater Glasgow and Clyde's service by providing some dental nurse triage cover for Glasgow and Clyde as Glasgow develops its service. This has demonstrated the value of networked dental triage services across Scotland. A number of the existing dental nurses involved in the triage service in Lanarkshire have now received additional training to ensure the continually improving quality of the service.
NHS Fife has extended its dental nurse triage service to provide triage for NHS Ayrshire & Arran's new Emergency Dental Service. This service is an interim service pending the further development of dental nurse triage in the West of Scotland to provide this service more locally.
In the meantime NHS Fife are planning a move to new premises that will provide them with appropriate facilities for their service. Once these have been finalised this will open the way to extend NHS 24's national ICT network to Fife.
In the North NHS Highland are starting a project to develop a pilot for EDS and NHS Grampian are considering the workforce implications of providing a dental nurse triage service in conjunction with NHS 24.
Work has also been undertaken to build on the SDCEP guidelines and to agree a national dental nurse triage protocol or algorithm to ensure common standards. This has been agreed by a group of professionals representing the body of experience in dental nurse triage and is going through an approvals process. It is intended to bring the final version back to the Dental Action Plan Lead Officers' Group for discussion and for consideration of the potential wider application of such an approach.
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CHILDREN'S ORAL HEALTH PROGRAMME
Margie Taylor and Graham Ball (Consultants in Dental Public Health) are currently finalising oral health plans for 2006/07 with NHS Boards in the West and East of Scotland respectively. Financial allocations for 2006/07 have already been made to all Boards, which should enable good progress to be made on delivering oral health programmes.
Key targets are:
- Every child in Scotland to receive a free oral health pack (toothpaste; toothbrush and leaflet) during their first year of life (see figure 1).
- Every child in Scotland to receive two free oral health packs at age 3 and two at age 4 (figure 2).
- Every child in Scotland to receive a free oral health pack on starting school (figure 3).
- Every nursery in Scotland to offer supervised toothbrushing for all 3 and 4 year old children (figure 4).
Achievements:
Based on these data, in the year ending March 2006:
- Nearly 50,000 oral health packs were distributed for children in their first year of life - more than 90% coverage across Scotland
- More than 185,000 oral health packs were distributed to nurseries
- Over 90% children in their first year at primary school received an oral health pack
- The national target of 90,000 children in daily toothbrushing programmes at nursery was exceeded
CHANGES TO SCOTTISH DENTAL FORMULARY
Following on from the changes announced in Scottish Executive Circular 2006 PCA(D)1, the Scottish Ministers' list for dental prescribing has been amended to include Sodium Fluoride Toothpaste, 1.1% for prescription to patients by General Dental Practitioners.
Scotland's Chief Dental Officer, Ray Watkins, welcomed this further addition to the dental formulary and the increased ability of GDPs to prescribe items essential to preventative care.
National Dental Inspection Programme Report on P7 Children
The dental health of primary seven schoolchildren across Scotland has come under the spotlight of the National Dental Inspection Programme (NDIP) with encouraging results.
There is still hard work to be done, but nearly half of all Scottish health boards have already reached or exceeded the national target set by the Scottish Executive. The target states that 60% of primary seven pupils should show no signs of obvious decay experience in any of their permanent teeth by the year 2010. Scotland is the only country to set such a dental target for primary seven children. The fact that six Scottish health boards have achieved this target four years ahead of the expected date shows that good progress is being made.
The NDIP monitors children's dental health in Scotland providing an essential source of information for tracking changes in the dental health of Scottish children, identifying trends and helping in the planning of future dental services with the aim of improving the nation's dental health.
The results cover the school year 2004/2005 and are the first to be published for the primary seven age group, acting as a benchmark against which future surveys can be judged. As well as showing health boards are well on track to meet the 2010 target, the report also shows that the majority of obvious decay experience is concentrated in the first permanent molars, which come into the mouth at approximately six years of age. This again demonstrates the need to ensure that good oral hygiene and dental disease prevention in children should begin at an early age.
The full report can be viewed at: http://www.scottishdental.org/dentalinspection.htm
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DEPUTY CHIEF DENTAL OFFICER
Mary McCann, Deputy Chief Dental Officer, announced her intention earlier this year to return to NHS general dental practice. Having spent almost 6 years in the post as Deputy Chief Dental Officer and having played an important role in the development and delivery of the first year of the dental action plan, Mary felt the time was right for her to return to general practice and to pursue other professional opportunities.
Announcing Mary's departure, Kevin Woods, Head of the Executive's Health Department said the Executive have been very grateful for the DCDO's professional advice and support while in this post and wish her every success in the future. A wish that is echoed by Mary's friends and colleagues.
Chief Dental Officer, Ray Watkins praised Mary's dedication and hard work over the last six years. He and Mary's other colleagues in the Executive wish her well for the future.
NEXT ISSUE WILL FURTHER CONTAIN INFORMATION ON:
- Deprived area allowance
- Scottish Dental Access Initiative
Useful Web Links
Scottish Executive Health Department Contacts
0131 556 8400
Head of Primary Care Division: Jonathan Pryce
Chief Dental Officer: Ray Watkins
Deputy Chief Dental Officer
Dental Branch Staff:
Eric Gray
Senga Robertson
Lynne Morrison
Donna Bryce
Sheila Taylor
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