Annual Report & Accounts 2004-2005 (English) (PDF, new window ...

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Annual Report & Accounts 2004-2005 (English) (PDF, new window ...

eport

2004 - 2005

ANNUAL

& ACCOUNTS

the Dental Practice Board for England and Wales


This is the DPB

Landmarks

1946 Created as the Dental Estimates Board by the

NHS Act. Came into existence along with the

NHS in 1948. First NHS arm’s length body.

1952 First NHS joint Consultative Staffs Committee

formed within Whitley Council framework.

1956 MacNair Report states: “the efficiency of the

Board is outstanding”.

1959 Special investigation section established.

1970 Mainframe computing.

1989 Name changed and new powers granted

under the Health and Medicine Act 1988.

1989 Department of Employment Fit for Work

award (for second time).

1990 Management of the Dental Reference

Service transferred to DPB.

1990 Patient registration payments introduced

doubling the number of payment transactions.

1991 Payment of dentists taken over from health

authorities.

1991 First NHS organisation to make electronic

communications available to professional

contractors.

1996 Electronic Commerce Association award for

excellence.

1999 Investors in People award.

2000 First NHS organisation to be recognised by BSI

as having an integrated management system.

2002 First NHS organisation to achieve the

information security standard BS 7799.

2002 Unisys Management Today Service

Excellence Award.

2003 Registration confirmed to new quality standard

ISO 9001: 2000.

2003 Health and Social Care Act provides for abolition

of the DPB.

2004 Announcement of intention to merge DPB into

the NHS Business Services Authority.

Who we are

• The Dental Practice Board is a statutory body set up

originally under the National Health Service Act 1946 and

now under the National Health Service Act 1977 as

amended by the Health and Medicines Act 1988. Our

procedure is governed by the Dental Practice Board

Regulations 1992.

• We are accountable to the Secretary of State for Health

and to the Welsh Assembly Government for carrying out

such duties as may be prescribed with respect to the

approval of estimates of dental treatment and appliances,

and to the remuneration of dental practitioners providing

general dental services.

• We are a centrally financed service covering England and

Wales. Our accounting officer and budget holder are

officials of the Department of Health.

What we do

• We approve payment applications, calculate and transfer

payments. We pay dentists promptly and accurately.

• In conjunction with the NHS Counter Fraud and Security

Management Service we prevent and detect fraud and

abuse by painstaking financial and quality audit which

protects the interests of patients, dentists and taxpayers.

• We provide dental health information to help create a

greater understanding of primary dental care.

Our values

• We use our vast experience to reduce cost and improve

the service we provide. We aim to be the pacesetter in

managed services and the byword for health management

information.

• In relentless pursuit of improvement, we combine public

service ethos with commercial sector efficiency and

traditional values with modern practice. We aim to be the

benchmark for public management.


Key performance indicators

Almost twenty years ago we adopted the world class

market sector as our performance benchmark. For

economy we use that sector’s long run achievement of

2 per cent a year unit cost reduction. For staff efficiency

we use 5 per cent a year productivity improvement

compared with the sector’s 4 per cent. We preferred the

higher figure because we started from a low point and

because it was necessary to achieve our cost reduction

rate while making room for investment in longer-term

efficiency.

We refer to our benchmarks as being applicable over

successive medium terms. For reporting purposes we

define a medium term as each three successive

accounting years. On our definition, as the table below

shows, over the latest decade we continued to outperform

our benchmarks. Unit costs fell at an average rate of 4

per cent a year. Staff productivity increased at an average

rate of 13 per cent a year. All our preparations for the

future include a commitment to match or better our

benchmarks.

Unit cost

average total expenditure

over the three accounting

ten year average

years to March

yearly rate of change

2005 1995 DPB benchmark

for each payment claim document cleared* 56p 86p down 4 pc down 2 pc

* after adjusting for inflation using GDP deflator

Staff productivity

average number of payment claim documents

cleared by each whole time equivalent employed* 142,503 41,909 up 13 pc up 5 pc

* includes overtime and temporary staff

Contents

Inside Front This is the DPB

Cover

1 Key performance indicators

2 The accounting year to March

2005

3 Board members

4 Operating environment

6 Activity and output

8 Effectiveness

10 Controls assurance

14 Staffing

16 Economy and efficiency

19 Modernising dentistry

21 Strategic management

25 Developments

27 Management team

28 Financial statement

29 Governance

36 Glossary

Annex one

Annex two

Inside Back

Cover

Annual accounts 2004-05 and

supplementary statement by the

Comptroller and Auditor General

Service level agreement

Further information &

contact points

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The accounting year to March 2005

previous year. Higher employer’s contributions to the

NHS pension scheme and payments following last

year’s two year redundancy programme were the

main factors in the increase. In the accounting year

to March 2006 cash utilisation will be £24.1 million.

