The British Dental Association has warned that dentists in Northern Ireland are not being
kept informed about the upcoming compulsory registration with the Regulation and Quality
Improvement Authority (RQIA) and has called on the organisation to provide dental clinics with
clear, written instructions.

Registration is scheduled to start on April 1, yet so far no dentist in Northern Ireland has received instructions about what the process will involve and what they are required to do.

The BDA is warning that unless the Regulation and Quality Improvement Authority (RQIA) issues instructions soon, the registration process will fail as dentists will not have had time to prepare.

Peter Crooks, Chair Northern Ireland Dental Practice Committee, said:

“RQIA expects dentists to comply with unpublished deadlines, without providing guidance on the key information dentists need to know.

“Far more must be done by RQIA to communicate with the dental profession to enable dental practices to understand the requirements of the legislation, and how to demonstrate compliance.

“The additional administration necessary to meet this new and costly regulatory burden will involve time away from treating patients. For this reason, practices need to be given adequate notice to enable them to prioritise patient care and comply with the requirements.”

The British Dental Authority has expressed its concern about the impact of plans for the revalidation of dentists on the number of patients who will be seen.

The General Dental Council have introduced the revalidation scheme to monitor dental surgeries and their staff, but the BDA argues that the planned measures are bureaucratic and time-consuming, and will cut down the amount of time dentists have to spend seeing patients.

Bosses at the BDA also says that the pilots for the scheme, that were carried out in 2009, did not look at a large enough group of dentists and that more investigations should be carried out into the costs involved.

Chair of the BDA’s executive board, Dr Susie Sanderson, said: ‘It is important that standards for professional revalidation in dentistry are transparent, consistent, and proportionate, and offer reassurance to patients.
‘The BDA supports measures that meet those criteria. We also agree with the view expressed by the Working Group on Non-Medical Revalidation that the intensity and frequency of revalidation must be proportionate to the risks inherent in the work a practitioner is involved in.

‘The BDA supports the work of the GDC as the regulator of dentistry in the UK, but we have some serious concerns about the proposals put forward in this consultation and the wider context in which they have been presented.

‘The circumstances confronting dentistry have changed since these proposals were initially mooted and it would be sensible to look at them again to assess the cost of changes and the benefits they might deliver. We would welcome the opportunity to input into that process.’

The head of the Dental Defence Union in the UK has expressed concern about the proposed revalidation process for dentists.

Rupert Hoppenbrouwers is calling on the General Dental Council to provide dentists and staff with more information about how the system will work and how much it is likely to cost.

In particular, Hoppenbrouwers has concerns about proposals for external authorities to monitor compliance and the rights of dentists to appeal any decisions made against them.

He said; ‘Given the existing regulatory load placed on dentists, most recently the need to register with the Care Quality Commission, we believe revalidation represents another massive change. We accept that revalidation is inevitable and we support the GDC’s intention to introduce it in a way which places minimum additional burdens on practising dentists.’

‘However, in our view, the consultation document does not provide any comfort that the procedure envisaged will have enough safeguards to be sufficiently fair, proportionate, robust, transparent and consistent.’

The Dental Defence Union have highlighted three areas that are of particular concern to their members and dental workers.

Firstly, that the General Dental Council is able to ensure that their external verifiers are completely independent and that there will be controls established to ensure the prices charged by these verifiers are affordable. Finally, legal experts are calling for procedures to be introduced for dentists to report external verifiers they feel are unqualified or unsuitable for the role, without suffering any consequences.

‘In addition, dentists who were removed from the register for not complying with revalidation would lose their career. The process that leads to such a sanction must be consistent with their rights to a fair procedure under Articles 6 and/or 8 of the European Convention on Human Rights. The consultation document does not provide such reassurance.’

Hoppenbrouwers continued; ‘For example, we believe that the GDC must first be seen to have investigated the reasons for a dentist’s non-compliance and be able to demonstrate it was reasonable to take this step. We believe erasure for any reason should only arise after a proper application of the GDC’s fitness to practise procedure.’

A 71-year-old dentist, who has run his dental surgery in Newton Health, Manchester since 1963, says he has been forced to close the practice because of increasing red tape and bureaucracy.

