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Wales: How well are the GDS contracts working?

Blog Author Russell Gidney

Blog Date 25/04/2022

​We've secured clarity on two important issues – no ACORNs in UDA-only contracts and UOA requirements. 


Before Easter, I had the chance to meet with the new CDO, Andrew Dickenson, and made our case for ongoing modifications to improve this year's GDS contract conditions in Wales.


We have been discussing how the default UDA-only contract is going to work with the Government for some time now. These ongoing discussions have also included debating the delivery of the UOAs for orthodontic services.


Following our conversations to move things forward, I am very pleased to report that there have been improvements on both the UDA-only contract, and the delivery of UOAs. 


No ACORNs required with UDA-only contract

We have now established that practices operating the UDA-only default contract can submit the FP17W without the need to include ACORN data. This will mean only using the four data points that relate to Delivering Better Oral Health. These are diet, alcohol, smoking and teeth cleaning with fluoride toothpaste. Reporting on these four areas will now be sufficient to successfully submit the form which will make the process much easier.


"ACORN data points are [now] advisory, not mandatory for practices operating the UDA-only contract"

I recently wrote to Andrew Dickenson to explain why we believe the ACORN is not a requirement for the UDA-only contract. Aside from the time to deliver this variation in working, the requirements of the software used for the ACORN form would mean that from April, a full assessment with 20 plus data points would be required for the FP17W form. Otherwise, it would be rejected. In other words, the ACORN-lite version which was originally envisioned for the UDA-only contract, would not have been software compatible – and without completing the ACORN the data points cannot be accurately completed.


This week the Deputy CDO (DCDO) announced that the ACORN data points are advisory, not mandatory. Those practices collecting the ACORN data while on the UDA-only contract, could benefit in future by having an established patient cohort RAG profile when any new contract is introduced. This is reasonable advice, but it will be up to the individual contract-holders operating the UDA-only contract to decide the future usefulness of the ACORN data while focusing on meeting their UDA target and effectively treating patients.


Clarification of UOA requirements

"We've been clear that there should be a reduction of 5% of the UOAs for the full contract value."

I recently wrote to the CDO making the case that there should be parity with the orthodontic contract regarding enhanced IPC requirements and ongoing COVID effects. We've been clear that there should be a reduction of 5% of the UOAs for the full contract value. I was able to debate the rationale behind this with Andrew Dickenson last week. 


The 5% tolerance alluded to in the guidance from the DCDO allows for individual LHBs to apply an abatement to the contract – meaning a 95% contract target with the usual tolerances. Based on this, I would advise any orthodontic contract holders who feel their delivery is affected by COVID in any way, or who are concerned about fulfilling 100% UOAs, to speak with your LHB contract manager to negotiate a similar position ASAP. 


BDA support

Practice owners are getting in touch with our Advice Team as they work through the many issues presented by the two contract options, including how to arrange payment of associates going forward. For our Expert members, the associate agreement template is available to support this process. The UDA-only template has now been clarified regarding the ACORN requirement.


We will keep you updated with developments and intend to run an open evening in early July. We hope this will be an opportunity for reflection to help in preparation for the mid-year reviews with the Health Boards.


If you would like to speak to us, or have any questions about the contract options, Extra and Expert members can contact our advisors for one-to-one advice by calling 020 7935 0875 or emailing advice.enquiries@bda.org.



 

Russell Gidney

Chair of the BDA's Welsh General Dental Practice Committee