Salaried Primary Care Dental Service (England): New Contract 2008
ADVICE DOCUMENT
This document has been produced by the British Orthodontic Society Community Group in response to queries from members regarding local implementation of the new contract.
It aims to address the following issues:
- The criteria whereby registered specialist orthodontists, providing a wholly orthodontic service for their employing Trust, should be assimilated onto Band C (Specialist Dentist) rather than Band B (Senior Dentist).
- Failure of employing Trusts to implement the new contract.
- Guidance on job planning and appraisal to support the specialist role under the new contract.
- The Mediation and Appeals process.
- Sources of further help and advice.
For clarity, CG comment is in ITALICS.
ASSIMILATION TO BAND B OR BAND C?
‘Entry criteria: a specialist dentist (clinical) appointed to band C of the scale shall also be on the GDC specialist list for the relevant specialty’. SPDCS (England) Terms & Conditions, Schedule1
Under the terms of the new contract, all previous Senior Dental Officers will be assimilated onto either Band B or Band C.
Band B dentists will be Senior Clinicians within the service who do not have a specialist registration relevant to their post.
Band C dentists will be Senior Clinicians within the service who are GDC registered specialists in the field of practice in which they are employed.
Supporting evidence:
·NHS Employers website
‘The contract includes a new structure for pay and career development to deliver the changes within Creating the Future - Modernising Careers for Salaried Dentists in Primary Care. The key elements are: a new single pay spine with three competency pay bands covering the following groups: dentists, senior dentists (Band B), specialist dentists (Band C) and managerial dentists’.
·SPDCS (England) Summary agreement. Annex 2
Band B competencies (orthodontics): a Band B (‘Senior Dentist’) undertakes appropriate investigations during patient examination to determine the need for specialist advice in the management of the developing dentition.
Are you that source of specialist advice? If so, you should usually be Band C.
Band C (Specialist Dentist)
Competencies for Band C dentists (clinical) are those defined by the Royal Colleges and accepted by the General Dental Council. (i.e. specialist registration)
http://www.rcseng.ac.uk/fds/training/documents.html
European primary and specialist dental qualifications regulations 1998
·BDA website
Specialist clinicians, Band C: will be currently SDO or ACD pay levels
i.e. Band C is not just for previous Assistant Clinical Directors and Clinical Directors.
·BDA website FAQs
Q. I want to assimilate 2 of my SDOs onto the Specialist Dentist Band C scale, but my Trust say they do not have the money to pay these salaries. In my opinion they are both using the competencies of a Specialist Dentist. What can I do?
A. Both would have a right of appeal under the terms of the new contract
Q. I am on a GDC specialist list. I think I should be a Band C specialist dentist, but my PCT have assimilated me onto Band B. What can I do?
A. You should collect evidence to enable you to clearly demonstrate to the PCT that you fulfil the competencies for a Band C Specialist Dentist in your specialty. Your PCT will need to confirm that local service needs & organisational objectives require the specialist post. Speak to the BDA.
Competencies for Band C (Specialist Dentist) can be found in Annex 4 of the Summary Agreement (p.42-44)
Where a registered specialist orthodontist is employed to provide a wholly orthodontic service to patients, and where the job plan and appraisal process supports the provision of an exclusively orthodontic service to patients within the Trust, assimilation under the terms of the new contract onto Band C (Specialist Dentist) should be “an automatic slotting-in process” (Sue Martin, BDA, in conversation with AN).
Exceptions to the rule
·SPDCS Summary Agreement p.11
The employing organization will need to confirm that local service needs and organisational objectives require the appointment of specialists into these posts.
i.e where the PCT does not recognize the need for a specialist service to be provided. (They would have to prove either that such a service is not currently being provided or that it is no longer needed). Also where existing local agreements differ from national Terms and Conditions, see below.
·Primary Care Contracting website
Quality assured Qs and As (agreed between DH, NHSe, BDA)
Where staff are currently on Trust contract Terms & Conditions (local agreements, where they differ from national T&C, shall override the requirements of the new contract, subject to local agreement).
Q. We are looking to set the new contract up for our dentists. Most are on the nationalterms and conditions so no difficulty with them. However we have some on local contracts and some on some 'hybrids' that have elements of the national terms and conditions within them. The question is can we put these dentists onto the new contract (or at least offer it)? The problem is some are on enhanced pay scales that don't match any of the existing pay points. We would aim to assimilate to point 6 which would be lower than they're current pay level. If we assimilate to higher points they won't reach the competencies for these points.
A. As per paragraph 1 of the Summary Agreement, any dentist on a contract that is not the previously agreed national contract or has any form of variation from the previous national contract is deemed as a local contract. In such instances, the Trust and dentist are required to agree any changes locally. There is nothing to prevent the Trust from offering the dentist the new national contract as it stands but this does not have to be taken up and is a matter for local agreement.
FAILURE OF AN EMPLOYING TRUST TO IMPLEMENT THE NEW CONTRACT
‘It is envisaged that all trusts employing dentists within the salaried primary dental care service on current national terms and conditions, or on local contracts based on national conditions, will adopt these new arrangements’. SPDCS (England) Summary Agreement p.4
Supporting evidence
·Primary care contracting website
Q. Is it compulsory for Trusts to implement the new terms and conditions for salaried dentists?
A. Yes, it is compulsory for all dentists on national terms and conditions - or local contracts - which shadow national terms and conditions. See paragraph 6 of the Summary Agreement and paragraph 22 of the AL DOS 1/2008.
Q.What would be the penalties to the PCT for not assimilating the salaried dentists by 1st April 2008?