Joshua Maslin’s decision to close his surgery leaves the deprived area of the city without a dentist.

He said: “Every time I dispose of a piece of paper used to package equipment I’ve got to write it down, and that’s just the tip of the iceberg.”

“It’s a million little things that end up costing dentists a lot of time when we could just be using our common sense. I feel like I’ve been forced out by raft after raft of new regulations, forms and inspections which only serve to give you less time with your patients.”

“The thing I love most about my job is helping people, but the endless bureaucracy involved in running your own practice means you don’t get the chance to spend enough time at the coalface, which is harming patient care.”

Mr Maslin said the decision to close his surgery came after the recent announcement that all dentists had to register with the Quality Care Commission, a move that would have cost him £20,000 to make the necessary upgrades.

He said: “I’ve been in Newton Heath for 47 years now and it was an incredibly difficult decision to leave as I’m obviously very attached to the area and my patients. I’ll take away some fantastic memories. I’ve thoroughly enjoyed working in Newton Heath and am extremely fond of my patients.”

“I could have retired a long time ago but I love what I do. As we were packing up one of my patients came stumbling through the door because he’d lost a filling so we unpacked what we needed and sorted him out. It was an emotional moment unscrewing my plaque off the door at the end of the day – it breaks my heart to be leaving, but it was really the only option left available to me.”

Attendees at the recent Local Dental Committees Official’s Day in London have agreed to back the British Dental Campaign against increased red tape in the profession.

The BDA in particular are calling for action about dentists’ concerns in relation to their required registration with the Care Quality Commission. Greater than sixty officers from Local Dental Committees across the UK interrupted the proceedings at the Official’s Day to pledge their support for the campaign, which involves sending a pre-printed postcard to politicians, warning of the implications of too much bureaucracy on patient care.

Chair of the Local Dental Committees, Dr Mick Armstrong, said: “CQC registration is a cause of anxiety for practitioners across England. The ability of dentists to care for their patients is under threat from increasing amounts of red tape. The registration of practices with the CQC threatens not only to increase the administrative burden on practices, but also to rob practices of significant sums of money they could better use in improving patient services. LDCs are proud to back this campaign which calls for a common sense approach that puts patient care first.”

Politicians who receive these postcards from dentists, surgery workers or just those who are backing the BDA’s campaign are being asked to write to the Health Secretary to point out the level of concern that exists within the profession about CQC registration.

In particular, dental leaders are worried that some paperwork already carried out in surgeries will be duplicated by the required registration and are calling for the whole process t be simplified. In response to their concerns, they are asking for the current deadline for registration to be extended so all worries can be addressed fully.

A father and son from Southampton have been found guilty in court of several offences relating to accusations that they were illegally carrying out varying dental treatments at their private surgery in the town.

The father, 65-year-old Barry Newcombe, pleaded guilty in court to treating patients while not currently registered with the General Dental Council. In his defence, Newcombe claimed that he had decided  to continue working as an orthodontist for a short period ahead of his upcoming retirement, even though he knew his registration with the General Dental Council had already lapsed. He was fined £600 for two offences under the 1984 Dentists Act and was ordered to pay costs of £13,000 to the General Dental Council.

Mr Newcombe had enjoyed a long and successful career as an orthodontist in the town for over 50 years before this incident and the two illegal dentistry offences he was found guilty of related to the insertion and fitting of dentures in different patients.

Hi son, Darren Newcombe, who is only a trained dental technician, was also found guilty of “being prepared to practise dentistry” at the same dental surgery in Regents Park Road, Southampton. He was given a conditional discharge by the court but was also ordered to pay costs of £3,685 to the General Dental Council.

GDC chief executive Evlynne Gilvarry said: “People who treat patients without being registered with the General Dental Council are working illegally and we are committed to taking action to ensure public safety.”

The quantity of people in the Grampian, Highlands and Tayside regions of Scotland who are registered with an NHS dentist has increased during the months of June and September this year.

