BDA NI representatives met with Department officials on 7 June for an important exchange at the NI Joint Negotiating Forum to discuss urgent action to address a range of issues impacting heavily on the CDS.
At the meeting, priority agenda items included progressing a Community Dental Services (CDS) workforce review, access to regional Special Care Consultants, prioritising theatre space for CDS and the impact this is having on staff morale, as well as finding remedies to a range of contractual anomalies.
As we await the publication of the Skills for Health Dental Workforce Review, reference was made to a series of workshops which are planned for early autumn, including one on CDS. We are expecting a “Save the Date” notice to arrive shortly.
"Pay has emerged as an issue of concern among CDS respondents."
Pay has emerged as an issue of concern among CDS respondents to our latest Doctors and Dentists Remuneration Body survey, with 54.5% of respondents describing pay as being unfair. The service faces challenges ahead, with a third of the CDS workforce planning to retire over the next five years, and almost 32% planning to reduce the hours committed to the service.
Almost 85% of respondents stated feeling unable to provide an adequate service to patients in the current working climate. Following these results, we made the case that it is vital for the service that we move forward with the CDS component of the workforce review as soon as possible.
Regional Special Care Consultants
"We reiterated that there needs to be a clear plan in place."
Two part time (0.8 WTE) Special Care Consultant posts have recently been advertised for Belfast Health and Social Care Trust. We have repeated the need for the CDS to have access to regional Special Care Consultants at a time when many practitioners are feeling pushed to the absolute limit. Data for Northern Ireland shows that a minimum of between two and three Regional Consultants in Special Care Dentistry are needed to service the population.
We reiterated that there needs to be a clear plan in place to ensure that the CDS can gain access to regional, consultant-led Special Care. Recent figures show that the number of specialists in Special Care Dentistry has now reduced from 17 to 13, exacerbated by most individuals reducing hours and many approaching retirement.
During the meeting, concerns were also raised regarding the lack of a regrading process and the fact that this is not included in the terms and conditions of the CDS contract. The Split Posts anomaly, which only exists in Northern Ireland, was also discussed.
This anomaly typically occurs in situations where an individual is assigned to a split post, which involves carrying out duties as both a Dental Officer (DO) and a Senior Dental Officer (SDO). The problem arises when the dental practitioner is expected to perform the responsibilities and duties of an SDO or DO on specified days, but an issue only an SDO can deal with occurs on a DO day instead.
This misalignment can create significant challenges and frustrations for dentists who either must choose between carrying out the work on DO pay, or make the morally difficult decision to refuse. A resolution is required that ends the worst excesses of this, establishing a system that accurately recognises and compensates dental practitioners, ensuring fairness and equity.
"We have provided the Department of Health with a clear picture of the range of pressures impacting the CDS workforce."
The meeting also saw discussion and proposals around training budgets, which cannot be carried forward from one year to the next. One proposal brought forward is that there would not be a running total of spend against the training budget for each dentist per year to allow for the fact that a dentist may do a lot of training one year, and very little the next.
There was a request to make it clear that the training budget is only to be used for CDS dentists to address training needs as identified via the appraisal process and not for mandatory training. Following this, came a commitment to look at how training budget allowances could be uplifted annually so as not to be devalued.
We have provided the Department of Health with a clear picture of the range of pressures impacting the CDS workforce, and what needs to be done to prioritise staff, and the service. We will keep you updated as we wait to see delivery.
Chair, Northern Ireland Community Dentists Committee