Key Stakeholder Group Note of Meeting 16 June Chief Dental Officer, England. Chief Executive, British Dental Health Foundation

Transcription

1 Key Stakeholder Group Note of Meeting 16 June 2008 Attendees Barry Cockcroft (Chair) Nigel Carter David Smith Richard Daniels Chris Edmonds Chief Dental Officer, England Chief Executive, British Dental Health Foundation Executive Member, Dental Laboratories Association Chief Executive, Dental Laboratories Association Managing Director, Dental Services Division, NHS Business Services Authority Richard Allott General Dental Practitioner / Chairman Doncaster LDC / Member of Doncaster PCT PEC Henrik Overgaard- Nielsen Chris Kettler Liz Phelps John Milne Linda Wallace Paul Langmaid Andrew Powell- Chandler David Lye William Burns Helen Miscampbell Victoria Jeffreys General Dental Practitioner / Chair, Federation of London LDC Specialist Orthodontic Practitioner / Executive Secretary, British Orthodontic Society Social Policy Officer, Citizens Advice General Dental Practitioner / General Dental Practitioners Committee of the British Dental Association Director of Professional and Advisory Services, British Dental Association. Chief Dental Officer, Welsh Assembly Government (Observer) Community Primary Care and Health Services Policy, Welsh Assembly Government (Observer) Head of Dental and Eye Care Division, Lead dental analyst Head of Strategy and Parliamentary Business, Dental Services, Dental Reforms Policy Manager, Dental Services, 1

2 Apologies David Peat Dr Mark Shackell Catherine McLoughlin Chief Executive, East Lancashire Primary Care Trust Consultant in Dental Public Health, Essex Public Health Resource Unit, East of England Strategic Health Authority Chair, Age Concern, England 1. Welcome and apologies The Chief Dental Officer (CDO) welcomed attendees to the meeting and noted apologies from David Peat, Mark Shackell and Catherine McLoughlin. 2. Note of last meeting The note of the last meeting had been previously agreed by , and placed on the website as usual. 2.1 Update on Actions CDO went through each item on the action list including: CDO noted that the information previously given to the group on the NEBDN s position on training accreditation had been corrected since the last meeting. He reiterated the NEBDN invitation that anyone with concerns about the current requirements make contact directly. CDO clarified that revising the urgent treatment guidance was a longer term issue that would keep under review, and keep on the agenda for future KSG meetings. CDO apologised for the delay in providing CAB and Age Concern with briefing on the sorts of information dental access helplines should provide. CDO invited the group to put forward examples of good or bad practice of out of hours dental care. Helen Miscampbell noted that John Milne, Liz Phelps and Nigel Carter had volunteered for the Patient Leaflet sub group. Chris Edmonds then volunteered a DSD rep (name to be agreed). The sub group will report back to the KSG at the September meeting. It was noted that would consider all suggestions but overall content control remained with. On the issue of dentists without a VT number CDO fed back that he had met the Deans and their view was that the current system should be workable. The view of the dentists present was that the issue was still causing problems for older dentists who wished to move PCT. agreed that this was an important issue but not core KSG business. 2

3 Separate meeting to be arranged for the dentists concerned to discuss outside the KSG with CDO and relevant policy leads. Outcome only to be brought back and noted via KSG. ACTION to provide the patient leaflet sub-group with a framework to enable them to appraise the patient leaflet, and clarify deadlines and objectives of the group etc. to arrange a separate meeting to take forward the issue of dentists without a VT number. CDO to chair. 2.2 National Position/ Latest Data Release Helen Miscampbell summarised the latest activity data set out in the note. The numbers of patients seen has reduced by 0.88 million in the period ending December 2007 compared to the 24 months ending March Commissioning continues to increase, and 96% of all disputed contracts are no longer outstanding. CDO commented that as explained at the previous meeting, the 4% of services that had to be replaced during 2006/07 (equivalent to around 960,000 patients) is still working it s way through the access figures as they are retrospective. The latest data shows that it will take time for the current growth to be seen in these retrospective figures. Helen also drew the groups attention to the Information Centre s consultation on how they record workforce data, which closes on 11 July The group was then invited to comment and the following points raised: However the workforce data is collected, each methodology has is limitations. It also takes up to 18 months for newly commissioned services to get fully up and running. Liz Phelps noted that, while overall activity commissioned continued to grow, activity listed as commissioned and provided appeared to have reduced by 0.2 million between Dec 07 and March 08. explained that this was a data correction (data entered previously in the commissioned and provided column in error) rather than an actual drop. commented that this data return and its guidance were currently being refreshed. is working on projections of when the access data will show in increase in patients seen, based on PCTs using the extra 11% dental funding allocations (net of patient charge income) and allowing for the fact that PCTs will be commissioning a mixture of new and expanded services. 3

