Key Stakeholder Group Note of Meeting 11 December Chief Dental Officer, England. Chief Executive, British Dental Health Foundation

Transcription

1 Key Stakeholder Group Note of Meeting 11 December 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 Nina Mackellow John Milne Linda Wallace Dr Mark Shackell Paul Langmaid Andrew Powell- Chandler David Lye Helen Miscampbell General Dental Practitioner / Chair, Federation of London LDC Specialist Orthodontic Practitioner / Executive Secretary, British Orthodontic Society Social Policy Officer, Citizens Advice Citizens Advice General Dental Practitioner / General Dental Practitioners Committee of the British Dental Association Director of Professional and Advisory Services, British Dental Association. Consultant in Dental Public Health, Essex Public Health Resource Unit, East of England Strategic Health Authority 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, DH Head of Strategy and Parliamentary Business, Dental Services, DH 1

2 Victoria Jeffreys Dental Reforms Policy Manager, Dental Services, DH Apologies David Peat Catherine McLoughlin William Burns Chief Executive, East Lancashire Primary Care Trust Chair, Age Concern, England Lead dental analyst, DH 1. Welcome and apologies The Chief Dental Officer (CDO) welcomed attendees to the meeting and noted apologies from David Peat, Catherine McLoughlin and Billy Burns. 2. Note of last meeting The note of the last meeting had been previously agreed by , and placed on the DH website. 2.1 Update on Actions CDO went through each item on the action list not on the main agenda including: Dentists without VT numbers: CDO updated the group on the outcome of his meeting with the Post Graduate Dental Deans on 13 October. This meeting agreed that deaneries will advise PCTs (on a case by case basis) to provide dentists with VT numbers unless the required account of the dentists recent experience and CPD suggests significant deficiencies. KSG members were content with this outcome and it was agreed that item is now closed but may be raised again if members come across practice that appears inconsistent with this approach. NHS Pension Scheme: - CDO set out the issues as set out in his earlier . Apart from the inherent complexity of calculating the NHS commitment of staff working in mixed practices, any request to extend the NHS pension scheme would need Treasury approval. In the current economic climate, DH view is that the Treasury is highly unlikely to agree to extend the NHS pension scheme to include dental practice staff, and further increase the public liability. DH agreed to bring the issue back to the July meeting for review. Electronic Signatures: CDO noted and summarised the information previously circulated to the group: Early discussions with system 2

3 suppliers suggest this is technically possible. Counter Fraud Services are now looking into the legal and security aspects. The lead on this item will be the new Dental Information Governance Group, which is meeting for the first time in the New Year, as part of its more general lead on security issues. The KSG will be kept updated. Urgent treatment guidance this action is not a priority at the moment, but it remains under review for the longer term. 3. Commissioning/Performance 3.1. Access and national position/latest data David Lye summarised the latest activity data and national actions on access: Numbers of patients seen continued to reduce in the latest two-year statistics. However, commissioning and courses of treatment delivered were up year-on-year. In addition, the Department is further increasing the priority given to increasing dental access as set out in the Health Select Committee response of 7 October. Since then a decision had been taken to set up a national access programme to build on the work PCC are already engaged in supporting PCTs to commission for access and quality. Details are likely to be announced in the New Year. The year-on year increases in commissioned activity and courses of treatment together with the increased NHS focus on improving access gave confidence that data on the numbers of patients seen would start to turn round very soon Emerging trends and themes from the vital signs David Lye explained to the group that five clear themes had emerged from the vital signs work that the Department had undertaken with SHAs, where dental commissioning needs to improve: Ensure PCTs spend their allocations in full Tackle under-delivery against contract by dentists Tackle inappropriate re-attendance rates, which allow dentists to achieve their contracted activity but effectively block access for new patients Use competitive tendering where appropriate to commission more costeffective services Increase the resources and skills of dental commissioning in PCTs Chris Edmonds confirmed that providers will shortly be receiving a vital 3

4 signs report very similar to the one being provided to PCTs. This report will be sent to providers quarterly just after it has been provided to the PCTs. He informed the group that RAG (red, amber, green)status indicators are also being developed for PCTs but stressed that these will need to be subject to local interpretation by PCTs and that something marked red will not automatically be a problem. David then invited comments from the group: Henrik Overgaard-Nielsen asked what happens to unspent dental allocations. CDO clarified that unspent dental funding has not to date been recouped centrally by the Department, but has remained with the PCT. 4. A Review of NHS Dentistry in England CDO welcomed Professor Jimmy Steele of Newcastle University to the meeting, and explained that he had been appointed as an independent chair of the review of NHS dentistry in England. Prof Steele s team will consist of: Eric Rooney, Consultant in Dental Public Health, Cumbria PCT, Janet Clarke, Clinical Director of Salaried Dental Services, Heart of Birmingham Teaching PCT and Tom Wilson, Director of Contracts, Milton Keynes PCT. Prof Steele explained that the terms of reference for the review were in the process of being finalised but set out the broad scope of the review as follows: Identify ways the Government and local NHS can work together with dentists and other providers to increase access to NHS dentists and improve quality of services; Suggest how the Government can build on its work to reduce inequalities in oral health and ensure that dentists and other dental professionals can provide appropriate levels of preventative work; Recommend how funding for dentistry should be allocated to Primary Care Trusts according to the size and particular needs of the local population; Identify how, over the next five years, developments in workforce planning, training, and regulation can best support the provision of high-quality dental services and enhance the working lives of dental professionals; and Recommend how the Government can best address the issues raised in the Health Select Committee s 2008 report on dentistry including looking at trends in complex treatment in the context of clinical needs and priorities and the suggestion that more treatment bands are introduced. Prof Steele confirmed that the KSG would have a formal role in the review as its stakeholder group. The preliminary findings and direction of the review would be considered at the next meeting and more informal 4

