BOS
BRITISH ORTHODONTIC SOCIETY
Registered Charity No. 1073464
CONSULTANT ORTHODONTISTS GROUP
Minutes of the Committee Meeting held on Friday 5 September 2008 at the BOS Office, 12 Bridewell Place, London, EC4 commencing at 10.00 a.m.
08/23PRESENT
Ms H Knight Chairman
MrJ Spencer Secretary
Ms N Atack
Mr P Cook
Mr A DiBiase
Mr N Harradine
Mr D Johnston
Ms R Mattick
Professor F McDonald
Mr N Mitchell
Mr J Noar
Mr D Tewson
APOLOGIES FOR ABSENCE
Mr M Dixon
Ms E Jones
Ms A Murray
Professor Nigel Hunt
Professor Jeremy Knox
Mr D Morrant
Mr D Morris
Mr I Hathorn, Chairman BOS sent apologies
By invitation:Tracy Posner, Les Joffe BOS Treasurer
08/24MINUTES OF THE COMMITTEE MEETING HELD ON 24 April 2008
These were accepted as a true record and signed by the Chairman after adding David Tewson to the list of apologies.
Paul Cook was not at the meeting on 24 April.The Committee members present at that meeting agreed that the wording of “08/04 GDC and training FTTAs” was correctly minuted but accepted that Paul Cook was not quoted correctly. The minute stated “There is a suggestion from the GDC that a four year orthodontic training pathway for postgraduates could be introduced and it would appear that Paul Cook supports that”.Paul Cook does not support that suggestion.
08/25MATTERS ARISING
Helen Knight highlighted the Health Select Committee report published in June.She reported that the Education Committee will meet in October.
A new survey of Society members is to be constructed and sent to the membership.It is vital that answers are found to some of the basic questions which the Society is often asked, such as the number of adults under treatment.
A COG reception has been organised following the AGM in Brighton.
08/26ITEMS OF URGENT BUSINESS
GDC and training FTTAs
The Specialist Dental Education Board (SDEB), the Body that advises the GDC on matters relating to specialist training, has recently asked all dental specialties to submit their curricula to the GDC for approval.The curricula should be “outcome based” stating the skills and knowledge a specialist would be expected to have attained during training. This will lead to greater flexibility in training; some trainees may seek a reduction in their training time based on experience or DwSI training or simply because they are high flying trainees. Paul Cook stressed that the GDC is only concerned with the curriculum leading to specialist registration.If it is felt that any additional training is required to work in a different area of dentistry, for example hospital or university, then that would not be a matter for the GDC. There is concern amongst some members of the GDC, particularly the lay members, that all orthodontic training should be to the same level and that this is a matter of public safety. A question was asked about why the extra FTTA training is needed. There is clearly a lack of understanding about the additional FTTA training necessary for a consultant to be able to offer more complex and interdisciplinary treatment to patients.This extra training is not required to treat the average orthodontic problem.Paul advised the Committee to make this very clear and thereby justify the extra training.However, it is quite clear to him that there is no possibility of two different specialist lists - one for postgraduates on obtaining the CCST and one for postgraduates completing FTTA training – as this would imply two different specialties. A dental specialty has to be clearly defined as a distinctive branch of dentistry.Further, he said, the GDC is not there to fight issues on behalf of the consultant service but rather to protect the patients and regulate the dental team. The public think of orthodontists as all the same, just working in different settings, and two Lists would lead to confusion.Committee members believed that the extra training should be seen as protecting patients given the complexity of the treatment required for many hospital patients and therefore should be of interest to the GDC. The GDC “control sanction” is that they expect dentists to work within their competency. If there are to be just basic dental qualifications on the Dental Register with an “S” marking the dentist as a Specialist Orthodontist, there will be no way of checking specialist qualifications. The Register will merely separate those with specialist training from those without.Helen Knight commented that the Department of Health appeared to have no problem with the extra FTTA training.A solution might be to adopt another name for FTTAs.Some Committee members saw this as a threat to the hospital consultant service – if all orthodontists were trained to the same level, there would be little need for the consultant working in the hospital setting.PCTs may see this as a way of saving money. It was felt that support from the GDC was vital.There will be a presentation on the future of Specialist Training at the COG AGM.
