The day we took NHSE to court

NHSERonuk Vasant tells the story of how he along with three other dental practices took NHSE to court…and won.

Court rooms are almost designed to be intimidating. The formality, the wigs, the unfamiliar language and processes. Nobody really wants to find themselves standing outside a court room, right? However, that is exactly where we, a group of NHS principals, found ourselves in October 2018.

A quick background

To understand what happened, we need to go back the start of the current (2006) GDS contract. Back then, Primary Care Trusts (PCTs) in England could form unique contractual arrangements in different areas to meet local healthcare priorities.

In Croydon from 2006 onwards, the local hospital was struggling with ever-increasing waiting lists for oral surgery procedures. The vast majority of which were surgical extractions on medically well patients, who we could treat in practice settings. The PCT entered into contractual relationships with several local practices. The contract enabled practices to provide minor oral surgery (MOS), or intermediate minor oral surgery (IMOS), services to ease the pressure on the hospitals. The pilot contracts in 2007 and 2008 were successful in drastically cutting waiting lists and reducing NHS expenditure.

In April 2009, Croydon PCT, encouraged by this success, naturally wanted to continue with the concept. Croydon PCT chose three practices, followed by a fourth after a few months, for this. All four practices held existing GDS contracts, and these were amended by means of a contract variation. In common with the rest of GDS services, we all understood this to mean that we had the right to provide IMOS services in perpetuity. The system worked fairly smoothly, and seemed to be a very successful example of the power of local commissioning. But hitherto it was limited to…

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