Your New Contract Questions Answered
29th Mar 2006
More than 1,000 dentists attended Denplan’s Impact seminars, which took place across the country throughout January and February, to get the latest news about and guidance on the new contract. Here, Denplan's chief dental officer, Roger Matthews, outlines answers to some of the questions dentists asked
If I don’t sign a contract, what happens?
If you don’t have a new nGDS or nPDS contract by 1 April, you cannot work in the NHS. Letters of Intent (proposed by some PCTs who ‘don’t have time’ to complete the contracting process) are not valid. 1 April is laid down in law and cannot be changed. If you wish to enter the ‘pre-contract dispute’ procedure, you will need to have a legally valid codicil to the contract, signed by you and the PCT.
My UDAs are wrong/my contract value is wrong. What can I do?
The Health Department say it’s up to the PCT, so there could be up to 283 interpretations of what’s ‘right’. However, your contract value should equal your earnings in the ‘test
period’ and your UDAs should reflect the work you did.
Issues around practice expansion/new start up or new associates or extended sickness, for example, during the test period, are for the PCT to decide.
What if my PCT doesn’t send me a contract in time?
You should write to the NHS Litigation Authority (www.nhsla.com) by 14 April to state your case. If you do not, you cannot work in the NHS. You would need to apply for a new contract with no guarantee of acceptance.
Do I have the right to a limited (child or child and exempt only) list?
If you had a practice limited to certain groups prior to January 2006 or, in some cases, during the test period, most PCTs will agree to this. But a number of PCTs have said they will not agree to this under any circumstances. If you want to change now, it’s unlikely you’ll get such an arrangement. To move to such an arrangement after 1 April will be a breach of the new Regulations, due to the anti-discrimination clauses.
What about Seniority pay?
If you were entitled to SP under the old GDS, this will continue for two years and then be replaced by a new skill and
performance-based system to be announced. You still need to notify the BSA (old DPB) on reaching your 55th birthday to get the payments.
What about my goodwill?
The value of NHS goodwill will be difficult to ascertain after 1 April. There are already documented instances of practice sales falling through when the purchaser has received no guarantee from the PCT that the contract value will be transferred. Also, the new contracts require the contractor to co-operate with the PCT in the transfer of his/her NHS patients to other NHS practices if he/she decides to terminate the new contract arrangements.
Can the PCT look at my records?
Under the new contract, the PCT, Patients Forums and the Healthcare Commission all have rights of access to your practice. The PCT can look at any records, including patient records, which are ‘reasonably connected’ with the new contract. So that could include bank paying-in books, patient receipts, lab bills, and even private treatment details if they believe that you are not declaring ‘mixed’ courses of treatment. All private treatment must now be recorded on a patient’s NHS notes.
Can I give priority to my registered patient?
Under the new arrangements, no patient is registered. You may refuse to treat any patient on reasonable grounds not related to age sex, gender, race, religion or dental condition, and if you don’t have the ‘capacity’ to see them (how this is defined is up to the PCT!). However, there is no patient list, and patients may apply to any practice with an NHS contract.
What monitoring will be required?
The list is much too long to enter here, but you can find it on the www.denplan.net impact website. For starters it includes;
clinical governance, quality assurance, clinical audit and monitoring, compliance with NICE guidelines, confidentiality and child protection policies, a register of all gifts, complaints procedure and reporting.
Can I still mix treatment for a patient?
Yes, you can, but the patient must sign a new equivalent to form FP17DC, which must be kept with the records. Since all treatment is contractually available on the NHS, you will have to show that the patient has consented to the private treatment freely, and you cannot mislead the patient about the quality of care available on the NHS.
Can I still see my NHS patient every six months?
The NICE guidance on dental recalls is a contractual re-
quirement. Although the Government has not said precisely what this implies, it has said publicly that, on average, patients will be seen every 18 months, as opposed to the current 6 months, and the NHS Patient leaflet suggests that a patient in good health will only need to attend every 1 to 2 years (enabling ‘dentists to see more patients’). It seems likely that this ‘access dividend’ will be enforced more explicitly as time goes by.
What if I complete all my UDAs in the first few months?
You can expect to be investigated! The Government has said – and told PCTs – that it expects dentists to follow the same pattern of provision as in the test year. Whilst there is nothing in the Contract to say that this cannot be done, it is implicit in the new arrangements – if there were no NHS dental availability from, say, January to March 2007, there would be major service issues. You won’t, of course, get paid any earlier – or any more – if you exceed your UDA quota, and it might be that the PCT has reason to apply to reduce your contract value in subsequent years, although this isn’t clear.
What if I don’t complete my UDA quota?
Your contract value for subsequent years will, in all likelihood, be reduced. If you fail to complete the required number of, say, adult (as opposed to child) UDAs that you did in the test period, you can expect further enquiries to be made. If you don’t complete at least 30% of your UDAs by 30 September, the PCT can ‘fine’ you the difference between twice the number actually done and your full contract value. You get this money back only after the year end, and on satisfactory completion of the full quota.
If I don’t take up a new contract, or pull out, what happens to my NHS pension pot?
Your existing NHS pension rights are not lost, but in future years, your pot will increase in line with inflation, rather than using the ‘dynamising’ factor that applies whilst you are still actively in contract.
You would need to talk to your Financial Advisor about this and also consult the NHS Pension Authority www.nhspa.gov.uk.
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