08/27BOS REPRESENTATIVE BODY
5.1 Report
The Representative Body meeting was held on 9 May.The BSPD are now officially working from the BOS offices with a member of the BOS staff contracted to work eight hours per week for them.The post of Executive Secretary becomes vacant on the retirement of Chris Kettler at the end of the year.This post will be split with Les Joffe working as CEO for two days per week from BOS head office and an Executive Secretary working from home for one day a month.The dividing wall between the Executive Secretary’s Office and the David Di Biase room has been breached by using bifold doors so the two rooms can be used together or separately. Questions about the benefit of Blackboard to BOS members were raised.Phil Benson is the new Journal of Orthodontics Editor.The Community Group advised that the new SPDCS contract was approved by ballot at the end of 2007 but has still not been implemented by many Trusts.The UTG held a meeting to discuss undergraduate education.BOS has held talks about greater co-operation between the ONG and the BOS.There was a complaint from a BOS member regarding an article entitled “Cephalometrics’ role” written by Andrew MacCance and published in the August 2008 issue of the BDA News, where papers are not refereed.The Chairman of the Ethics Committee, Joe Noar, has written to Stephen Hancocks pointing out the inaccuracies within the article.
5.2 Clinical Standards Committee
A report was circulated. James Spencer will edit the piece on consultant orthodontists which appears in the Guide for Purchasers.Other Groups within the Society are updating the paragraphs about their Group. When completed, a decision will be taken on whether to print a new edition or to place it on the website for members to download.The next meeting is on 12 November.
5.3 Ethics Committee
A report was circulated. The Chairman had some concerns about poor attendance at Committee meetings which he is taking steps to resolve.He reported that the Executive Secretary, Chris Kettler, was often able to help complainants and therefore only the more serious complaints reached him.There was nothing further to report on the problems surrounding the use of specialist titles.Robert Evans is taking over from Fraser McDonald as the UTG representative.
5.4 Scholarship Committee
There was no report.
08/28CHAIRMAN’S ITEMS
6.1 Chairman’s Report
The Chairman has received an email from a consultant in Warwick advising of problems in the local area.The specialist practitioner led Local Clinical Network has discussed orthodontic provision with the local PCT with no consultant orthodontic input.The agreed care pathway appears to exclude treatment in the hospital service.A review of local provision has been undertaken with one of the recommendations being a link to the Warwick orthodontic course rather than the Dental Hospital in Birmingham. There is clearly a problem in the area which inevitably involves personalities.Helen Knight commented that, all in all, this is a sorry tale but should be seen as a wakeup call.There has been no further movement on training in primary care.The part time orthodontic MSc course at Warwick continues unabated.It is being driven by Professor Malcolm Harris with orthodontic specialists, Richard Cure (Clinical Director of Orthodontics at Warwick) and Liz Hopkins, Ian Hutchinson, Rob Slater and Simon Perks involved in teaching.It is understood that Richard Cure’s practice premises have excellent technology with a well equipped lecture theatre in the basement.Paul Cook said it was important not to dismiss the Warwick course just because it was different but to look to the future. It would be better to ask Warwick how the Society might help them in particular by strengthening the programme. The CDO has made it clear to Liz Jones, Lead Postgraduate Dental Dean, and Nigel Hunt, Chairman of SAC, that he would prefer to move forward with the Society in planning for the future of some training in primary care.James Spencer suggested an option of deciding at the end of the second year of SpR training whether a trainee would continue to do 5 years of training (the 4th and 5th years as a Fellowship period) or 3 years in which case some of the 3rd year could be training in primary care.It was essential to run two or three pilots for any proposals for primary care training.If this moves some teaching from the hospital setting, consultants would need to ask themselves what to do with their teaching skills.Many FTTAs now prefer a part time consultant post coupled with a part time post in specialist practice.
6.2 FTTA Training
This was covered earlier in the meeting.
08/29SECRETARY’S ITEMS
New Consultant Appointments
Gavin Mack, King’s and St Georges
Annalise McNair, Salisbury
Sophie Ahmed, East Grinstead
James Spencer has forwarded a copy of the new list of consultant opportunities to the Chairman of the Training Grades Group.Many consultant posts have been created by the introduction of the 18 week “street to treat”.But there are far fewer applicants for FTTA posts now than in previous years.
COG Elections
Dave Tewson has been elected as the COG Scholarship and Awards Committee Representative.
Proposed Constitutional Changes
This will be put to the AGM and the updated version placed on the website.
James Spencer commented that shared care has not happened in the specialty.
08/30TREASURER’S ITEMS
Treasurers Report - Provision for Future Projects
Alison Murray was not at the meeting but had circulated a report.This showed that the Symposium had made a good profit of around £9,000 due to the higher than expected number of delegates.Sales of the DVD stand at £13,746 against a cost to produce of £20,775.88.
