Explain rejection of NICE review, says BDA

The British Dental Association (BDA) is outraged that the Department of Health is refusing to seek NICE guidance on the HTM 01-05 decontamination guidelines for dental surgeries, despite their request.

Susie Sanderson, chair of the BDA executive board, has now written to chief dental officer (CDO) Barry Cockcroft seeking an explanation for his decision to reject a referral of the HTM01-05 proposals to NICE. 

Meanwhile, NICE chief executive, Andrew Dillon, confirmed that the CDO is claiming such a referral is ‘not necessary or appropriate’.

Barry Cockcroft explained that because hygiene regulations change with new scientific evidence, the document is not best suited to NICE assessment but promised: ‘I have made a commitment to review this guidance within the next two years to reflect emerging evidence.’

However, the BDA says there is a need for clarity and says NICE would be the most appropriate body to carry out an evaluation.

Susie Sanderson has since written to seek clarification from Dr Cockcroft – and is asking for the promised grading of the evidence supplied in November as was promised at the time.

Dr Sanderson said: ‘Given the impact of the standards demanded by HTM01-05, it is not unreasonable for the BDA and individual dentists to seek reassurance that its scientific foundations are firm. The Department of Health’s delay first in providing the scientific references, then in the gradation of those references and now its rejection of an objective external analysis, do nothing to offer that reassurance.

‘I have written to Dr Cockcroft urging him to address this issue which is causing significant anxiety in dental practice.’

Dr Cockcroft explained: ‘The HTM 01-05 was first published on the DoH website in October 2008. The BDA first asked for the publication of a list of evidence-based references in October 2009 and a full list of references went out to the BDA on Monday 1 December 2009.

‘As our knowledge improves, we will constantly update it and, as we commission research, we can fill gaps in our knowledge. We are moving towards best practice and it is difficult to put a timescale on it. We want to improve quality of service and we need to see that practices are clearly demonstrating they are trying to improve quality of their processes.’

In his letter to NHS dentists, Dr Cockcroft says that ‘all working drafts were shared with key stakeholders, including the British Dental Association and we have responded to any comments received.’

Looking ahead, he expects dental practice compliance to HTM 01-05 guidance should satisfy the ‘essential quality requirements’ around the decontamination of dental equipment and that the accompanying audit tool (in the form of a CD-rom) will be sent out, along with the guidance, to all NHS practices soon.

Discussing the costs to the dentist, he said that although many primary care trusts (PCTs) are making ‘significant investment’ he recognised that others ‘may not have such a good working relationship with DCPs’ and suggested dentists needed to ‘take interest’ in the regulations as will PCTs when commissioning services from practices.

The BDA agreed with this and anticipated that the contribution of PCTs in meeting the cost of compliance will vary.

They suggest that: ‘Where contributions are made by PCTs, they are likely to be to initial capital funding. The ongoing costs, including staff, consumables and vitally time, will be borne solely by practice owners and will have far greater long-term impact on the viability of NHS dental practice.

A BDA spokesman added: ‘The requirements of HTM 01-05 increase the administrative burden on dentists considerably. The BDA does not assess compliance, but we have been contacted by significant numbers of dentists seeking advice on what the regulations will mean for their surgeries.’

He added that the cost of complying with HTM 01-05 is currently being analysed by the BDA.

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