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​Wales: CDO says contract value abatement last quarter stands

20 August 2020

The Chief Dental Officer (CDO) has responded to the concerns we’ve raised regarding the higher rate of GDS NHS contract value abatement in Wales, but declined to revisit the figure.

On 16 July we wrote to the Welsh CDO pointing out that the 20% abatement of the ACV of the GDS contract in Wales for April, May and June was significantly greater than the equivalent in England which was nearly 4% less (3.75%).

This is because the abatement in Wales was based on loss of PCR, whereas in England it was based on the real reduction of costs for labs and materials during the period when practices in England were not treating any patients. However, we pointed out that dentists in Wales had been doing more for less, as practices in Wales remained open during the red alert phase to see some patients face-to-face.

The CDO replied on 13 August. Dr Bridgman said “Practices were notified in March they would receive 80% of their NHS annual contract value monthly payments from April-June 2020; and that performance targets would be suspended. It was acknowledged at the time the funding support offered was not at full contract value but it did reflect wider Welsh Government support available… The decision was made and issued in a timely manner, during a period of great uncertainty.” She further added, “… no future ‘abatement’ or uncertainty accompanied the reasonable financial support offer made. The payments were secure, regardless of past performance. Many practices appreciated the fact that they did not need to worry about paying back funds in future or mandatory redeployment of them or their staff.” In her letter Dr Bridgman makes it clear that there would be no opportunity to revisit the abatement.

We have welcomed the suspension of the UDA targets and diminished clawback for this financial year. But while the Government provision of PPE to NHS contract holders in Wales is also welcome, we consider that the monetary value does not make up for the shortfall.

The CDO has said: “We are currently reviewing arrangements for the next quarter of this recovery year to ensure dental teams are supported and vital dental services are protected. Considerations will include expected reduced laboratory bills and the impact on laboratory services; the passing on of intended staff payments and the needs/throughput of patients.”

The CDO added: “I trust the dental community in Wales will take the opportunity of this ‘target free’ recovery year to test the learning and tools developed by contract reform practices and take the opportunity to experience a new way of working at a more considered pace, with a greater emphasis on care and prevention, rather than repair.”

We highlighted in our evidence to the Senedd Health Committee last month that this situation has caused financial hardship for many practice owners who have had to continue paying their staff 100% NHS income but with an estimated ACV shortfall of 7%. Even now practices are having to manage on 90% ACV, assuming they offer AGPs, so are still having to bridge the financial gap. We will be pressing for a full reinstatement of the ACV in the next quarter.