08/31COG SYMPOSIUM
Symposium 2009
The Symposium will take place on 3 and 4 March 2009 in Newcastle.Most of the speakers have confirmed.They include Ray Edler, Ballard Lecturer, Richard Cousley, Joyce Russell, Scott Deacon, and Kevin O’Brien. The political session will include a talk on Managed Clinical Networks. Rye Mattick asked the Committee to advise her of any other speakers/topics of value to the Group.Dinner will be at the Baltic Centre. Rye Mattick will investigate some form of entertainment such as harmony. On line booking will be available. There is no obvious recipient of the Ballard Medal. There is one medal left. Following the meeting, James Spencer will email Committee members listing previous recipients of the Medal and asking for nominations.
08/32COG WEBSITE
Helen Knight thanked Norman Hay for his work on the COG part of the site so far, saying the pages now looked good. Norman Hay asked for further suggestions on improving the pages to be sent to him.It was agreed that only details of the Chairman and Secretary should appear on the site.
08/33NORTHERN IRELAND COG
A written report was submittedThe Group last met on 19 September.Waiting list targets have been set but it is basically impossible to achieve them.There is presently a two year waiting list in hospitals.An FTTA post was advertised in July but did not attract any applicants; similarly a part time vacancy at Altnagelvin is unfilled.To achieve the waiting list target, more consultant posts will be needed and that assumes there will be consultants to fill them! The consultant undertaking Joint Restorative Clinics in hospitals outside of Belfast has resigned with little prospect of finding a successor.The next meeting of the Group is scheduled for December.
08/34SCOTTISH COG
A written report was circulated.There are several vacant consultant posts which have been advertised but have attracted no interest.An 18 week referral to treatment target has been set for the end of 2011 which includes orthodontic treatment waiting lists for the first time.An orthodontic therapist started work at Crosshouse Hospital in August.There is concern about training opportunities for orthodontic technicians and no progress on training enhanced practitioners (Scottish equivalent of DwSI.The next meeting of the SCOG is on 14 November.
08/35WELSH COG
A written report was circulated.Joy Hickman has managed to secure HDS funding in the north and attracted colleagues to the area.There are still vacant sessions at Glan Clwyd although an appointment between Glan Clwyd and Wrexham is to be made.The North Wales units have expressed interest in setting up a registrar training post and employing an orthodontic therapist.The MCN for Bridgend-Swansea has been approached to consider planning services in West Wales.The North Glamorgan Trust still has a consultant post vacant.New patients have to be seen within eight weeks but there are no targets for treatment waiting lists although this is to be reconsidered in 2009/2010.Two SpRs and five postgraduate students begin training in October 2008.Two academic FTTA posts have been advertised.
POLITICAL SECTION
08/36GENERAL DENTAL COUNCIL
A report was circulated in the meeting papers.There will soon be more dental nurses on the Register than dentists: at the end of July 2008, there were 35,626 registered dentists and 35,337 dental nurses with more applications being processed at the GDC.There have been problems in some hospital departments where previously a registered nurse could assist an orthodontist and this is no longer the case leading to clinic cancellations.Individuals working with an orthodontist must either be a registered dental nurse or undergoing approved training.Some orthodontists in specialist practice are also experiencing problems.If they train their own nurses from scratch, they will need to provide access to general dental training as well as training in their own specialist practice.Chris Kettler, BOS Executive Secretary, has written a comprehensive paper on Professional Indemnity for dental nurses which will be published on the BOS website.The first orthodontic therapists have qualified from Leeds.Paul Cook commented that when all the orthodontic therapist courses are working to full capacity, it is likely that there will be more orthodontic therapists qualifying each year than orthodontic specialists. A new specialty of Special Care Dentistry has been approved by the GDC.The Annual Retention fee will not rise this year.Orthodontic Specialty Training has already been discussed.
08/37CCHDS
The next meeting of the CCHDS will be held in November.
08/38OPC
The last meeting of the Orthodontic Practice Committee was held in July.The Parliamentary Select Committee report was published on 23 June and the proposed BOS response circulated for comment.The Society has offered to help with needs assessment, highlighted in the Report, to address the disparity of services across the country.The Report also recognised Local Managed Clinical Networks as being important to the organisation of orthodontic treatment in an area.It has proved difficult to identify Local Clinical Networks and the database is out of date.It might be useful to contact COG members asking them to advise if there is an LCN operating in their area.There is a meeting with the CDO in November.The OPC are producing several documents aimed at PCTs including guidance on referrals and setting up LMCNs. They also plan to produce a guideline for members on PAR scoring of cases.There is a need to help members with the tendering process and documentation will be produced and workshops arranged. Eighteen week “street to treat” is likely to be introduced in primary care.It is understood that the SHA covering the East of England has already set a deadline for its introduction.COG Committee discussed a problem in the north of England where a large corporate pulled out of an orthodontic contract.The Department of Health are very anxious to increase access to dental treatment and have allocated 11% more funding for dentistry.
