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Dental contract uplift and efficiencies 2014/15

This information sets out the Secretary of State’s determination on dental contracts and agreements for 2014/15 and the associated NHS England dental quality and productivity measures.

Contract Uplifts

After taking account of the recommendation of the Doctors and Dentists Review Body (DDRB) the Department of Health has decided to uplift all GDS contracts and PDS agreements by 1.6% to allow for a 1% increase in net pay and for other increases in expenses.  This will automatically be applied by the NHS BSA, and no action is required from area teams.  A full list of changes relating to dental contracts is at Annex A.

General

As part of the package of measures for 14/15, the BDA General Dental Practice Committee has agreed to work with us to support our developing strategic aims for NHS dentistry, particularly:

  • To improve the oral health of the population, especially children, hard to reach and vulnerable groups, and to reduce inequalities of outcomes;
  • to move to a more preventative approach based on the needs of the individual patient and the population focusing on:
    – quality rather than activity
    – outcomes of care, especially long term outcomes, rather than delivery of treatment
    – continuity of care for patients over a longer period of time;
  • Increased integration of care across primary, community and hospital settings;
  • ensuring good and equitable access to NHS dentistry.

Efficiencies and other gains

Our efficiency package for 2014/15 is expected to deliver savings across, national and local levels, in line with the rest of the NHS, some 4%, and includes:

  • Reducing costs of unnecessary activity
  • No increase in funding or weighting of courses of treatment to reflect increased complexity arising from demographic changes;
  • Continuation of dental practice computerisation to enable the delivery of the new dental contractual reform proposals;
  • Amending dental payments for maternity, paternity and sickness leave
  • Reducing dental foundation trainee salaries over time to match the first post registration year for doctors to regain a level playing field in this area.

Annex B sets out our detailed efficiency and savings assumptions.

Implications for Area Teams

Area Teams should take account of the national and local efficiencies.  The package is split into two parts:

  • those efficiencies to be delivered by national changes to reimbursement rates, regulations and the Statement of Financial Entitlements, including the changes to Foundation Trainee pay, entitlements and allowances and the tightening of central systems on fraud and activity cycles.
  • efficiencies which will have national support, especially from new systems, information and reporting from the NHS BSA, but will need to be delivered by Area Teams, this includes new measures to claw back funding for under-delivery of contracts and reducing unnecessary referrals from primary to secondary care.

The National Support Team and the NHS BSA will be providing further information and guidance to assist Area Teams.


Annex A

Dental Contracts and Agreements – uplifts for 14/15

In respect to General Dental Practitioners (GDPs), the government has accepted the DDRB’s recommendation for an increase of 1% to general dental practitioners’ income after allowing for movement in their expenses, but has abated the increase in the general dental service contract for the  GDP staff costs element of the formula from the recommended 2.5% to 1%. This results in an overall uplift of 1.6% to be applied to gross earnings for independent dental contractors for 2014-15.

Dental contractors who employ a Foundation Trainee, and satisfy the criteria specified in the Statement of Finance Entitlements, receive a training allowance of £753.46 per month.  This should be uplifted by 1% and the figure revised to £761.00 per month.

Foundation Trainee salaries for current cohorts should also be increased by 1% in line with Government’s pay cap.


Annex B

2014/15 dental efficiency and other gains

Changes Estimated efficiency 2014/15
Local Efficiencies (backed by NHS BSA and new systems)
Reducing costs of unnecessary activity, through new measures to:

  • claw back funding for excessive under-delivery of contract activity;
  • move to a shorter return cycle for activity and performance data (which will also assist in moving to a capitation system);
  • improved anti-fraud measures;
  • reducing unnecessary dental referrals from primary to secondary dental care through increasing activity undertaken in primary care, supported by changes to remuneration structure and changes to reporting and monitoring arrangements.
1.5 to 2.0%
National Efficiencies (no local action required)
Efficiencies from increasing complexity of treatment, without any increases to funding or changes to weighting of courses of treatment 0.7%
Continuation of practice computerisation. 0.2%
Changes in maternity, paternity and sickness pay 0.2%
Reduce Foundation Trainee salary over time by some £2,000 0.2%
Plus efficiency from below-inflation uplift (gross uplift of 1.6%) 0.8%
Total 3.6 to 4.1%

 

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13 comments

  1. Miss A says:

    It’s not just the corporate companies that think this is acceptable. I questioned my principal, about my pay increase and we told that because practice expenses have been Increased I would not be getting it. This needs to addressed by the BDA within the new contract so that the principals can not just pay what they like. They are earning twice the amount of an associate after expenses are taken into account and according to the dental earning figures the associates earnings have suffered more than the practice owners. Something need to be done as moral is so low. Especially with potential increase in GDC annual fee, increases in indemnity, increase in pension payments all way over inflation.