A.The new contract, including the implementation timescale, was agreed following negotiations between the British Dental Association and NHS Employers acting on behalf of the employing bodies of salaried primary care dentists, taking account of the practicalities of implementation. The Department of Health has approved the implementation of the new contract. The Department’s Advance Letter DOS 1/2008 says, at paragraph 2:
It is anticipated that by 1st April 2008 existing salaried primary care dentists employed on the previously agreed national contract will have moved to the new terms and conditions.
Employing bodies should therefore use their best endeavours to assimilate staff by 1st April 2008, both to meet the recommended timescale for implementation and in the interests of good employee relationships.
PCTs will also wish to remind themselves that the only element of the contract which is backdated is the salary component. It is mandatory that this is backdated to 1st June 2007. However, employers will only realise the other benefits of the contract, including the increased working hours and the appraisal and job planning processes, once they have implemented the contract for all their staff.
JOB PLANNING AND APPRAISAL UNDER THE NEW CONTRACT
‘Career development is central to the success of this contract for both dentists and their employers. To support this, all dentists will be required to take part in the annual appraisal and job planning process. Both the employer’s and the employee’s commitment to this is essential.’ SPDCS (England) Summary Agreement p.14
All SPDCS dentists should have a current job plan which sets out their clinical role within the service. For a registered specialist providing the relevant specialist service this would need to include details of the specialist work provided, relevant specialist CPD requirements, and any referral pathways to that service.
Annual appraisal forms an integral part of the new contract. Where a registered specialist provides the relevant specialist service for the Trust, their annual appraisal should include a specialist appraisal by another senior specialist in the same specialty. Satisfactory annual appraisal is a requirement for moving up pay levels within the band.
Supporting evidence: Job plans
·SPDCS (England) Terms & Conditions 2007
4.10 The nature of the dentist’s personal objectives will depend in part on his
or her role, but they may include objectives relating to:
• competencies relevant to the dentist’s pay band
i.e. specialist competencies if appropriate to the post
• clinical quality
• high quality patient care
• activity and efficiency
• local service objectives
• service development
• management of resources, including efficient use of NHS resources
• multi-disciplinary team working
i.e. orthodontic role within the wider CDS/PDS
Supporting evidence: Appraisal
·NHSe website
An individual’s first appraisal under the new contract will start to introduce the new process by confirming that the employee is meeting the competencies for the level.
·Primary Care Contracting website
Q. Who should undertake the appraisal of Clinical Directors and Band C specialists?
A. A Clinical Director should be appraised by their line manager and Medical Director (or equivalent). Where specialist clinical input is required, it may be necessary to look outside the PCT. Clinical Directors may wish to consider collaborative arrangements with their neighbouring PCTs.
Specialists should be appraised by both a specialist (or consultant) from within the same speciality and also the Clinical Director. Again it may be necessary to look outside the PCT for an appropriate specialist.
If possible it is recommended that both halves of the appraisal occur concurrently with both ’appraisers’ present throughout.
·SPDCS Terms & Conditions
Option for specialty review
5.8 Where it is apparent that a specialist component is an essential part of
the appraisal, the appraiser and the dentist should plan this into the
timetable in advance of the appraisal interview.
5.9 If required, either party may request an internal or external review. This
should be completed within one month and a further meeting scheduled
as soon as possible (within two months) to complete the appraisal
process
If necessary, consider approaching your local Consultant Orthodontist for an external review for specialist appraisal and confirmation of job plan/competencies.
5.10 The results of any other internal or external review carried out will need
to be considered at the next appraisal meeting. This will not prevent the
employer from following its normal processes in dealing with external
reviews.
For Specialist Dentists with an additional Administrative/Managerial responsibility
Q. Has any guidance been issued about the possibility of incorporating management competencies into a specialist competency framework? (For example, where a Clinical Director is a specialist as well as manager.)
A.No.In such circumstances, the Clinical Director/Specialist must agree with their manager a set of competencies applicable to the role identified. Consideration needs to be given to the relative balance between the leadership and managerial aspects and the degree of use of the specialist competencies. Consideration also needs to be given to the complexity of the service and the degree of support for the managerial function that is available to the Clinical Director. These factors should determine the competencies to be included in the competency profile and used at annual appraisal and job planning.
MEDIATION AND APPEALS
‘Where it has not been possible to agree a job plan or a dentist disputes a decision that he or she has not met, the required criteria for a pay threshold in respect of a given year, a mediation procedure and an appeal procedure are available’.SPDCS (England) Terms & Conditions November 2007
The agreed job plan should specify the specialist nature of work undertaken. This underpins the specialist (Band C) pay banding.
Local mediation
6.3 The dentist may refer the matter to the medical director, or to a locally
agreed designated other person (subject to local arrangements). Where a
dentist is employed by more than one NHS organisation, a designated
employer will take the lead. The purpose of the referral will be to reach
agreement if at all possible.
Formal appeal
6.4 A formal appeal panel will be convened only where it has not been
possible to resolve the disagreement using the mediation process.
Further information on the mediation and appeals process is available in the SPDCS (England) Terms & Conditions 2007 document, available on the NHSe website.
FURTHER HELP AND ADVICE
For BDA members:
http://www.bda.org/advice/quicknav_advice.cfm?PID=salaried-template1.cfm&CONTENTID=224
- Contact the BDA IRO (Policy and Knowledge) Team on 020 7563 4139
For BOS members:
Contact BOS CG Chairman, Alison Newlyn, via alison.newlyn@sash.nhs.uk
Useful websites
http://www.bda.org/
http://www.dh.gov.uk/
http://www.primarycarecontracting.nhs.uk
http://www.nhsemployers.org/
AN
Community Group, BOS
14 May 2008
