Audit fear for NHS practices

31 December, 2014

NHS committed dentists are facing the prospect of heavy financial penalties against an entire practice, even if only one of its practitioners fails to complete their clinical audit requirements.

In an NHS committed practice where three out of four dentists have met the audit requirements but one practitioner has not, the NHS Board will have the right to withhold the additional three or six per cent General Dental Practice Allowance (GDPA) and reimbursement of practice rental costs – which could have serious financial implications for practices working to tight margins. (See table)

BDA Scotland says that is unfair and potentially damaging to the profession.

“By withdrawing the GDPA and penalising the whole practice for what might be the failings of one practitioner, we believe this is an overly punitive measure to address an issue which the Scottish Government and NHS Education Scotland (NES) have been aware of for some years,” said Pat Kilpatrick, national director of BDA Scotland.

“In our view, it’s a disproportionate response and is likely to alienate the profession and fail to engender any enthusiasm in clinical audit and the service improvement agenda more widely.”

The number of dentists who could potentially be at risk of the punitive measures and lose the right to receive their GDPA is currently unclear. Responding to a Freedom of Information request from Scottish Dental, NES said it does not hold the requested information, because dentists can choose whether to record their clinical audits with either NES or with their local health board.

Chief Dental Officer Margie Taylor said that efforts have been made to make clinical audit requirements both more relevant and uncomplicated.

“Many dentists have already met the audit requirements. A substantial amount of work has been done by NES and local NHS Boards making achieving the 15 hours audit in the three year cycle as simple as possible, so it should in fact be relatively straightforward,” she said.

“The nationally approved audits have been made readily available and have attracted participation by practitioners across the country and, in addition, funding is in place.”

Draconian penalties

One senior dental practitioner spoke to Scottish Dental on the condition of anonymity, to voice his criticism of the proposed practice sanctions.

“Clinical audit is an individual thing, so it should be the individual who is targeted, not the practice,” he said.

“You could have 10 dentists in a practice and if one doesn’t complete their clinical audit then the principal is stuck with the sanction of not receiving the GDPA. It’s draconian.

“It’s also penalising the NHS committed practices, because if you are not committed to the NHS you won’t lose your GDPA, and they are the ones that can ill afford it.

“Sanctions should have been in place before the clinical audit cycle started, so everyone would have gone into it with their eyes open. It’s fine if you know what the outcome is going to be, but the CDO is going about it retrospectively, bringing in sanctions for the period that ended in Aug 2013.”

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