Orthodontic Service at Nobles & National Clinical Assessment Service

Summary

The request sought details on the orthodontic budget and contracts for consultants at Nobles Hospital, resulting in the disclosure of total budget figures and contract types, while the specific annual cost of the consultant contract was withheld as it had not yet been calculated.

Key Facts

• The annual budget for NHS Orthodontic Services covering both Primary Care and Consultant-led Services is £492,300.
• Consultants Alan Gowan and Joanna Dance work under open-ended 'Bank' (zero-hour) contracts.
• There is no specific budget allocated for the National Clinical Assessment Service.
• The annual cost of the consultant contract is unknown because the arrangement has not run for a full year since April 2018.
• Consultant working hours were reduced from 15 days per month to approximately one week in four to improve operational effectiveness.

Data Disclosed

• £492,300
• £13,000.00
• £38,250.00
• 2018-08-14
• 2018-09-07
• April 2018
• 15 days per month
• 1 week in 4
• 2 years
• 4pm-7pm
• 11 days

Original Request

Please can you confirm what the annual budget is orthodontics is within both Primary Care and the Nobles Hospital Service including National Clinical Assessment Service? What contract was awarded to Alan Gowan and Joanna Dance, the consultants that provide the service at Nobles Hospital for treating patients with an Index of Orthodontic Treatment of 5? What is the duration of the contract awarded to them for? What is the annual cost of this contract? What financial incentives were provided within this contract in terms of are their travel and accomodation costs covered by the Government are they given an allowance for food and for working away from home? Was the contract advertised if so can a copy be provided for my perusal?

Data Tables (1)

Full Response Text

Chief Executive: Malcolm Couch Freedom of Information Team DHSC Digital Cronk Coar Strang IM4 4RJ

(01624) 642621 dhsc@foi.gov.im Website: www.gov.im/dhsc

Our ref: 569238 7th September 2018

Dear ###

We write further to your request which was received on 14th August 2018, which states:

‘Question 01) Please can you confirm what the annual budget is for orthodontics, within both Primary Care and the Nobles Hospital Service, including National Clinical Assessment Service? Question 02) What contract was awarded to Alan Gowan and Joanna Dance, the consultants that provide the service at Nobles Hospital for treating patients with an Index of Orthodontic Treatment of 5? Question 03) What is the duration of the contract awarded to them for? Question 04: What is the annual cost of this contract? Question 05: What financial incentives were provided within this contract in terms of are their travel and accommodation costs covered by the Government are they given an allowance for food and for working away from home? Question 06: Was the contract advertised if so can a copy be provided for my perusal?’ Response to your request: We are pleased to be able to provide a response to your request with answers to some of your questions; and while our aim is to provide information whenever possible, in this instance we are unable to provide some of the information you have requested; the reasons are shown as part of the corresponding answers below.

Question 01) Please can you confirm what the annual budget is for orthodontics is within both Primary Care and the Nobles Hospital Service including National Clinical Assessment Service? The annual budget for NHS Orthodontic Services for the Department of Health and Social Care is £492,300. This budget is to provide both Primary Care and Consultant- led Services.
There is no budget for National Clinical Assessment Services. There is however a budget set aside for Dental Advice, (£13,000.00 pa) and for the National Health Services Business Services Authority (NHSBSA), (£38,250.00 pa). It is planned that funding received via patient contributions for Dental Services can be utilised this year, to inject into Orthodontic Services, and increase the number of children that can be seen within Primary Care Services to reduce the waiting list. Question 02) What contract was awarded to Alan Gowan and Joanna Dance, the consultants that provide the service at Nobles Hospital for treating patients with an Index of Orthodontic Treatment of 5? The named consultants are working under ‘Bank’ contracts (zero hour contracts). This is to enable the Department of Health and Social Care with the assistance of both Consultants, to right-size the Consultant-led service from what it was pre-April 2018 (3 weeks in 4), to what we believe it should be, (approximately 1 week in 4), thus improving operational effectiveness and reducing public expenditure. This is a work in progress and may take up to 2 years to reduce as suggested.
However, since April 2018 the following table shows the number of days worked by the Consultants (please note that it was 15 days per month pre-April): - Although the above already shows a reduction in Consultant working hours, all patients who were previously in the hospital system have been seen, as required, along with the waiting list reducing (i.e. new patients being seen).
One of the Consultants holds evening sessions (4pm-7pm) and of the above days worked, 11 of these have contained evening appointments. This has enabled the Service to also be available outside of working/school hours (not previously available within the hospital service).
Opportunity has also been taken to ensure that patients are being seen in the most appropriate service; therefore patients suitable for primary care treatment have been transferred accordingly.

Question 03) What is the duration of the contract awarded to them for? The Contract held by the Consultants, and indeed the Bank Nurses who also work within the Consultant-led service, is open-ended as they are all zero-hour contracts. Question 04) What is the annual cost of this contract? The annual cost of the Consultant-led Orthodontic Service, which has been in place since April 2018, is not yet known as it has not run for one full year yet.
The Secondary Care budget was merged with Primary Care Service budget effective 1st April 2018 (total figure as per Question 01.) Question 05) What financial incentives were provided within this contract in terms of are their travel and accommodation costs covered by the Government are they given an allowance for food and for working away from home? The Department of Health and Social Care fund the Consultant’s travel and accommodation only. No other allowances are paid.
Question 06) Was the contract advertised- if so can a copy be provided for my perusal? No Contract was advertised.
The contracts are bank contracts (zero hours). The service was previously run by Nobles Hospital until the end of March 2018, and subsequently transferred to Primary Care on 1st April 18. Primary Care received confirmation of the previous Consultant’s decision to terminate his bank contract on 12th March 18, making advertising for the post, with the ability to continue care for all patients who were being treated at the hospital very difficult.
Dr Dancer made contact with the Department at this time, and both she and Dr Gowan had vast experience with regard to delivering and right-sized Orthodontic provision, and both fully met the specification for the post.
The Department therefore made arrangements with Dr Dancer and Dr Gowan to commence working with the Department from April 2018, under bank contract; thus continuing care for all patients.
The original idea was to move the Consultant Orthodontic Service out of the hospital setting and into the community. However, it was very quickly established that this service needed to be within the hospital, to give the best patient care possible, and to enable the service to link with other services such as Oral Surgery and Radiology.

In the view of being open and transparent, we have attached a copy of both the Job Description for the Consultant Bank position, and the Contractual terms. Please note that some information has been redacted from the contracts. Section 25(b)(i)&(ii) While our aim is to provide information whenever possible, in this instance we are unable to provide some of the information you have requested (namely some of the details within the contract), because it is absolutely exempt under section 25 of the Act (absolutely exempt personal information). The reasons why that exemption applies are that: • The Department of Health and Social Care is satisfied that the information amounts to personal data of which you are not the data subject; and • The Department of Health and Social Care is satisfied that disclosure of the information would contravene one of the data protection principles as set out at Article 5 of the General Data Protection Regulation, as it applies in the Isle of Man pursuant to the Data Protection (Application of GDPR) Order 2018, namely that the Department of Health and Social Care can only disclose the information where it would be fair, lawful and meet one of the conditions for lawful processing in Article 6, and in this case, none of those conditions Please quote the reference number 569238 in any future communications.

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I will now close your request as of this date.

Yours sincerely