5 contacts made between now and then with members. He agreed to circulate the full terms of reference once these were available. He confirmed that the review was expected to report in the spring of next year. ACTION DH to circulate the review terms of reference and desired outcomes to the KSG. DH 5. Welsh Update Andrew Powell Chandler updated the group on the outcome of the task and finish review in Wales. The key findings included: There was no appetite for a major change to the new system among dentists in Wales the general view was that the current contractual framework was workable, subject to certain amendments. A consultation exercise following the review confirmed this. The WAG Health Minister then reconvened the review group to look at the findings of the consultation, and prioritise the recommendations. A further report has just been submitted to the Minister. CDO Wales reminded the group of two other developments affecting NHS dental services in Wales. As of 1 January 2009 the Private Dentistry (Wales) Regulations 2008 come into force, regulating private as well as NHS dental practices. This and the implementation of the review is against the background of the wider reorganisation and amalgamation of the Welsh Health Boards. 6. Quality 6.1. Clinical Data Set CDO updated the group that information from the clinical data set continues to be collected and the quality of the data is improving Clinical Outcomes and Effectiveness Group (COEG) CDO informed the group that the Clinical Outcomes and Effectiveness Group had had their first meeting on 17 November. The key focus of the group is ensuring access to a quality NHS dental service. The group had become quite large, as there was much appetite from stakeholders to be involved in this work, so smaller topic focused sub groups have been set up to focus on particular issues. Work in this area is still in its early stages, and DH will continue to keep the KSG informed of progress. 5

6 7. Patient information 7.1. NHS Identity CDO informed the group that the technical guidance is now complete and is available on the DH website. There have been around 2,000 hits and 80 downloads so far. There are encouraging sign that PCTs are beginning to use the use of the NHS logo as part of their new contract specifications. During the subsequent discussion: John Milne questioned how new signage should be funded. CDO confirmed that NHS signage is a valid use of a PCTs dental allocation Patient Leaflet Liz Phelps reported that the sub-group had met that morning to consider a second draft of the patient leaflet. A third draft incorporating the comments made at that meeting will be circulated for comment. Liz Phelps went on to explain that the document is now more of a longer booklet, and contains myth busters such as scale and polish only being available privately. Issues for consideration included whether the information on patient charges and complaints should be made into a separate leaflet and whether the value of more information was outweighed by the risk that too great an amount of information would deter patients from reading it at all. The following points were made during the subsequent discussion: The full KSG group should see the third draft of the patient leaflet. Liz asked DH to ensure this was circulated as soon as possible to allow maximum time for comment. There is a need to better inform front line practice staff including receptionists of NHS patients rights this document could be a good start. ACTION DH to circulate the third draft of the patient leaflet to the KSG for comment as soon as possible. DH 7.3. Mystery Shopping of PCT Helplines Exercise Liz Phelps introduced her colleague Nina Mackellow who worked on the mystery shopping exercise to inform the group of the findings: Nina Mackellow first drew the group s attention to the fact the exercise did not cover a representative sample of PCTs, as 6

7 CAB are only in a position to ask for the cooperation of individual bureaux, rather then instruct them. The exercise involved a CAB member calling a dental helpline for information about available services, and then, if given the details of one or more dental practices, making a follow up call to make an appointment. 79 responses were included in the survey, across 55 PCTs. The majority of mystery shoppers (72%) reported that their calls were either useful and / or provided them with the information they needed. However, callers were less satisfied in areas of shortage not just because it was not possible to get an appointment with a dentist, but also because of the service they received from the helpline. Leaving details on an answer phone was seen as an unsatisfactory way of registering on a waiting list and answer phone messages that give no indication of who will contact you or when were particularly unhelpful. Dental helplines need to keep informed of new commissioning to give callers an idea of the length of possible waiting lists, and keep up to date as existing practices open and close their lists. It is also important in the CAB s view to give the caller wherever possible, the choice of dentist, rather than just offering a single contact number. During the subsequent discussion: CDO thanked Nina Mackellow and Liz Phelps for the very valuable piece of work, and asked what CAB intended to do with the report. DH would be happy to put the report in anonymous form on its website. Liz Phelps confirmed that this would be welcome and that CAB would like DH to share the lessons learnt through the exercise with PCTs. ACTION DH to put the report on its website and discuss with CAB the most appropriate way to disseminate the lessons learnt from the mystery shopping exercise to PCTs. DH/ CAB 8. Workforce MEE will be regularly monitoring workforce planning issues. 9. Orthodontics Chris Kettler asked for an update on the ongoing action of publishing orthodontic data, in a similar manner to how general dentistry statistics are published. DH confirmed that this action is still on track, the Department is in 7

8 discussions with the Information Centre for Health and Social Care about the most appropriate way to do this. CDO noted that this was Chris Kettler s last KSG meeting as BOS representative and that his successor will be Richard Jones, Chairman of the BOS Orthodontic Practice Committee. CDO and the group thanked Chris for his contribution to the work of the KSG. 10. Media Update The KSG agreed that it was no longer helpful to spend time on this item. ACTION DH to remove media update from future agendas. DH 11. AOB Chris Edmonds informed the group that the tendering process for the re-let of the current dental contract support services and a new IT system was now down to two suppliers, Capita and CSC, in partnership with RRD. The new contract go live date is likely to be 1st July 2010 and it is intended that the new IT system will be developed in 2010 in time for implementation in the financial year 2011/12. Liz Phelps asked for an update on the action to identify an additional PCT representative for the group. DH confirmed that this work is ongoing. ACTION DH to identify a PCT representative to join the KSG. DH 8