EDUCATIONAL SECTION
08/39DEANERY
A document by the Lead Dean for Orthodontics, Liz Jones, was tabled.There is a problem with a lack of interest in applying for FTTA posts at the moment and the number of applicants for SpR training in London was significantly down this year.Orthodontic training in primary care is under discussion at the Department of Health.The role of the SAC/JCSTD is changing.Postgraduate Deans are taking more responsibility for training with a consequent reduction in the activities and size of the SAC.SACs have set up liaison representatives to improve involvement with the local Postgraduate Deaneries.Problems with training should go through the Deaneries as they are responsible for quality assurance.
08/40SAC
There was nothing to add.
08/41TRAINING GRADES GROUP
There was no report.
08/42ANY OTHER BUSINESS
Les Joffe explained the idea behind the launch of Trade Sponsorship Packages.These are designed to offer traders varying levels of commitment to the Society for a year in advance.Companies can choose a selection of sponsorship opportunities from items such as advertising in the Journal and/or BOSNews, exhibiting at meetings, sponsorship of prizes and so on. Companies will be offered a discounted rate depending on how much they take and when they pay.Les Joffe explained that this would not affect the amount of sponsorship money for the COG Symposium. The full amount would be passed over to the COG i.e. if the discounted rate is £270 and the full amount £300, £300 would be passed over. In addition, the COG would be able to veto any company from having a stand at the Symposium.COG charge more for stand space than other Groups because traditionally the Group has only allowed two or three stands.Les Joffe indicated that the Group can ask for more than the nominal amount he has included in the packages, but they should minus the package amount from their invoice.COG has a free hand to negotiate with any traders who have not signed up for packages.
08/43DATE TIME AND LOCATION OF NEXT MEETING
The next meetings in 2008 will take place on:
Tuesday 9 December, at the BOS Office.
The meeting ended at 2.05 p.m.
BOS
BRITISH ORTHODONTIC SOCIETY
Registered Charity No. 1073464
CONSULTANT ORTHODONTISTS GROUP
Minutes of the Committee Meeting held on Thursday 24 April 2008 at the BOS Office, 12 Bridewell Place, London, EC4 commencing at 10.00 a.m.
08/01PRESENT
Ms H Knight Chairman
MrJ Spencer Secretary
Ms A Murray Treasurer
Ms N Atack
Mr A DiBiase
Mr M Dixon
Professor N Hunt
Mr D Johnston
Mrs E Jones
Mr J Knox
Ms R Mattick
Mr N Mitchell
Mr J Noar
By Invitation for 1 item:
Mr N. Harradine, Incoming Chairman of BOS (GDC and training FTTAs)
APOLOGIES FOR ABSENCE
Mr P Cook
Mr M Easton
Mr N Hay
Mr J Kindelan
Professor F McDonald
Mr D Morris
08/02MINUTES OF THE COMMITTEE MEETING HELD ON 5 DECEMBER 2007
These were accepted as a true record and signed by the Chairman after Mr N Mitchell was added to the list of members present and an amendment made to minute 07/57.One sentence currently reads:
Cases for postgraduate trainees are picked off the specialist practice lists and there is concern that some of these could be cases the specialist would rather not treat.
This is inaccurate and should read:
In the future, it may be possible for cases for postgraduate trainees to be picked off the specialist practice lists and there is concern that some of these could be cases the specialist would rather not treat.
08/03MATTERS ARISING
Agenda item 07/45, ACCEA Nominations
Iain Hathorn has written to the ACCEA requesting information on awards in London at the various award levels, to see if dental colleagues are being as successful as medical and surgical colleagues.Personal statements will be published this year.They will be open to scrutiny by others who could report exaggerated or untrue claims or plagiarised wording.
Agenda item 07/47 Chairman’s Items, Response to the Parliamentary Health Select Committee
The Health Select Committee is an agenda item.
08/04ITEMS OF URGENT BUSINESS
GDC and training FTTAs
Helen Knight thanked Nigel Harradine for attending for this specific item and also Derrick Willmot.
