Chairman’s report This year has been a busy and demanding one for the SDPB, with challenges arising from operational matters and striving to meet the strategic goals that were set in the previous year’s Annual Report. With the SDPB accountable to Scottish Ministers, the change of Parliamentary administration has necessitated that the Board should seek direction on a number of strategic goals and objectives. In that regard the SDPB has met with Ms. Shona Robison MSP, Minister for Public Health. The SDPB continues to hold six full Board meetings per year and has other regular meetings. The Board meets regularly with the Scottish Government Health Directorates (SGHD), the Chief Dental Officer and the Scottish Dental Practice Committee. The Chairman also holds regular meetings with the Director Donald B McNicol and Assistant Director of Practitioner Services and the Senior Dental Adviser Chairman (PSD), which reinforces the robust and open working relationship that the SDPB has with its executive arm. This is reflected in the support and direction that the Board has provided Practitioner Services, for example in providing interpretation of the narrative of the Statement of Dental Remuneration. During the year, the SDPB provided interpretation with regard to orthodontic repairs and extractions of special difficulty. I am pleased to report that the strategic goals from 2007/08 have been met or have been pursued to a position where the goal lies outwith the remit of the Board. The new Statement of Dental Remuneration (nSDR) continues to be work in progress, with the SDPB working closely with the SGHD. The SDPB has consistently sought to establish a central disciplinary mechanism within the NHS in Scotland, and with the formation of the Central Disciplinary Unit this goal has been achieved, for which the SGHD should be congratulated. In October 2007, the prior approval limit was raised to £350, following recommendations made by the SDPB. The Board is continuing to robustly engage with and enact the prior approval regulations and is working increasingly closely with the Dental Advisers at PSD to enforce these regulations, and I make no apology to those practitioners who seek to flout these regulations and find themselves being refused payment. The SDPB continues to develop a “Prior Approval Pathway” to ease the prior approval burden and is developing a mechanism to address prior approval and domiciliary visits. At the beginning of the year, Crawford Gordon retired from the Board, having served two terms. Crawford brought considerable expertise and gravitas to the SDPB, which was reflected when he was appointed acting Chairman for the first quarter of 2005. I wish to acknowledge Crawford’s commitment to the SDPB and the considerable knowledge that he brought to Board meetings. Following Crawford’s retiral, the Board welcomed our new dental member, Miss Laura McCormick. Laura is a partner in a Glasgow practice and is a vocational training adviser. In conclusion I would like to thank my Board Members for the commitment and support that they have afforded the SDPB during the year and for the wise counsel that they continue to provide me with. I would also like to thank Miss Anne Ferguson, SDPB Board Secretary, who has consistently provided me and the Board with a high level of secretarial support with precision and accuracy. Finally, I would like to thank and acknowledge Stephen Goold and his team at the Information Services Division (ISD) for their vision in developing our new-look, web-based Annual Report and for meeting the challenges this has provided, but also for the continued support that they provide the Board throughout the year. Donald B McNicol BDS, MFGDP(UK), MGDS RCPS(Glas), FFGDP(UK) Board observation and comment Practitioner Services (Dental) PSD performed at a consistently high level during the year, and the SDPB continues to have a high degree of confidence in our Executive arm. In that regard, I wish to thank Brian Cowie and his staff for the sustained effort that they have afforded the SDPB and practitioners over the year. Key performance indicators continue to be met and reviewed: for example, targets for prior approval turn-around within 10 working days are consistently met by the Dental Advisers and the Prior Approval Team, thereby providing an excellent level of service to both practitioners and patients. The Board and PSD continue to work together to assess and review the performance and delivery of service to practitioners. This service consistently delivers accurate and timeous payments, which has allowed the Board to look more closely at issues around governance and the patient outcome. The SDPB will continue to robustly support PSD when the proposed treatment or treatment outcome requires to be challenged. From this perspective, I wish to congratulate John Cameron, Senior Dental Adviser, for the significant work he has done around governance within PSD and for successfully negotiating the specific challenges associated with establishing a new post. SDPB remit and function Following on from the “Action Plan for Improving Oral Health and Modernising NHS Dental Services”, the SDPB carried out a review of its remit and function. This complex and demanding piece of work was skilfully led and negotiated by Board members Bob Thomson and Laura McCormick, with their work passed by the SDPB and submitted to the SGHD. From the SDPB’s perspective, it would appear that the Board and its remit and function sit comfortably within the models identified in the SGHD document “Better Health, Better Care”. Annual Report As was the case last year, the SDPB Annual Report reflects the diversity of the provision of NHS general dental health care in Scotland, though this leads to several caveats in how figures are interpreted: it is important for the reader to be aware that a direct comparison cannot be made between the working practices of salaried and non-salaried general dental practitioners, due to a multitude of factors, not least the inability to define whole-time equivalence and the challenges of treating different patient groups and different working environments. It is also important to stress that from “gross fees” practitioners must pay their practice expenses (staff and practice running costs, etc.), which currently sit at roughly 57%. Observations The Board continues to actively pursue quality and probity, where patient safety and the protection of the public purse are concerned. There has been an increase in the number of poor grades awarded by Dental Reference Officers: these have centred around inappropriate diagnosis and subsequent treatment planning and inadequate treatment of periodontal disease; where inappropriate prescribing patterns practitioners have been identified, recoveries in excess of £50,000 have been made. These grades and recoveries are small, though, in terms of the volumes of treatment provided and claims made, and practitioners in Scotland can rightly be proud of the quality of service that they provide to patients. Encouragingly, rises in the number of people registered with an NHS dentist have been reported during 2007/08. The average cost of a course of child treatment has been rising consistently in recent years, and in 2008 stands at £58. While past increases have been linked to the availability of fissure sealants to be prescribed and claimed under the Statement of Dental Remuneration, it would appear the increase in 2007/08 reflects increases in orthodontic treatment. Allowances now make a significant contribution to the fee stream of the practitioner in Scotland. It is important to stress that allowances must be assessed individually, as some are payments to individual practitioners (e.g. recruitment and retention allowances, commitment payments) and some are practice payments (e.g. general dental practice allowance, practice improvement allowance. With there being such emphasis on these monies paid to practitioners, and the criteria to access these allowances, I would wish to thank Lorraine Bagen and her team for their management of these payments, which at times are challenging and emotive. I would like to acknowledge the continued commitment from the Minister for Public Health and the SGHD towards the provision of allowances for NHS dentistry." SDPB strategic goals for the coming year Drive forward implementation of the nSDR Position the SDPB towards a greater proactive role in promoting NHS dentistry to undergraduates, graduates and the profession Develop with partners a strategy to enhance the SDRS and increase patient attendance Continue to develop a proposal for an alternative prior approval pathway Continue to robustly enforce prior approval regulations Seek to promote a mechanism for managing the poorly performing dentist Seek to put in place a robust process whereby patients who have received an unsatisfactory SDRS grade/report may have that treatment rectified timeously, at no cost and with minimum inconvenience to themselves Analyse and determine the effectiveness of selective allowances Produce the Annual Report, 2008- 2009.