We are able to report on yet another successful

year. In an atmosphere of considerable uncertainty

about their future, staff at the Dental Practice Board

met all headline service levels, increased their

productivity and dealt with consequences of

changed timing for introduction of the new payment

scheme for dentists and with the formation of the

proposed NHS Business Services Authority.

Merging the role and functions of the DPB with other

organisations into the BSA adds a new dimension to

uncertainty about jobs and location. The uncertainty

is just as true for dental reference officers even

though presently they work from home. Preparing for

the merger requires time and effort diverted from

other subjects. One consequence of a later start

date for the new payment scheme for dentists has

been an increase in the number of PDS

arrangements to administer alongside the reducing

but still greater number of GDS arrangements. This

makes preparing for the new scheme more difficult.

During the year forty nine staff left and one joined.

Year end headcount at 290 was therefore 48 lower.

On average over the year we employed the full time

equivalent of 307 permanent and temporary staff

down from 338. Unexpected additional work for PDS

schemes and BSA formation was absorbed. Once

again more work of a higher standard was provided

by fewer staff. Their productivity rose by 10 per cent

year on year. Our commitment to the BSA is to

reduce the staff headcount to at the most 230 by

March 2007. This commitment is within the scope of

our medium term benchmark of 5 per cent a year

productivity increase. We propose to continue with

our existing plans. To achieve this we expect, during

the current accounting year, to redeploy staff within

the NHS wherever possible and to call for volunteers

for voluntary severance or early retirement.

Cash utilisation during the year was within allocation

of £24.9 million but £1.2 million more than the

Once again the biggest risk of inappropriate

payments to dentists was associated with patient

charges. Based on 137 thousand checks completed

or in process on cases selected since July 2003 our

projection remains that between 82 and 91 per cent

of all checks started will be confirmed within 96

weeks as eligible for exemption from or remission of

patient charges and between 3 and 9 per cent will

be confirmed as not eligible.

There were no changes in board membership during

the year. We are grateful to our staff and to our

board members for continuing to deliver improved

results in unsettling circumstances. Throughout the

year on which we are reporting the implications of

and the effects of the new scheme for paying

dentists and formation of the NHS Business

Services Authority permeated all aspects of our

work. Uncertainty about timing of their

implementation has been especially difficult. Now

that we expect both dates to be April 2006 we will

make sure of an orderly transition of the new

payment scheme and the new authority.

Financial Statements (Annex One)

The financial statements on pages 10 to 32 of

Annex 1, together with the Foreword and other

statements on pages 1 to 7 of Annex 1, and the

Certificate and Report of the Comptroller and

Auditor General on pages 8 and 9 of Annex 1,

reproduce in full those included in the Accounts for

the Dental Practice Board for 2004-05 laid before

the Houses of Parliament on 19 July 2005 under

reference HC136. Pages 1 to 36 and Annex 2 of

this Annual Report provide additional information, for

which we are responsible, that is not included with

those accounts. The auditor is required by auditing

standards to read other information in documents

containing audited financial statements and to

consider the implications for his audit opinion. A

supplementary statement has accordingly been

provided by the Comptroller and Auditor General at

page 9 of Annex 1 in respect of his reading of the

additional information.

John Taylor & Mary Wyllie, 27 June 2005

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Board members

Pictured from the reader’s left: David Ferns, Carol Ferguson, Derek Spratt, Mary Wyllie, Sandeep Lakhanpaul and Ruby Austin

The Dental Practice Board is a statutory body.

It is governed by a board whose only executive

member is the chief executive. The chairman and

a majority of other members must be dentists.

Independent members in office during the year

were all appointed by the Secretary of State for

Health. Executive management is not involved in

the appointment of board members.

Lowestoft, practising almost entirely within the GDS since

graduation in 1982. He has recently trained as a clinical

audit facilitator. Born 1960.

Sandeep Lakhanpaul BDS was appointed a member of the

board in January 2002. Mr. Lakhanpaul is a general dental

practitioner within the GDS in Nottingham. He is also a

member of the Nottingham Emergency Dental Service

management board. Born 1967.

Ruby Austin MBE MGDS RCS (Eng) FFGDP (UK) was

appointed member of the board in April 1996. He is a general

dental practitioner practising almost entirely within the GDS.

He holds several training and advisory positions and is an

elected member of the GDPC. Mr. Austin was appointed vice

chairman of the board in April 2002. Born 1937.

Carol Ferguson MA CA* was appointed member of the

board in May 2000. Following a 25 year career in investment

management and finance, she is now a non-executive

director on a number of boards including Monks Investment

Trust, Gartmore Investment Trust, Merrill Lynch Greater

Europe Investment Trust, Vernalis plc and the Institute of

Chartered Accountants’ Compensation Scheme Ltd. Miss

Ferguson chairs the Audit and Risk Management committee.