There was considerable discussion on the possibility that the GDC may no longer accept two levels of training i.e. completion of three year specialist training, the award of a CCST and a decision to opt for practice OR completion of three year specialist training, the award of a CCST and a further two years training as an FTTA with a view to a hospital consultant appointment. Paul Cook, a member of the GDC and Chairman of the GDC Education Committee, has written to Liz Jones, London Postgraduate Dental Dean, with copy to Nigel Hunt, Chairman of the SAC, and Kevin O’Brien, Chairman of the Specialist Dental Education Board, indicating that the GDC may no longer be prepared to accept these two levels of training. There is a suggestion from the GDC that a four year orthodontic training pathway for postgraduates could be introduced and it would appear that Paul Cook supports that.SDEB has requested that SACs write SpR and FTTA curricula and a working group including Nigel Hunt, Jonathan Sandy, Jonathan Sandler and Fraser McDonald is to take this forward.Nigel Hunt felt there is little point in spending many hours doing this if there is to be a substantial change to training. Further, members of the Working Group may not be prepared to accept what they see as dumbing down of training and may resign from the Working Group.Most COG Committee members could see no reason for any change to a system which works very well.With regard to the four year training, the extra one year’s training is not necessary for those trainees who want to enter specialist practice; they can refer complex cases on to the hospital.Specialists would probably not be willing to undertake this type of complex treatment in their practice given the contract they work with.And the extra one year’s training would not be sufficient for those who want to move into the hospital service and treat multi disciplinary and complex cases. Some members of the GDC Education Committee, particularly the lay members, apparently believe that training should all be to the same level on the grounds of patient safety.They appear not to understand that the additional two year training is only required to treat the more complex, multidisciplinary cases in the hospital service and that the three year training pathway is more than sufficient to treat the less complex orthodontic patient normally seen in high street practice i.e. the majority of patients.There was concern that the lay members are being given “selective” information.There have been moves in the past to allow two specialist lists and two CCSTs depending on the length of training;this was a major divisive issue within the Society some years ago but was seen as a lesser issue now.More recently, Ray Edler was involved in discussions for a separate specialist title for hospital consultant orthodontists which was rejected.Nigel Harradine said the starting point must be the COG Committee and the Society agreeing to aim for two CCSTs.Paul Cook is known to be very pessimistic that this can be achieved but it is not known why.Nigel Harradine will discuss the issues with the BOS Executive and decide how best to influence opinion at the GDC; Nigel Hunt will talk to Kevin O’Brien and other members of the SDEB.Nigel Hunt is meeting with Kevin O’Brien,Chair of the Specialist Dental Education Board, on 12 June and Nigel Harradine agreed to attend if possible.
08/05CHAIRMAN’S ITEMS
Health Select Committee and canvassing of MPs
BOS Chairman, Iain Hathorn, gave evidence to the Parliamentary Health Select Committee on 21 February.The HSC seemed surprised at the possible ramifications of the introduction of the 18 week rule in secondary care.COG Committee have a letter prepared to send to COG members for them to use as a basis to enlist the support of their local MP but it is difficult to know exactly what to include until the Report from the HSC is available.However, when the Report is available, if action is required, it needs to be taken very quickly.
Implementation of the 18 week rule will mean that orthodontic trainers cannot hold waiting lists of suitable patients for trainees which will lead to fewer patients being treated by postgraduate students. Jayne Harrison has documented pointers on justifying batching suitable patients which has been accepted under a local agreement and which might be useful to others.James Spencer attended a DoH 18 week event in London.Consultants are finding different ways of achieving the 18 week wait target - the PCTs holding the waiting list, using a triage system and pushing out suitable cases to the local specialist practitioners, for instance.
BOS Education Committee
Sue Cunningham will chair the Committee, Steve Chadwick is also involved.The Board of Trustees will decide on the Committee members from the names submitted by the Groups.Volunteers for this Committee should be aware that it will be very much a working Committee and require time and commitment.
Primary Care Training
The Orthodontic Specialists Group has been asked to contribute a module but has not produced a document to date.Tony Jenner, deputy CDO, was the main promoter of the concept of training in primary care but will be retiring soon and the idea might not be pursued at the Department.Helen Knight commented that the Postgraduate Dental Dean in Bristol has suggested that the next intake of postgraduates should not be placed in Bath but in specialist practice.This is being strongly resisted and is not progressing at the moment.James Spencer commented that the training budgets are held by the Deanery and therefore the Deaneries have the final say in where postgraduates are trained.
