On behalf of Dr Alison Taylor, NHS England and NHS Improvement Medical Director for System Improvement and Professional Standards, Brett Duane and Mark Johnston, Co-chairs of the Kent, Surrey and Sussex LDN; Nick Forster, Chair of the Hampshire and Isle of Wight LDN and Nilesh Patel, Chair of the Thames Valley LDN
As you are aware, the attached communication from NHS England and NHS Improvement of 25 March, 15 April, 22 April, 13 July and 23 July advised that dental providers would continue to receive monthly payments equal to 1/12th of their current annual contract value. This financial commitment was made with the requirement on providers to ensure that all staff engaged in the provision of NHS care including associates, non-clinical and others, to continue to be paid at previous levels. When the South East dental team became aware that some providers had not paid associates or staff in line with this communication, the attached email of 22 April 2020 was circulated to reiterate this requirement. That email also advised the abatement that was to be applied retrospectively, to 1/12th monthly payments, related only to reduced variable practice overheads such as consumables, materials and lab costs, so it was not appropriate to apply such an abatement to associate and staff payments.
Despite the above we have become aware that some associates and staff have not been paid, some have been paid but not at previous levels, some have had an abatement applied and some have only been paid if they signed new contracts with less favourable terms and conditions.
We apologise for the generic nature of this email, as many providers have behaved in a strictly fair and ethical manner and in line with the above requirement. However, a significant number of associates and staff have contacted the dental team (and LDCs and LDNs) advising that this is not always the case. Where some have reported anonymously and in fear for their future employment we have not been able to make individual contact with the relevant providers. To do so would be our preference, in order to understand any extenuating circumstances from the provider perspective as well.
We must express our extreme disappointment that many providers have not behaved in the spirit in which the 1/12th payments to providers have been made. The impact this has had on those individuals that have not been fairly treated has been significant and we are sure that some will be aware of the suicide of a dentist in London recently, of which these circumstances may have played a part in their actions. Whilst we and the dental team are sympathetic to the effect that Covid-19 has had on practices’ abilities to generate income from the private element of their practices, it is wholly inappropriate and unprofessional to put NHS associates and staff under financial hardship by not continuing to pay them, when the NHS has furnished providers with 1/12th payments. This is not something we expect of GDC registrants and is not in line with GDC maintaining standards 6.1.3 which states “Dentists must treat colleagues fairly in all financial transactions”. We are aware that many have contacted the GDC direct.
As many providers are aware, recruitment within the dental profession is challenging and the impact of providers behaving in this unethical manner may impact on their ability to retain NHS associates and staff which in turn would have adverse consequences for NHS patients.
We therefore strongly urge that where associates and staff have not yet been paid at previous levels, this is urgently rectified (for associates that may have received variable monthly payments dependent upon actual UDA delivery, this should be their average net of agreed deductions such as LDC levies and contribution towards lab costs). Payment at previous levels needs to be maintained going forward as practices will not be measured against UDAs if they choose to accept the arrangements outlined in the letter 5 dated 13 July, so it is not appropriate to resume payment for associates against the reduced UDA delivery they will now carry out.
Where there are exceptional circumstances that result in an associate not being eligible to receive their previous level of pay, (eg reduction of their NHS provision just prior to Covid with a corresponding increase in NHS provision for another associate at the same time), please ensure that that this is clearly explained.
Once again we apologise for the generic nature of this email but trust that those to whom this does not apply (because they have honoured payments to associates and staff at previous levels), will understand the detrimental impact this is having on individuals as well as the profession as a whole and therefore its necessity.