Born 1946.

David Ferns BDS* was appointed member of the board in

January 2002. Mr. Ferns is a general dental practitioner in

Derek Spratt BA* was appointed a member of the board in

May 2000. Mr. Spratt graduated in 1964 with an honours

degree in philosophy. After a spell at GEC

Telecommunications, he joined John Lewis where he worked

until his retirement in 1998, at which time he held the post of

Director of Computer Services. Born 1942.

John Taylor BA Hons MBA CMgr FCMI was appointed to

the board in April 1991. He has been chief executive since

April 1987. Born 1939.

Mary Wyllie BDS DDPH RCS (Eng)* was appointed

member of the board in July 1999 and chairman from July

2001. After qualifying from Liverpool in 1963, Mrs. Wyllie

spent 10 years in the GDS and 10 years in the CDS. She

became an NHS general manager in 1976, later becoming

Chief Executive of West Essex Health Authority. Mrs. Wyllie

chairs the Remuneration Committee. Born 1939.

* members of the audit and risk management and remuneration committees

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Operating environment

At the end of March 2005 there were 21,038

dentists providing NHS primary care in England

and Wales.

thousands

20

19

18

17

1

0

GDS principals and PDS

dentists excluding VDPs

GDS assistants

GDS and PDS VDPs

1995 2005

NHS Dentists

This year two developments overshadowed all aspects of our

work: one was the rapid increase in personal dental services,

the other the impending formation of the NHS Business

Services Authority.

Dentists

In England and Wales the number of dentists providing

primary care increased over the year by 724 to 21,038 (see

graph). Including the Isle of Man and non dentists we held at

the year end 21,465 personal numbers for payment purposes

an increase of 806 (see table). There was a sharp reduction

in the number of dentists providing general dental services

and a sharp increase in those providing personal dental

At 31 March 2005 there were in existence 21,465

(up 3.9 per cent) personal numbers eligible for

payments.

Year to March

2005 2004

non dentists 330 311

GDS only 16,405 18,808

PDS only 3,395 901

salaried only 44 56

GDS and PDS 1,183 485

GDS and salaried 30 37

PDS and salaried 26 18

GDS and PDS and salaried 15 9

Isle of Man 37 34

total 21,465 20,659

personal numbers

services.

Surgery addresses

Over the year the number of surgery addresses from which

dentists offered NHS primary care rose by 36 to 9,786. The

average number of dentists operating at each address was

again higher.

Patient registrations

Compared with the previous year the number of patients

registered with a dentist fell by 1 per cent to 25.3 million

(see table).

At the end of March 2005 there were 0.2 million

fewer patient registrations than a year earlier and

there had been a big switch from GDS to PDS.

GDS PDS combined

million million million

adults 14.1 4.0 18.1 down 0.1

children 5.8 1.4 7.2 down 0.1

19.9 5.4 25.3

down 5.0 up 4.8

Documents

Excluding the Isle of Man we received 45.5 million

documents containing applications for payment, item of

service and registration under GDS and activity records

under PDS. This was 1.2 million lower than the previous

year and the second successive yearly decrease.

Fees

We approved for payment to dentists £1,815 million. This was

£71 million or 4.1 per cent more than the previous year (see

patient registrations

table). In the same period we paid to dentists net of

calculated patient charges and other adjustments £1,423

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‘I would like you and your colleagues to know how much I have appreciated the support and help

received from DPB over the years. In fact, I cannot recall a single occasion when a problem or query

has not been dealt with in a professional and friendly manner. I have genuinely felt supported and I

wish the highest standards set by the DPB were followed by many other organisations’

extract from an unsolicited letter received from a dentist on his retirement

million which was £130 million or 10.1 per cent more than the

previous year. One of possibly many factors explaining the

greater proportion increase in payments made compared

with fees authorised is the increase in GDS payment

applications for which the patient was declared to be exempt

from charges or eligible for their full or part remission (see

chart).

Modernising dentistry

We are contributing to the modernisation initiatives aimed at

shifting the balance of power to primary care trusts (PCTs) in

England and the local health boards (LHBs) in Wales. A

revised payment system for dentists is being prepared for

implementation by April 2006.

The density of take

up of PDS in PCTs is

greater in the North

and West than in the

South and East.

over 75%

over 25% and

under 75%

up to 25%

no PDS activity

surgeries with PDS activity at 31 March 2005

Personal Dental services

The expansion of PDS contracts to 4,500 dentists in more

than 2,000 practices during the past year has maintained the

high level of interest in this area of dentistry, with schemes

now operating in most PCTs across England. A majority of

new practices joining PDS use familiar rather than new

methods of working and of paying for dental services. The

gradual conversion of Community Dental and Emergency

Dental Services into PDS also continues. Much work has

been carried out on DPB systems to allow for a continuation

in the growth of practices entering PDS contracts.