Members’ titles and the BOS website
Helen Knight reported a huge amount of email traffic regarding this issue.A member of the OSG has complained that a fellow member is described as a specialist orthodontist on the BOS website but is not on the GDC Specialist List and should therefore not be described as such.As Chairman of the Ethics Committee, Joe Noar has been handling the issue.All OSG members will now be checked against the GDC Specialist List; those found not to be on the List will be given a different description by the BOS.Exactly how they will be described is still under discussion.Associate Specialists, members of the COG, are designated Consultant Orthodontists on the BOS website; this description also needs to be reviewed.
08/06SECRETARY’S ITEMS
New Consultant Appointments
Kate House at Cheltenham/Gloucestershire.
Forthcoming Elections
Two new Committee members are required to replace Jay Kindelan and Dave Tewson.Joe Noar has been the COG Scholarship Committee representative since 1999 and will be replaced.James Spencer will email the COG membership asking for nominations. He added that he thought the term of office for Committee representation should normally be four years.He will also advise David Bearn, Chairman of the Scholarship Committee, of the impending change in COG Scholarship Committee representation.Both Helen Knight (Chairman) and James Spencer (Secretary) come to the end of their term of office in 2009 - the term of office for Chairman is three years, Secretary (and Treasurer) is five year . These posts do not normally fall vacant at the same time.James Spencer shadowed Nigel Carter for two or three meetings when Nigel was Secretary and suggested the new Secretary should shadow him.
COG Survey
There was a very poor response to the recent BOS web based survey.Approximately 50% of the replies were from members of the COG.Chris Kettler is to discuss the development of another survey with Tracy Posner (Media) and Alison Williams who has considerable experience of constructing questionnaires.This new survey will be put together during the next twelve months and conducted by post.Sue Cunningham reported at the last Board of Trustees meeting that email surveys elicit a poorer response than postal surveys – usually about 30% email against 70% postal.It is vital that the BOS has the data to respond to media enquiries and to provide statistical information to the Department of Health and others. The survey will consist of core questions and specific questions from each Group.James invited Committee members to email him with any questions they felt it would be useful to include.
It would be immensely helpful for the COG to have more information on COG members such ashow many units they work in, how many sessions they undertake and so on.James Spencer will work on a short pro forma to email COG members.
18 week consensus events and advice to membership
The 18 week pathway comes in at the end of 2008. COG Committee undertook to help its members manage the service by emailing them with evidence based ideas.
Orthognathic Documents
Rye Mattick volunteered to look for different photographs for one of the documents and email them to James Spencer by Friday 2 May.The documents will be printed and postedto members as well as being available on the BOS/COG website.
08/07TREASURER’S ITEMS
COG Accounts
The Committee agreed to undertake the survey mentioned earlier in the meeting. The Treasurer confirmed that the Group has sufficient funds to carry this out. It will be a paper based survey with non responders followed up with a second and third mailing as necessary.The COG symposium should make a profit depending on the final expenses still to come in.
There is one Ballard Medal left.The die is stored and new medals cost between £100 and £150.The Medal is not presented every year.
Provision for Future Projects
Alison Murray requested members to email her with any suggestions for future projects.
COG Reception at BOC
When the Sunday Gala night was introduced, the individual Group receptions were supposed to be subsumed into that.However, this has not happened and the OSG and TGG continue to hold a Group reception.COG Committee discussed whether to do likewise either before or after their AGM on Monday.In principle, they decided to have a drinks reception on the Monday night following the AGM but subject to a venue being available – James Spencer will follow this up with the Conference Committee.The COG dinner will be held later that evening.
08/08COG SYMPOSIUM
Symposium 2008 and Future Strategy
Evaluation feedback from delegates was very positive.Rye recorded her thanks to the companies who had sponsored the meeting, Ormco, 3dmD and Archform, ensuring it was a financial success.The quality of the FTTA presentations could have been better and there were possibly too many speakers.The speakers were not invited to the dinner until very near the meeting date which had generated some complaint. But taken overall, the meeting had been very successful indeed.
The Royal College of Physicians is a very good venue but is also very expensive.Hotel accommodation in London is also more expensive than elsewhere. Rye has investigated holding the two day meeting in Newcastle where there are two or three excellent venues which are much cheaper; the Baltic Centre has very good space which would cost in the region of £14,000 to hire for the two days.The treasurer suggested that the meeting be budgeted on attracting around 100 delegates.Suggestions for content included a cleft/orthognathic theme.James Spencer suggested asking consultants if their FTTAs have any interesting work to present.Committee members agreed that it might be a good idea to hold the meeting in London one year and in the provinces the next, possibly where the meeting organiser is based.