4 The reporting period for the patients seen data was set at 24 months to correspond to the NICE guidelines on frequency of dental check ups. A query was raised about whether the termination of child only contracts was affecting referrals nationwide. had advised PCTs that while the strategic goal of moving away from child only contracts was a good one, the process needed to be carefully managed in order to avoid loss of access for children. During a subsequent discussion about child only contracts, a query was raised about whether PCTs are sending out mixed messages to dentists about child only contracts, as some allow them, and some PCTs do not. clarified that is the PCT s duty to decide locally how best to provide NHS dental care to meet local demand. Therefore, when tailoring their commissioning to their local population, it is entirely probable that different PCTs will take different approaches. A further comment was made about whether patients are receiving the right information about seeking another dentist, should their own dentist have finished their contract early. It is after all not in the dentist s interest to send their patients elsewhere, and some may try and see patients privately instead. advised that people unable to receive NHS treatment from their usual dentist should speak to their PCT to enable them to find care elsewhere. This raises issues about the importance of the continuity of care with the same dentist versus the continuity of NHS care. explained that while some people might wish to have continuity of treatment by the same dentist, patients should not be forced into private care in order to receive treatment. 3. Ongoing work programme 3.1 Better Commissioning and Performance a) Access This was covered under the discussion of the latest access data release. b) Update on Metrics David Lye informed the group that SHAs had recently received their first vital signs report, which includes a number of key metrics and measures drawn from PCT management data. This is not publishable or audited data but a summary of PCTs own management data. This report will be produced and circulated to SHAs on a quarterly basis. anticipates that SHAs will share this information with PCTs and use the information to help with commissioning to ensure that the objectives in the Operating Framework are met. 4

5 A first practice level report for 2008/09 will be circulated to PCTs by the end of July 2008, and will include data from the first quarter of the 2008/09 financial year. The group was then invited to comment: PCTs had complained that the previous system for collecting management data was too resource intensive. The new system is more targeted and should prove very useful to PCTs. A query was raised about whether the practice-level information would be shared with the practices themselves. had sympathy with the request, but would need to consider the resource consequences for DSD, which prepares the reports. ACTION to discuss with the DSD the possibility of practices still receiving information from the metrics, as they did under GDS. c) Five Year On Study David Lye explained that although there would be benefits to waiting until the Health Select Committee (HSC) publishes its report on NHS dentistry, in order to meet our commitment to finish the study by the end of the year (that we gave to the HSC) we need to start planning the work now. David asked the group to look at the draft project initiation document and consider whether the document covered all the objectives that the study should cover, whether the exclusions of what s outside the project seemed right, and whether had listed all the key stakeholders that need to be involved in the study. David explained that as the KSG would be the external reference group for the project, would be sending them monthly highlight reports on the project, as well as updating them at KSG meetings. David then invited comments from the group: Nigel Carter welcomed the focus of the study on health inequalities, but pointed out that references to quality and equality in the background section needed clarifying. 5

6 The General Dental Council, although not represented on the KSG, should be given the opportunity to contribute to the study. CDO explained that although is aiming to finish the report by the end of the year, some of the work flowing through it will continue after this point eg the workforce review. There was a call to reflect the original dental reforms objective of improving the working life of dentists within the study. When considering future demand for NHS dental services, people that were currently receiving private care but want to move back to the NHS needed to be counted. There was a suggestion to include someone from LINKS in the study, to ensure patients are represented. There was endorsement from the DLA for the study s inclusion of the issue of creating the appropriate skill mix. The study would need to reflect the plans emerging from the Next Stage Review such as extended opening hours etc. The study would need to reflect issues surrounding public perceptions and information. Areas of high access could still have high needs, as some sectors of the population were not seeking accessible dental care. The study needed to include good value for money. ACTION Correct reference to the GDC in the Five year on Study PID. Clarify the references to quality and equality in the background section of the PID Include an objective in the PID to assess whether local commissioning is enabling the workforce to feel valued. Ensure the five year on study links in with the Next Stage Review. Ensure the value for money is included in the PID s quality section to send group a web link to the HSC report when its published. 4. Quality 4.1. Clinical Data Set The new Clinical Dataset was introduced for courses of treatment beginning on or after 1 April Reports for PCTs and providers were currently being developed. 6

