How badly must a regulator perform before someone intervenes, asks BDA

Please see below our response to the PSA’s annual report on healthcare regulators which was published on Friday.

26 June 2015
How badly must a regulator perform before someone intervenes, asks BDA

The British Dental Association (BDA) is concerned that the General Dental Council (GDC) has come bottom of the league in an assessment of the performance of nine healthcare regulators, published today by the Professional Standards Authority (PSA).

The PSA highlights that the GDC failed to meet a total of seven of its standards of good regulation.

On fitness to practise, the GDC fully met only one of the 10 standards, and failed to meet six others, representing what the PSA describes as a significant decline in its performance compared to an assessment it carried out in 2013/14.

The BDA notes that the jury couldn’t decide on whether the GDC had met two additional standards on fitness to practise pending an ongoing enquiry by the PSA.

The PSA has yet to comment on whether it considers the GDC’s activities in this area are “transparent, fair, proportionate and focused on public protection”.

Commenting on the PSA report, BDA Chair Mick Armstrong, said:

“Sadly this report makes familiar reading.  Yet again GDC registrants must acknowledge that they are being regulated by the worst health regulator in the UK.  What is worse is that, as far as dentists are concerned, it is now also the most expensive by a country mile.

“The findings in relation to fitness to practise come as little surprise as stories of waste, mismanagement and unreasonable practices abound.

“It is difficult to understand how badly the GDC has to perform before someone actually intervenes.”


(To access the report here’s the link.)

The Monday Morning Quote #324

“Theory with data is blind.

Data without theory are trivia”

Science Blogs – The End of Theory?  via @trishgreenhalgh

The Sound of Periodontitis – a great film produced by EFP.

One of the very few things that I miss about clinical practice is helping patients with gum problems to accept that they have a problem. Being the leader of the team in assisting patients to get themselves back to health and then ensuring that they maintained their health was so a source of great satisfaction.

I often felt that my enthusiasm for treating perio was out of step with a lot of my contemporaries, so much so that I remember using the phrase “Periodontitis – the disease that dare not speak it’s name” at one meeting on crown and bridge.

This film, The Sound of Periodontitis, made by the European Federation of Periodontology (EFP), was launched at the recent EuroPerio meeting – I’m sorry I missed the conference as it seems to have been a great few days.

I wish this film had been available for us 25 years ago. Please share.

Demand and not profitability dominates dental practice values – says NASDA

Demand and not profitability dominates dental practice values says the most recent bulletin from UNW Dental Unit.

The latest NASDAL quarterly goodwill survey, for the quarter ending 30th April 2015, indicates that prices achieved on the sale of some dental practices are more indicative of high demand than the profits that can be achieved.

The highest values are still being commanded by NHS practices, which, in the view of the impending reform of contracts, is illogical, given the uncertainty of the reformed contract, but reflecting the massive surplus of buyers over sellers.

However, private dental practice values appear to be gaining ground. The average goodwill value secured for a private practice was 99% of gross fee income. This compares with a figure of 90% for the quarter ending January 2015 and 88% for the quarter ending October 2014.

Meanwhile, the value of NHS practices continues to outstrip mixed and private practices. The average goodwill figures are 125% of turnover for NHS practices, and 104% for mixed practices. The overall average figure for all types of practice is 113%.

It is very important to note that there were a number of transactions in the survey which varied significantly from the averages, so the survey results should be seen as providing a rough guideline only, and specific practice circumstances must always be taken into account.

The whole document is shown below:

UNW Dental Bulletin June 2015


The Monday Morning Quote #323

“Expect a lot from yourself, and little from others.

A lot of trouble will be spared.”



NHS Confidence Monitor – your voice is needed.

If you are an Dental Professional and you are working under the current NHS contract as either of those demeaning terms provider or performer please take a few minutes to complete the NHS Confidence Monitor.

The first of these surveys was commissioned by Practice Plan at the end of 2014. The results can be seen here.

To have your say, please complete the current survey:

…and then share, it runs until mid-July.


“Which” kicks (NHS) Dentists – so what’s new?…and what to do.

Following on from another Consumer’s Association report.

Dentistry is an easy target for any journalist that wants to have a go at a profession. Let’s face it, from Marathon Man through The Little Shop of Horrors via Lemming of the BDA and Robert Lindsay’s misanthropic, cynical and assistant sacking GDP Ben, dentists tend not to be portrayed as heroic or even that admirable. Add to that they are “associated” with healthcare, historically wield unpleasant instruments of repair and they also dealt with money so are perceived as “money” orientated. Just put “I hate dentists” into Google.