It is understood that Les Joffe is looking at sponsorship deals with the trade which would include the COG Symposium.There are several companies which have already expressed an interest in having a stand.COG charge for “exclusivity” at the meeting and would like to continue to do that.
08/09REPORTS
Northern Ireland COG
A written report was submittedThere should be eleven consultant orthodontists working in Northern Ireland but there are only five at the moment. There are presently three SpRs in training with funding recently approved for a fourth orthodontic training post. From April 2008, waiting list targets are 13 weeks for new patient assessment and 21 weeks for treatment making a total of 34 weeks from “street to treat”.To achieve this, more consultants are required.James Lundy, a specialist practitioner, has been elected by the NIOG as the Northern Ireland representative to the BOS Representative Body.
08/10Scottish COG
Representatives from the SCOG met the Chief Dental Officer for Scotland on 20 March.The main topic was the continuing manpower shortage.The 18 week treatment target will be introduced in Scotland in 2011 but will be impossible to achieve with the current manpower situation.A pilot training scheme for orthodontic therapists is to start in Edinburgh soon. SCOG is still waiting for information about the training of enhanced practitioners in Scotland and how this will be organised.The SCOG met on 23 April.
08/11Welsh COG
Wales was originally exempted from the 18 week “street to treat” rule in secondary care but this exemption has been removed and Wales will now have to comply.
POLITICAL SECTION
08/12GENERAL DENTAL COUNCIL
Paul Cook was not at the meeting.
08/13CCHDS
A meeting of the CCHDS was held yesterday but Nick Mitchell was unable to attend.
08/14OPC
Report of the Orthodontic Practice Committee Meeting in March, Referral Guidelines, MCNs
Andrew DiBiase reported on the meeting held on 28 March.The main points from his report are as follows:
Judicial review of Eddie Crouch case:Judge ruled in favour of the right of the PCT to terminate the contract without prior notice and period of notice but not that there should have been a public consultation exercise/needs assessment prior to awarding contracts.
There is no further news on training in primary care.
The BOS submission to the Parliamentary Health Select Committee is available on the BOS website.As reported above, the Society was asked to give oral evidence which was presented by the Chairman, Iain Hathorn.When the HSC Report has been published, Lee Scott, MP – who was on the Parliamentary Health Select Committee - is proposing to set up an all party group to lobby MPs on orthodontics matters.
Key Stake Holders Group (Implementation Review Group):a documententitled “NSH Dentistry – Information for Patients” produced by the Department of Health was shown to the meeting.This was produced without reference to the Society and contains inaccuracies.Chris Kettler, BOS representative, has requested data on orthodontic services which has not been forthcoming.
From April 2008, there is a requirement to perform PAR scores on a given number of cases but practitioners are at liberty to select the cases they score, which needn’t be consecutive, and also score them themselves.It was agreed that this renders the whole process meaningless.James Spencer commented that all cases in his department are independently PAR scored.
There was a poor response from LOCs to the email requesting information on MCNsin the local area. Helen Knight suggested asking for this information in the COG survey and also advising Richard Jones that he should contact all COG members for help.
COG Committee discussed the referral guidelines produced by Jo Clarke.The Committee agreed that an illustrated guide was a good way to show when to make a referral and give a good indication if treatment might follow. Andrew di Biase is working with Helen Newbrook to produce guidance to MCNs on establishing unbiased local referral management guidelines and a sample proforma.The Society position is that everyone is entitled to a specialist opinion.That does not mean they are entitled to NHS treatment. Andrew Di Biase will produce draftsof the documents for the next Committee meeting.Helen Knight also asked Committee members to discuss the issue in their departments and feedback thoughts to Andrew.
EDUCATIONAL SECTION
08/15DEANERY
Deanery issues have been covered during the meeting.
08/16SAC
There have been several meetings since the last COG Committee meeting: JCSTD in December, the annual Workforce Review Team meeting on 27 February, a meeting of the Chairs of SAC and JCSTD on 28 February and a full meeting of the SAC on 17 March.The main issues discussed at these meetings are as follows:
There has been no progress with SpR training in the primary care setting.OSG has not produced the module on aims and objectives and Tony Jenner has been busy with commissioning issues.
SDEB has requested all SACs to re-write the curriculum highlighting core knowledge.