7 4.2. Care Quality Commission As detailed information on the Care Quality Commission had been circulated to the group prior to the meeting, the CDO briefly drew the group s attentions to the fact that the consultation was due to end on 17 June Responses to the consultation from dental stakeholders had been positive so far. 5. Patient information 5.1. NHS Identity David Lye explained that the recent consultation on NHS identity considered whether the NHS logo should be available to be used by any NHS providers wishing to do so, only those who meet a set criteria, or whether it should be mandatory for all NHS providers. received 101 responses to the consultation and are now in the process of analysing them before making recommendations on the way forward to the Minister. The most popular view was that use of the NHS Identity should be voluntary, and not subject to criteria, other than the practice s participation in the NHS. During the subsequent discussion, the following points were raised: committed to release the results of the consultation as soon as practicable, as is keen to improve the visibility of the NHS logo, and want to quickly enable practitioners to use it. The current guidance on the use of the logo was more aimed at secondary care; it might be worth revising the guidance to make it more relevant for primary care. Although the logo is a registered trade mark, there is some flexibility in how it is used. There was a query raised about how the NHS identity work links in with the work on health and social care accreditation. ACTION to consider providing guidance on the PCC website on how the NHS logo can be used and discuss with NHS logo team whether it is appropriate to provide tailored guidance (in the form of top tips on PCC website) on logo use in primary care. Nigel Carter to provide with information on the work he has been involved in on Health and Social Care Information Accreditation Scheme. NC 7

8 6. Orthodontics 6.1. Progress with 18 weeks Chris Kettler emphasised that the British Orthodontic Society were very pleased to have been involved in drawing up the orthodontic care pathway. Chris Kettler went on to say that in terms of access to orthodontic treatment, the main problem areas still appear to be in the North of the country where specialist practices are limited. Chris feared that because of this, in some areas PCTs were raising the bar of the IOTN index. CDO commented that the only dental data that was distinguishable in the 18 weeks data was oral surgery, and as of the end of March 84% of admitted oral surgery patients were seen within 18 weeks, and 29% of non-admitted. Orthodontic data is included in the other specialties category. ACTION to the group the orthodontic pathway. Henrik Overgaard-Nielsen to in his queries on 18 weeks. to respond. HON/ 7. Media Update CDO updated the group on several positive dental stories that have appeared in the local media recently, mostly about new or expanded services. 8. Welsh Update CDO Wales and Andrew Powell-Chandler updated the group with the following: The report following the review of the Dental Reforms in Wales is expected to go to the Minister for clearance before Summer recess. The main review looks at the new dental contractual system, but there is also a more focused review of salaried and community dentists. Work is also continuing on developing a range of indicators other than UDAs, as well as on the Oral Health Action Plan, and the regulation of private dentistry. Wales is currently consulting on the possible reorganisation of health trusts and boards, and whether to establish a civil service type body to sit in between the Assembly and the health trusts. 8

9 9. AOB A review of the Dental Reference Service (DRS) has been completed by the NHSBSA DSD and the incremental implementation of the new working model will start on 1 July 2008, with one Clinical Policy Adviser from the DRS operating in each SHA area. The service is moving towards a risk based model of operation and will be focussing more of its resources to the benefit of PCTs on contracts identified as 'at risk'. Practitioners will be notified of this new initiative via CDO update. Separately the DSD is starting the process to re-let its IT and data capture contracts and expect to advertise the work involved in the Official Journal of the EU ( OJEU ) in the next month or so and the contract with the successful supplier/s will probably be let by the end of summer During a discussion on fluoridation CDO made the point that any decisions to be made about whether or not to fluoridate an area must be made locally and reflect the views of the local population. 9