UK: Dental Brief - Issue No: 2

Last Updated: 4 August 2011
Article by Jenin Khanam

CR Seminar

The CR Dental Team with Nat West and Christies Valuers will be conducting an evening dental seminar on 8th September 2011. We will cover a wide range of topics including:

  • How to approach the bank for finance in the current climate - what dentists should know
  • Goodwill and valuation - how is it calculated
  • Squat practices - a practical guide and tax saving ideas
  • The latest employment legislation and how it affects a dental practice
  • Legal and practical advice on buying and selling a dental practice - including CQC requirements

The Seminar is free, subject to availability. To reserve a place, contact:

Recent Court of Appeal Decision

Shockwaves will reverberate through the dental world following the recent Court of Appeal decision in favour of Warwickshire Primary Care Trust. The court concluded that dentists who were practising as partners and provided dental services under section 35 arrangement (and therefore had protected status) having entered individual contracts with the PCT (despite being entitled to contracts as partners) were not entitled to GDS contracts as partners but only as individuals.

The fact that the PCT insisted that only contracts to individuals were on offer did not affect the legal position. The Court upheld an adjudicator's decision that the dentists should have appealed at the time of the initial offer by the PCT. Instead the individual contracts granted to the dentists were deemed to have been made under a regulation which states "Nothing in this Order shall require a Primary Care Trust to enter into a general dental services contract with any person (whether as an individual or as a member of a partnership) on more than one occasion". Therefore leading to the dentists losing their protected status as the PCT were not required to enter into new GDS contracts on a partnership basis.

Mergers Inc

A combined group of 440 Dental Practice will be operating under one corporate umbrella once the merger between Associate Dental Practices (ADP) and Integrated Dental Holdings (IDH) proceeds.

To address Office of Fair Trading (OFT) concerns that there would be a realistic prospect of "substantial lessening of competition" ADP and IDH have offered to divest themselves of their practices and NHS contracts in nine geographical locations which have been identified as areas of concern by way of an undertaking.

If the undertaking is accepted, the increased market share will ensure that the merged corporate brand will be a force to reckoned with. However whether the merger will bring the emergence of supermarket style/ branded dental service remains to be seen.

Audit Commission suggests £500m in NHS savings

The Audit Commission has suggested that the NHS could save £500m a year by reducing low clinical value treatments i.e. those that are classed as clinically ineffective or not cost effective.

The Audit has listed five categories of low value treatment:

  • Effective procedures where cheaper alternatives should be tried first
  • Effective interventions with a low benefit or low risk balance in mild cases
  • Potentially cosmetic interventions
  • Relatively ineffective procedures
  • Cancelled procedures

Identifying such low clinical value treatment could prove to be controversial and the report will have a significant impact on dental practices. The days of treatments such as cosmetic interventions, some orthodontic treatment, or wisdom tooth extraction may be numbered.

For patients and for the underlying philosophy of the NHS, a more fundamental issue is rearing its head: the widening gap between those who can be treated because they can afford to pay for it, and those who cannot.

Tooth Whitening

Since a House of Lords judgment in 2001 tooth whitening gels have been classified as cosmetic products, which means that they must not contain more than 0.1% hydrogen peroxide.

Any person who contravenes the restriction on hydrogen peroxide content by supplying or applying whitening products exceeding the 0.1% hydrogen peroxide limit faces a fine of up to £5,000 and/ or a term of imprisonment of a maximum of six months.

The supply and application of tooth whitening products has always been controversial and in early May this year the Dental Directory withdrew its tooth whitening products and suspended its supply to dentists following action by the Essex Trading Standard Office. However, after much lobbying Essex Trading Standard Office confirmed that the Dental Directory was able to resume supply of tooth bleaching products with a concentration of more than 0.1% of hydrogen peroxide to registered dentists for chair side use only. The advertisement and supply of home care tooth whitening products is still prohibited.

The Chief Dental Officer, Barry Cockcroft, together with the Health Secretary, Andrew Lansley and BIS Minister, Edward Davey have commenced the internal procedure for proposals on changes to hydrogen peroxide content ahead of their submissions to the European Parliament to consider in July. Hopefully the proposed amendments submitted for the cosmetic directive will reach a resolution sooner rather than later and provide the much needed and much anticipated clarification on dental bleaching.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

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Jenin Khanam
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