Public health bosses have been working to increase the number of NHS places available for patients, especially those who live in more remote rural regions, where they do not even have access to private dental surgeries. The three areas all saw an rise in the number of new patients finding an NHS dentist to register with, with Tayside the most successful. Now 69.2% of the population in this area are registered with a dentist, with 55.5% in the Highlands and Grampian lagging behind with 49.5%.

Public Health Minister Shona Robison said: “I am pleased that there have been increases in both child and adult dental registrations in the last quarter. “However, we know there are still problems with access to a NHS dentist in some areas of Scotland and we are continuing to tackle this.”

The north of Scotland is still behind the rest of the country as a whole when it comes to the number of people registered with an NHS dentist; across Scotland 70.9% of the population have found an NHS surgery to sign up with.

Ms Robison was full of praise for the individual health boards who have been committed to taking action in order to better the shortage of NHS dental places. The quantity of dental practitioners working in NHS surgeries in Grampian has gone up from 252 to 266 in the same time period covered by the statistics. The oral health and dentistry official for NHS Grampian, Bruce Archibald, warned they still have some way to go, despite 80,000 people signing up for NHS treatment in the area in the last 2 years.

“Too many people still struggle to access a NHS dentist and we are continuing to work hard to address this,” he said.

The General Dental Council recently started a consultation into its planned revalidation programme on October 14. Currently, the GDC’s Fitness to Practice certification assumes that dental surgeries are continuing to meet their standards, unless they receive information to the contrary. Under the new scheme, to be introduced in 2014, surgeries will instead be re-evaluated every five years. It is expected that most dentists and their surgeries will already be meeting these high standards and that revalidation will not affect them or interrupt their ability to practice. It is also hoped that an on-going assessment programme will contribute to further training and personal development within the industry.

The revalidation process will consist of three stages; every five years the surgery will undergo stage one, which involves a compliance check of all dentists at each practice. If a dentist does not pass this initial examination, then in stage two they will be given a chance to improve and remedy any problems the GDC has found. Finally, in stage three, any dentists who are still failing will be assessed further and in greater depth to establish why they have not been able to improve. If a dentist refuses to co-operate with the revalidation process or continually fails the assessment, then the GDC has the power to remove them from the register.

The aim of the revalidation scheme is to protect patients from sub-standard or dangerous dentists and to tackle any potential problems with staff before they become serious. The consultation process which began recently will allow dentists themselves to provide their input on the scheme, by giving their feedback on the criteria for revalidation and the format of the assessments. Dentists will be invited to provide their comments by the GDC, who expect to carry out further consultations in 2011 and 2012 as the revalidation programme evolves.

Two men have been jailed in connection with fraud committed at a dental practice in Droitwich.

Dentist Dr Jaspal Singh Bachada and his accomplice, Ikhlaq Hussain, have been jailed for fraud that was done between 2002 and 2006.

The judge that imprisoned Bachada said he would base the verdict on £25,000 but admitted such a great depth of information had been hidden that it was unfeasible to work out a precise amount.

The two men were uncovered after staff came forward to report concerns about the two men’s actions.

They managed to do this despite intimidation – including an incident when workers removed a PC backup disc as proof and were followed in a high speed car chase.

This ended when they ran with the evidence into a police holding to hand it in.

Police carrying out investigations uncovered absent patient accounts in a garden shed.

The court also heard that a single patient’s accounts had been rewritten with the help of legal representative, Mrs Diljit Bachada, also listed as a dental nurse.

The judge claimed the men had gained ownership of an “impeccably” run dentist in Droitwich, lessened its values, using it to overprice NHS patients.

Reflecting on what had happened, the judge said: “The NHS cannot operate unless it can rely on the honesty of professionals.”

Ikhlaq Hussain, 38, of College Road, Alum Rock, Birmingham, received 30 months’ imprisonment and Dr Jaspal Singh Bachada, 37, of Redlake Drive, Stourbridge, received 20 months

Dudley PCT has called for each man to be taken off the dental register, although Bachada has been in suspension since October 2009.

The duo also face court action to recoup unlawfully attained money.

An NHS Counter Fraud Service spokesperson said: “The patients they deceived included OAPs and people on benefits who should have been exempt from the lower NHS charges, but ended up paying private prices.