Danger for NHS Performers

Dental Protection warned today that dentists working within primary dental care NHS provider contracts are currently subject to a postcode lottery when disputes arose with the Trust. Since abandoning the previous nationally agreed procedures that applied to all dentists with an NHS contract number, disciplinary issues are now determined within individual Trusts without any standardised approach and with a variable level of understanding (and hence interpretation) of the new procedures.

Not only does this mean that some dentists are being inappropriately and unfairly treated, but the time spent in resolving procedural inconsistencies is increasingly occupying the time and resources of defence organisations. There have been costly, but important legal challenges. In the long run these become unnecessary costs that the dental profession will be funding through their indemnity costs. This can and should be avoided. Equally concerning is the damage patients may suffer if their access to clinical care is interrupted by such a dispute.

Dental Protection together with its parent organisation MPS, have highlighted this disparity along with several other issues in their recent submission to the Department of Health's Performers List Review.

Kevin Lewis, Dental Director said, "These Performers List arrangements have been put together centrally, but they are falling apart locally". He went on to highlight the following points from the submission;

"These inconsistencies could be reduced by the adoption of a single, national list, with clear criteria and guidelines. A national list would also concentrate expertise and improve the quality of decision making."

"Suspension; contingent removal; conditional inclusion and removal from the list are too blunt and restrictive to adequately deal with the full spectrum of potential contractual, disciplinary and performance matters. We have found that the lack of lesser sanctions has led to a heavy handed and disproportionate approach in some cases. We would like to see a wider and more flexible range of options for PCTs to deal with cases."

"We have seen the power of suspension over-used and abused by some PCTs. Misuse of the suspension power can result in injustice, in damage to the clinician's reputation, career and personal life, and in waste of NHS resources. Suspension is an extreme measure; it effectively debars the clinician from practicing in NHS primary dental care and deprives patients of a valuable service."

"There is a real need for clearer guidelines for judging when suspension is appropriate. This is particularly so now the Court of Appeal has held that suspension from work of a professional person is not a neutral act (Mezey v South West London & St. George's Mental Health Trust). We would also like to see a more robust review and appeals procedure for suspensions."