There is a predicted reduction in the workforce over the next five years with a great shortage of academics.The Department of Health say they need to see the effect of orthodontic therapists before deciding what action, if any, needs to be taken.
FGDP(UK)/BOS DwSI course: The SAC are anxious to arrange practice visits but the FGDP(UK) are being slow to respond.Iain Hathorn has written to them to urge them to move more quickly.
The current proposals do not require Post Graduate Deans to consult the SACs over changes to existing posts or to approve new posts but Nigel Hunt thinks this should be mandatory.Liz Jones confirmed the wording has now been strengthened.
Postgraduate Deans are taking more responsibility for training with a consequent reduction in the activities and size of the SAC.SACs have set up liaison representatives to improve involvement with the local Postgraduate Deaneries.Problems with trainingshould go through the Deaneries as they are responsible for quality assurance.
The JCSTD are looking at a more formal process for the appointment of specialty trainers with a job description and person specification.A training day will be organised in due course.
08/17CLINICAL STANDARDS COMMITTEE
David Morris has produced a document on “The Justification for Orthodontic Treatment” which was circulated together with his report on the Clinical Standards Committee.Committee members were asked to email comments on the document directly to David Morris.The Committee is working on a large number of projects including new patient information leaflets on healthy teeth, digit sucking, interproximal reduction and orthodontic mini-screws.Advice sheets on TMJDS and orthodontics is under development.Several advice sheets are currently being updated.A national audit on mini-screws will start on 1 June. The next Committee meeting is on 8 July.
08/18ETHICS COMMITTEE
Joe Noar, Chairman of the Ethics Committee, gave more details on the problems involving the complaint from a member of OSG about a fellow member being described as a specialist orthodontist when she is not on the GDC Specialist List.This was referred to earlier in the meeting by Helen Knight.A decision needs to be made on how those members of OSG who are not on the GDC Specialist List should be described.The matter is to be discussed at the meeting of the Representative Body in May.
The Ethics Committee met in February.The Committee has produced a paper on out of hours working and responsibility for out of hours support and a paper on the relationship of private to NHS practice.The Panel of Expert Witnesses has been updated and amended.The Committee discussed professional indemnity for DCPs and the GDC proposal to remove additional qualifications from the Dental Register which the Committee could understand the reasoning behind.The next meeting is in May.
08/19SCHOLARSHIP COMMITTEE
David Bearn has taken over as Chairman of this Committee, Rye Mattick is Vice Chairman and also responsible for the BOSF.The Committee met in February.They discussed fund raising and sponsorship which is to be centralised from the BOS office with corporate packages on offer to trade companies.Changes to some awards were agreed including the Clinical Audit Prize which will be for the best audit published in the CEB in any one year, the Chapman Prize which will be awarded to a researcher who has published an article of outstanding merit in the orthodontic press internationally during any one year; Gunter Russell prize is to be split into two, one for audit and one for research; Houston Research Award will be renamed Houston Young Researcher of the Year and mark the best MSc project completed in that calendar year; Maurice Berman prize has been suspended for the time being.Joe Noar is to rewrite the regulations for the Against the Odds prize which would need to be accepted by the OSG.There was considerable discussion on the Geoffrey Fletcher Scholarship which will now be awarded for the best candidate in the intercollegiate ISFE exam each year.At COG Committee, Helen Knight commented that she wondered if the marking regime for that exam was sensitive enough to be used in this way.
08/20TRAINING GRADES GROUP
Mike Dixon proposed that the ISFE day should be integrated with the COG symposium and run as a parallel session.He suggested co-opting a member of the TGG to work with Rye Mattick and Nikki Attack.This will need further discussion. TGG are to review three areas this year – training numbers and fees, study leave and budgets and the outcome of training.The Group are building up a network of representatives in the dental schools through the UK.
08/21ANY OTHER BUSINESS
James Spencer asked the Ethics Committee to consider updating the Advice Sheet on Waiting Lists.This will be considered at the Ethics meeting in May.
Nominations for Society Awards – Life Member, Special Service, Distinction - are requested for the Nominations Committee meeting in May at Celtic Manor.Suggested names were Joe Noar, Jay Kindelan, Stephen Rudge, David Tewson and David Morris.Helen Knight asked members to contact her with further suggestions.
The Chairman will write to thank Joe Noar, Jay Kindelan, David Tewson for their contribution to the COG Committee.
08/22DATE TIME AND LOCATION OF NEXT MEETING
The next meetings in 2008 will take place on:
Friday 5 September
Tuesday 9 December, at the BOS Office.
The meeting ended at 3.15 p.m.
