LDC Chair Annual Report - presented at the AGM 11/6/24

Welcome to the AGM of Lincolnshire LDC. As always, it is good to see both new and familiar

faces and I hope you find tonight’s meeting informative and interesting.

Firstly, we would like to offer our congratulations to Jason Wong on his recent appointment

to the position of Chief Dental Officer for England. Jason was Secretary of Lincolnshire LDC

for 16 years and is still an active member of the Committee. It is a great personal honour for

Jason to have been selected for this role and it is well deserved appointment. In today’s

dental climate, there will be many challenges ahead, but Jason’s background in general

practice, LDC, and much more will stand him in good stead. I hope we will all support him in

whatever way we can.

An up-and-coming General Election is focusing minds, and the NHS, with all its problems,

will be a major topic of discussion. Lack of access to NHS Dental care is nationwide and

there is no need to dwell on the effects this is having on NHS care in Lincolnshire. Dentistry

continues to increasingly feature in local, national and social media, with the need for

Contract Reform to secure the existing NHS workforce always to the fore. We hear stories of

DIY Dentistry and contract hand backs, leaving large areas of the country without access to

NHS Care. Both major parties promise additional NHS appointments, but without an

adequate workforce, it is going to be difficult to see how they can do this effectively.

At a local level, there is a significant body of work going on behind the scenes. A year on

from its inception, the ICS/ ICB continues to develop. Dentistry is well supported, and links

developed over many years are strong. The dental voice is heard, and we are very much

integrated into the various key structures and committees within the ICB. This, I may add, is

not always the case in other areas. A disappointment was that claw-back money was not

ring fenced for the last financial year, as promised. This affected all the ICB s within the

Midlands area.

We were delighted to welcome Anna Ireland to the position of Dental Public Health Consultant for Lincolnshire. Anna was formerly national lead for Dental Public Health but has

taken a step back from this role, to work part time. Anna has recently completed the Needs

Assessment for Lincolnshire, and this will be published in due course for you to see. The Lincolnshire Dental Strategy continues to develop. We are the only area in the Midlands where this has been sanctioned, with our four key themes being Workforce, Access, Prevention and Integration. The challenge, however, is to translate the discussion into meaningful ways to benefit our patients and our dental teams.

Workforce continues to be a dominant topic as without a substantive, suitably trained workforce, it is very difficult/ impossible to deliver Access, Prevention, and Integration. You may remember last year I went to Kerala in India to make links and to look at possible recruitment opportunities. At that time, it took some 4-5 years for a non-EU graduate to get a performer number to work in UK. Our group therefore made two recommendations to the GDC. The first was to increase the number of places for ORE 1 and ORE 2 and the second was to introduce a third category of registration, namely Provisional Registration, to allow graduates under supervision to treat patients in Primary Care. It was pleasing that both proposals were accepted with a consultation document currently underway for Provisional Registration. As regards all the legislation that goes with such a change, it might be wise to adjust our expectations and consider Provisional Registration as something for the future rather than the present.

We are aware that in Lincolnshire we have a significant number of overseas qualified dentists currently working as therapists, hygienists and DCPs. This is borne out by NHS data which shows that, percentage wise, the delivery of NHS care by DCPs in Lincolnshire, is one of the highest in the Country. The LDC understands the frustration caused by the delay in allowing Hygienists and Therapists to supply and administer specific medicines under exemptions. Hopefully a resolution is forthcoming, but the issues surrounding this seem to have been going on for some time. The LDC would like to reach out to this particular group, but we seem to be struggling with a lack of engagement. Something we, and WT & E (formerly Health Education England) would like to address. So, if you are a DCP reading this, and qualified as a dentist, we would appreciate it if you would please contact lincsldc@gmail.com

The LDC continues to receive feedback from many sources on the lack of provision of NHS

orthodontics in Lincolnshire. We have communicated our concerns many times to the ICB

and also at the regional level and highlighted the obvious disparity between our service in

Lincolnshire and other areas in Midlands. Our workforce in Primary care is small and a

further concern is the age of those providing NHS orthodontic care, with many of our

practitioners at retirement age.

In February, we finally received the long-awaited Dental Recovery Plan. The plan links to the

previously published NHS Long Term Plan. The key features are a minimum UDA Rate of

£28. A patient premium to encourage dentists to see patients who had not been seen for 2

years. Golden Hellos and Dental Vans in areas where access is reduced. A focus on prevention / tooth brushing for children and a consultation on Fluoridation of water supplies. Individuals will have their own view, but from a Lincolnshire perspective, 43% of practices will benefit from the uplift in UDA rate. This is significant, as it compares to a national average of circa 10 %........... which shows just how far behind the curve we have been. A step in the right direction admittedly, but in a marketplace eager to retain and recruit an NHS workforce, we must be, not just competitive, but also innovative and focused on local need…………More difficult when funding is limited. Many of these changes have only a 13- month time frame and as a result make long term planning and investment a challenge.

A real positive is that our proposed Centre of Dental Development is progressing. The ICB

have recently appointed a Project Manager, Susie MacPherson and you will get the chance

to meet Susie as she is giving a presentation at the AGM.

Four weeks ago, we visited the recently opened CDD in Ipswich. Suffolk University, the ICB

and a Community Interest Company are behind this development which incorporates an

NHS service delivery element as well as a training facility for therapists / hygienists. Their big

advantage, which has made progression from drawing board to seeing patients a reality, is

they had funding secured and also a premises identified within the University Campus.

Suffolk is paving the way and showing what can be done in a rural locality. There is an

ambition to establish a Dental School here in time, but like us, baby steps first. What is

important for us is to establish a support network to reduce the feeling of professional

isolation. Many of the more experienced dentists working in the area have been FDs or

Trainers and Foundation and Dental Core Training are effective ways of retaining dentists in

our area. If you are considering training as an option for the first time, please contact Jon

Farmer or Jennie Ross at WT&E or the LDC. 2022/23 was the first year Lincolnshire had a leadership fellow in Primary Care. Conner Reynolds is the Leadership Fellow for this year,

and I was pleased to attend the BDIA event London in March where Conner delivered a

presentation about life as a Leadership Fellow in Lincolnshire. I am pleased to let you know

that next year we will have two Leadership Fellows based in the County and if you are a younger graduate who might be interested in one of these roles, and wish to find our more, please let me know through the LDC at lincsldc@gmail.com

I know many of you attended our keynote lecture given by Graham Lloyd Jones in March.

Thank you for your support. The feedback we received afterwards was fantastic and a reflection of the quality of the delivery and the thought-provoking nature of the presentation.

The link between oral health and general health has always been there, but the evidence on

how poor oral health impacts on an individual’s general health is now overwhelming. There

is an important role for the dental team to play in educating our patients and other health

care professionals. With an ageing population and limited resources for health care, the focus has to be away from repair and disease to prevention, integration, reducing health

inequalities and putting the mouth back in the body.

We had over 90 people signed up to the event and what was pleasing was that the whole

dental team was represented. Not only that, but we also had representatives from Pharmacy,

Optometry and Medicine, as well as several attendees from the ICB. Online CPD fulfils a

purpose, but a face-to-face course or lecture offers so much more, namely the chance to

meet and interact with others.

Finally, there were a few changes to the Committee this year and we welcomed Kapil Sanghi

and Paul O’Malley. I would like to thank them and all the other LDC members for their help

and support throughout the year. A special mention to Sharon for all of this, and her much

appreciated administrative support and often needed IT skills.

Kenny Hume Chair Lincolnshire LDC