Chairmans report

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					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.

				
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