So when a Mangold or a Vine from Panorama or any wannabe sensationalist writer in other media is looking for a story then “teeth” is an obvious way to go.

Is it any different now? Well, the attacks are similar, encouraging the “oo in’t it awful” but the context has changed. I have written about this at some length in the past.

Well yes it is different because the landscape has changed. The Consumers Association did do the recent “mystery shopper” work, I don’t doubt their results, they do have a current campaign about dental charges which has over 19,000 signatures (although some way short of the desired 25,000).

The discredited (but still in post) chair of the GDC does want dentist to be like supermarkets.

The Dental Law Partnership (other ambulance chasers are available) are encouraging complaints. Why? Because there is plenty about which to complain. If dentist didn’t make themselves easy targets they would move on to greener pastures.

  • There has to be clarity in everything that you do, which means that..
  • You need to be squeaky clean about all your communications whether verbal or written, which means that..
  • All team members have to be trained in communication skills and rehearsed, which means that..
  • You have to invest in your team, which means that..
  • If you are looking to “sell” work that isn’t available on the NHS – and please make sure that it isn’t and the patient is in no doubt about it – your well trained team will be able to do that for you, which means that..
  • You will be able to reduce your dependence on an NHS that is running out of money, that measures output not quality of care, that is dangling the carrot of a better contract in 2018 (at the earliest), which means that..
  • You will be able to concentrate on the important things: the relationship with your patients, helping them to improve their dental health so they become people who want all your services, and a practice where you aren’t living in fear of the GDC, CQC, DoH and their works and pomps.

Sounds simplistic? As the research shows, people don’t like dentists in general but do like their own.

People do want to know, like and trust their dentist and team.

They do want to do business with you.

And they do want to send their friends.

The culture has changed, the landscape has altered, the principles remain the same.

It’s up to you to take the initiative.


‘NHS dentists’ not offering NHS appointments – says Which Magazine

Following their report into Dental prices and the ensuing campaign Which magazine has done more research into availability of NHS dentistry. I feel it’s about time that everyone involved with NHS dentistry embraced (to use the buzzword) candour. A whole dose of honesty is needed all round, from government through the profession everyone must be able to agree what’s available (and what isn’t) and under what terms patients are being seen. It will take effort from the DoH – something that has been sadly lacking for the past 25 years and has only got worse since 2006 under the regime of the last CDO, Dr Cockcroft.

Here’s the press release.

‘NHS dentists’ not offering NHS appointments
We ask the Competition and Markets Authority to step in and ensure dentists comply with existing rules, as our new research reveals a third of dentists who say they’re accepting new patients actually don’t, and those that do have lengthy waits.
Our undercover researchers called 500 dental surgeries advertising on the Government’s official website, NHS Choices, as accepting new NHS patients to see if they could book an appointment.

We found the information on NHS Choices is often inaccurate as three in ten (31%) practices turned down our researchers because they didn’t have availability. Of those that did offer us an appointment, 29% couldn’t see us within two weeks, with one surgery saying we could book but we’d be facing a wait of eight to nine months.

We also found practices making people jump through unnecessary hoops before booking an appointment, like visiting the surgery to fill out forms. Some were even asked to pay deposits, and in one case we were told this was non-refundable if we missed the appointment, but neither of these practices is permitted under Government legislation.

Long waiting lists for new patients were also an issue, and we saw one practice that had a list 13 pages long and another that predicted a wait of two years. Some practices also suggested our researchers pay privately to see a dentist, despite our fieldworkers specifically asking for an NHS appointment.

We repeated our research near the beginning of the new financial year to see if the information would improve when dentists got their new budgets, but we actually found an even worse picture. Nearly four in ten (37%) surgeries wouldn’t give us an NHS appointment and around a third (36%) couldn’t see us within a fortnight.

This lack of clarity around availability for NHS appointments is part of a wider issue of poor information and communication in dentistry that Which? has exposed. Our ‘Clean Up Dental Costs’ campaign previously found evidence of dentists not being clear about the cost of treatment or what treatment patients are entitled to on the NHS, which could lead to people paying more than they need to.

These are all issues which the Office of Fair Trading identified in its dentistry report in 2012, yet three years on the sector has failed to deliver on the recommendations made. We are calling on the Competition and Markets Authority to step in and ensure the dental sector complies with existing rules and improves the way treatment options, prices, and appointment availability are communicated to patients.