    • NHS England says:

      Hi,

      NHS England now holds contracts with providers of NHS dental services, not all the individuals performing those services, so this is clearly an issue for the BDA to provide guidance to their members.

      They do represent both practice owners, the providers, and individual dentists who don’t directly contract with the NHS, the performers.

      Kind Regards
      NHS England

  2. Distraught bunny says:

    It’s companies like IDH who are profiting from this, not dentist. Not acceptable!!!! They will fill their pockets with fat cat wages and the dentists, I.e the people delivering the work who spent 5 long years studying for it and amassing debts from it are not being recognised and rewarded for it. There needs to be GDC intervention here, they should also be protecting us dentists, not just patients. Get GDC, BDA, indemnity and any other relevant sources to challenge IDH. Yes IDH, it is NOT acceptable for you to be doing this, got enough money to buy Dental Directory, with our money?!!! Disgraceful!

  3. Mr G says:

    Its very true. As an associate I have not seen an up lift in my UDA value since 2009! It seems practice owners are free to take the money that is clearly meant to be given to all performers.

    How can this be allowed. The system is so broken i fear it may never be fixed

  4. Miss K says:

    Are the contract providers not obliged to pass this on to their performers/associates? We have not seen a contract uplift in 3 years now.

    The corporates are taking the extra money and not passing it on to those that are working hard to treat the patients!

    • Mr G says:

      I agree, I have not seen an uplift in my UDA value as a performer since 2009! Whats the point in the uplift when practice owners pocket all of the money for themselves. As a performer my expenses such have lab fees have risen year on year, and I am expected to improve my standard for less and less money taken home each month

  5. Mr R says:

    The reduction of foundation trainee’s salary sounds wrong, since there was no indication of such changes when we were attending our Foundation Training interviews in November. Some people may have chosen to apply elsewhere if this was known. This is a 7% pay cut before we even start. Sounds very unwelcoming to those wishing to embark on an NHS career.

  6. MR O says:

    Last year we received a 1.5% contract increase. All our staff received a 1% raise, but due to ever increasing costs of materials, utilities, indemnity(up 24% this year) amongst other increases, as the contract providers our increase in earnings only went up 0.49%. This increase in earnings was only due to a raise in the amount of private work we do. Without any private patients we would have seen a drop in our income. After a 3 year pay freeze and then two years of these low increases the NHS contractors are being crippled.

  7. Howard williams says:

    Quick comment re referals to secondary care.Presume it is to save money?Suggest someone takes a look at why it costs so much to perform these procedures in secondary care that could be done in primary care for 3 uda,s!
    Either secondary care is ripping off the system or primary care is not rewarded fairly for doing it .
    If you had anyone working for NHS england who faintly understood both sides of the story the system would work,but the whole organisation consists of academics with diplomas in public health or failed general practicioners .

  8. Patrick Holmes says:

    These assumptions presume that the quality of the dentistry provided are maintained. I no longer work under the NHS as I could no longer provide the care which I felt I had been trained to provide, and which patients deserved.
    Nor do they reflect the increase in the amount of paperwork that needs to be generated.
    If you were able to truly concentrate on the quality of the treatment, I am certain that you could destroy these targets. Double the lifespan of a filling, pay 25% more for the provider—happy patient, happy dentist, happy tax-payer.

    • Anonymous says:

      totally agree having spoke to someone who went privatel 3years ago for that reason is now doing amazingly well. The funding isnt there anymore but practices are still expected to fulfil a good service with ever increasing costs.
      It is a shame as after the long training it is putting new dentists off from entering the NHS system.