The Future of NHS Dentistry
I’m just on my way back home on the London to Birmingham Virgin Pendolino, having spent the day with 20 other professional advisers who all work with dentists – they’re accountants, solicitors, practice valuers, financiers, bankers and other Independent Financial Advisers. We all form the Association of Specialist Providers to Dentists (ASPD for short) which was set up to provide a network of specialists who can take advantage of each others skills when we’re acting for a client.
We’ve been discussing PCT’s and the new contract at most of the meetings for what seems like years now and it’ll be no surprise to you that today was no exception. This afternoon we had an excellent presentation from Lester Ellman who you’ll know as the chair of the BDA’s General Dental Practice Committee.
If you’ve heard him before you’ll understand why I might be a little depressed now. Despite the BDAs best efforts they’ve had very little luck getting any positive reassurances from the Department of Health about contracts, transfer of contracts, incorporation, goodwill values, or UDA (units of dental activity) values. It seems that from 2009, despite most GDS contracts being guaranteed (depends if you’ve incorporated), UDA values are not. The DoH have stated they want to harmonise UDA values across the country and regions and with pretty much all PCT’s being short on patient charge revenue (PCR to you), it seems unlikely your UDA value is going to be harmonised upwards.
Lester went as far to say that he couldn’t see a future in NHS dentistry for adults. Now I’m not sure I’d be quite as pessimistic but with his comments and having read all about Eddie Crouch’s Judicial Review on the way down to London this morning, I’m getting more so by the day. In fact if you have a significant NHS contract, or are thinking of buying into one, now might be a good time to get to grips with the reality of what the PCTs and the government is trying to do.
Another element of the problem facing us as advisers and you the dentists is that PCTs are variable throughout the country. Some are happy to negotiate, so if you’re 8% below your UDA target then they’ll let you catch up next year, others will clawback your money before you can say Barry Cockroft. Some will give letters of comfort, if you’re selling your practice, to the potential buyer. Others will want to select the buyer (even if they’re offering less money) based on criteria known only to the PCT.
So what is Lester’s suggestion? He was quite clear on this – start doing private dentistry now. If you need help he’s happy to help you convert. As all advisers will tell you it’s not a simple case of writing to all your patients, you should do it gradually and advise your patients on a one-to-one basis so they can understand all the options available.
And what’s the ASPD got to do with all this? Well, with 26 members throughout the UK we’ve got experience of most of the PCTs and we’re developing a database of which PCTs are reasonable and those less likely to be. We’ve also developed methods of overcoming some of the problems of transferring ownership of an NHS practice.
Despite being a thoroughly depressing hour, I’m reasonably upbeat as there are still many options available to clients. For those dependant on an NHS income though, those options will start to reduce over the next few months so if you’re worried about it - which you should be - start doing something now.
For a full list of the advisers in ASPD please visit www.aspd.co.uk
You can read about the BDA in Amnesty Call in this article in Dentistry on 29th August 2007 - www.dentistry.co.uk/news/news_detail.php?id=772