Which? executive director, Richard Lloyd, said:

“We found it’s frustratingly difficult to get an NHS appointment with a dentist as information about availability doesn’t reflect reality. This is a kick in the teeth for patients and yet more evidence of poor communication from the dental sector.

“We want the Competition and Markets Authority to step in and ensure that dentists put the existing rules into practice so that people can easily find out where they can get NHS dentistry.”

In a separate survey of consumers, we found four in ten (39%) people would use NHS Choices to find a new dentist, highlighting how important it is that the website is kept up to date. It also revealed that 45% of patients who tried to book an appointment with a new NHS dentist in the last year found it difficult and one in five (19%) new patients went without dental treatment because they couldn’t find an NHS dentist.

Which? has some top tips to help you find an NHS dentist:

1.    There’s no need to register with a dentist as you would with a GP, as you’re not bound to a catchment area. Simply find a practice that’s convenient to you – whether near home or work.
2.    Get recommendations from friends or family to help you choose a reputable surgery.
3.    If you can’t find an NHS dentist, contact your local NHS England Area Team, which should be able to tell you about available dentists in your area.
4.    Before you book an appointment, double-check whether you’re booking NHS or privately and how much the treatment will cost.
5.    Be clear about NHS pricing before you see the dentist. Prices should be displayed in the surgery so ask if you don’t see them.

Notes to editors:
To see a copy of the full investigation, please email
1.    Previous Which? research published in January 2015 found:
–      Half (51%) of people who visited a dentist in the last six months didn’t see a price list and one in five (22%) weren’t clear about costs ahead of treatment.
–      A third (31%) of people who pay for dental treatment say costs have put them off having treatment.
–      One in five (19%) NHS patients who pay said they paid more than once charge for one course of NHS treatment over the last two years, when they shouldn’t have.
–      In a separate mystery shopping investigation, half (12) of the 25 visits to a dentist were rated poor or very poor for explaining the difference between NHS and private options and eight poor or very poor for explaining prices.

2.    Our ‘Clean Up Dental Costs’ campaign is calling on the CMA to step in and make sure the sector is doing its job so dentists comply with existing rules. This means that:
·         all dentists make information on prices clearly available.
·         dentists explain treatment options, and make sure their patients know if their treatment is NHS.
·         patients get accurate information about NHS services in their area.

3.     Over 19,000 people have supported our campaign since it launched in January.

4.    The Office of Fair Trading carried out a market study in 2012, which recommended the General Dental Council and NHS England enforce the displaying of price lists and provision of treatment plans, with the Care Quality Commission inspecting compliance. The OFT also recommended that dentists be given the ability to update their information on NHS Choices, and suggested that NHS dentists who are unable to take on new NHS patients be required to refer patients to NHS Choices. Which? believes more needs to be done to ensure these rules are enforced.

5.    Methodology for mystery shopping:
Part one – In March 2015, Which? fieldworkers contacted a representative sample of 500 dental surgeries across England. The dental practice provider profiles on NHS Choices were reviewed, and where they included a link to the practice’s own website these were reviewed too. In addition to checking the accuracy of information on NHS Choices, the fieldworkers also looked at this information on providers’ own websites to look for the availability of NHS appointments. All practices contacted were, at the time of calling, showing on the NHS Choices website that they were accepting new NHS patients. All practices were contacted by telephone during opening hours and fieldworkers asked the practices about availability of NHS appointments. Data were weighted to be exactly representative of all NHS dentists in England by NHS Area Team.

Part two – In May 2015, the fieldwork among 500 dentist surgeries in England was repeated. The sample included the same dentists from phase 1, unless they were no longer offering NHS availability on NHS Choices in which case a new dentist from the same NHS area team was used instead. Part two included some additional questions and data collection from part one.

6.    Methodology for consumer survey: Populus, on behalf of Which?, interviewed a representative sample of 2063 UK adults online between 3rd and 4th June 2015. Data were weighted to be demographically representative of all UK adults.

7.    Regional breakdown:








8.    Best and worst areas for NHS availability:

image 2

The Monday Morning Quote #322

“Do you know the difference between education and experience?

Education is when you read the fine print; experience is what you get when you don’t.

Pete Seeger, activist/musician


Barry Cockcroft joins IDH – caption competition…

The ex-Chief Dental Officer of England Barry Cockcroft is to join the UK’s largest corporate chain of dental practices, IDH – so recently cunningly re-branded as “MyDentist”.

Any suggestions as to what Bazza was saying here?


Screen Shot 2015-02-24 at 21.42.00


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