Launching IDA Wales
Owain Dimmick and Helen Rimmer explain what that led them to forming IDA Wales and outline what the association stands for now.
The end of March 2020 saw dentistry in Wales at crisis point.
Mass confusion of new regulations reigned and an air of helplessness and panic set in amongst dental practitioners across the country.
At the start of the COVID-19 shutdown, the Welsh government, through the CDO Wales, seemed to lead the way. They allowed practices to remain ‘open’ to triage patients; albeit with very limited treatment options available.
This was in contrast to England where a total shutdown of dentistry had been imposed at the instigation of the CQC. At the time, Wales appeared to guide in a cautious but sensible way.
As it became clear other European countries continued to provide dentistry without any issues, Wales, in our opinion, appeared to take a backwards step.
On the 22 May, we were finally given a standard operating procedure (SOP) that was, and still is, a regulatory requirement and not guidance.
In essence, it was a blueprint for NHS contract reform. We believe it presents huge limitations on the provision of dentistry outside of that framework.
It appears practices with NHS contracts were devoid of options: continue with UDAs and operate at a loss, or be paid 80-90% of their previous NHS earnings to triage patients and provide non-AGP emergency care using the newly established hubs for anything else.
This consequently left private practices and mixed practices in a very challenging situation. It also forced us to use an SOP designed for a new NHS contract, making private dentistry untenable.
Over the next few months, private practices began to face a financial crisis and the realisation of possible bankruptcy.
As discontent grew over this imminent disaster, Trevor Ferguson, a past dean of the FGDP, gathered a group of like-minded dentists together to voice their concerns to the Welsh government.
This group was initially under the umbrella of the BAPD (UK). However, as time went on it became clear the issues in Wales were unique to Wales.
Dentistry in Wales is controlled and regulated through our devolved government. They were making it very clear that it didn’t matter what was happening across the border.
Worryingly, it also became clear that other major dental representative groups were not voicing the concerns of independent dental practices across Wales.
At this point we decided as a group to separate entirely from the BAPD (UK) and focus purely on Welsh matters.
Creating IDA Wales
We developed a clear mission statement to guide our organisation going forward: ‘IDA Wales membership is open to all dental practitioners in Wales who provide any form or quantity of independently funded/private dental treatment. Our aim therefore is to represent their views in future discussions with HIW, Welsh government and the CDO Wales, providing a strong voice for the non-NHS aspects of dental provision. We will also support our members in obtaining clarity on and directly influencing any changes within the dental profession in Wales.’
IDA Wales consequently appointed interim chairs democratically-elected individual posts from the active members group. The committee consists of general dentists (majority/fully private, fully mixed and majority NHS), orthodontists, endodontists, implant dentists and facial aesthetic dentists from across the length and breadth of Wales.
We are a not-for-profit organisation and are already gaining ‘seats at the table’ positions with HIW and the CDO Wales. We are pushing for representation and a voice that we feel is absent amongst independent dentists in Wales.
Our main focus at the moment is addressing our latest regulatory document; the Welsh SOP.
It has many unique features which are challenging to operate within. The invention of ‘settle time’ is one whereby dental practices need 15 minutes after non-AGP appointments for the air to settle.
Wales is the only country that requires this.
We can only reduce fallow times to a minimum of 20 minutes with the aid of high output air extractors. No other mitigating factors, such as fogging and air purifiers, are taken into consideration.
The Welsh government also terms dental practices as ‘non-essential medical’. This has significant effects on the timings of the reinstatement of dental services. It therefore potentially leaves dentists vulnerable to future local and national lockdowns.
Key short-term aims
- Gain representation on the clinical leads group that feeds information to the Welsh CDO
- Change the Welsh SOP to an advisory document and not a regulatory one. We should grant the professional respect to make their own clinical judgments, based on their own risk assessments
- Urgent review of the regulations that surround fallow and settle times
- Gain named or specified key worker status for dental professionals and their staff
- Offer rapid COVID-19 testing to private dental practices and their staff.
Dentistry in Wales has never before seen a crisis like this. The ambition of IDA Wales is that never again will we face similar challenges without any representation.
We are the voice of independent dentistry in Wales. We will ensure people who ultimately have control over our ability to practice dentistry in Wales hear us.
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