NHS Business Services Authority

The Health and Social Care (Community Health and

Standards) Act 2003 provides for the DPB to be abolished. It

is expected that a new NHS Business Services Authority

(NHS BSA) will carry out our existing functions. In July 2004

the Department of Health announced its intention to reduce

its number of arm’s length bodies. As a result the Dental

Practice Board, the NHS Pensions Agency and the

Prescription Pricing Authority and possibly another body will

merge to form the NHS BSA. It is assumed the NHS BSA will

take on the issue of relocation of the DPB raised originally in

the review by Sir Michael Lyons.

Gross fees authorised for payment were £71

million up on the previous year. Net payments

transferred to dentists were up £130 million.

Year to March

2005 2004

£million £million

fees authorised 1,815 1,747

change on previous year 71 78

fees paid 1,423 1,293

change on previous year 130 70

The proportion of GDS courses of treatment for

which the patient was declared to be exempt

from charges or to be eligible for full or partial

remission of charges continued the recent

upward trend.

per cent

28

27

26

25

24

23

22

fees authorised and payments made

1995 2005

patient charges

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Activity and output

Over the year we received 45.6 million payment

claim documents and processed to completion

46.1 million.

50

40

30

20

10

0

1949 2005

During the year we authorised 73.1 million

separate GDS payments and completed in all 95.3

million payment transactions.

Year to March

2005 2004

millions millions

item of service 31.4 34.4

new registrations 13.8 15.4

re-registrations 27.8 28.5

GDS authorisations 73.1 78.4

registrations deletions 18.6 16.1

GDS transactions 91.7 94.5

PDS activity records 3.3 0.8

Isle of Man, Salaried and Emergency 0.3 0.3

all transactions 95.3 95.6

Receipt of new prior approval applications fell

again, this year to 443 thousand.

800

documents dealt with

transaction processing

new applications

decisions returned

Over what is now almost six decades since the introduction

of NHS primary dental care there have been only three

pauses in the steady increase in activity. The first coincided

with the fee cut in 1950, the second with the new contract in

1990 and now with the new payment scheme to be

introduced by April 2006.

Document processing

During the year we received 45.6 million payment application

documents. We processed to completion 46.1 million thereby

reducing work on hand.

Payment

In all we completed 95.3 million payment transactions down by

0.3 million on the previous year (see table). A sharp increase

in PDS activity almost offset the similar fall in GDS activity.

Prior approval

We received 443 thousand new applications for our prior

approval of proposed treatment plans and 172 thousand

resubmissions. We returned to dentists 576 thousand

decisions.

Dental Reference Service

We received 37,992 reports of patient examinations from our

dental reference officers. Of these 22,303 related to the

standard of proposed treatment plans and 15,689 to the

standard of completed treatment. During the year dental

reference officers began the switch in emphasis of their activity

from inspection to clinical governance in expectation that the

new payment scheme would begin in April 2005.

600

Patient charge refunds

thousands

400

200

During the year we checked 32,848 refund claims. The total

value of refunds paid was £1,489,354.36. Of these we

refunded 22,098 applications in full, 6,765 in part and

refused 3,840 in full. The value of the claims rejected was

0

1995

prior approval

2005

£680,397.13 or about a third of the total amount claimed.

The most frequent reason for rejecting claims was that the

dentist informed us that the treatment was provided privately.

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‘Overall, based on the processes current as of today and on the samples taken, the

Complaints Management System is working effectively.’

BSI Assessment Report: CMSAS 86: 2000 – Complaints Management Standard April 2005

Benefit eligibility checks

Based on 137 thousand checks completed or in process on

cases selected since July 2003 (see chart) our projection

remains that between 82 and 91 per cent of all checks

started will be confirmed within 96 weeks as eligible for

exemption from or remission of patient charges and between

3 and 9 per cent will be confirmed as not eligible. Any

remainder will not be determined within that time. When

considering these projections bear in mind that confirmations

of eligibility are reached sooner than those of ineligibility (see

graph below right). At the accounting year end we had issued

3,171 penalty notices. In total we received £194 thousand

following decisions to recover money where checks

confirmed the claimant to be ineligible for exemption from or

remission of charges.

Probity

In the year to March 2005 the number of cases referred by

us to health bodies for consideration of disciplinary

proceedings was 23. This is a sharp reduction from the

previous year’s figure of 130 and continues the trend for

fewer disciplinary referrals that has been seen since the year

to March 2002. These year on year reductions in the number

of referrals have come about for a number of reasons that

relate to: our efforts to provide services that are valued by

our customers, the introduction of the Counter Fraud

Services, changes to the Dental Reference Service (DRS)

and our need to classify and tackle risks to funds more

efficiently because of the reduction in our human resources.

During the year we completed 32 thousand

applications for refund of patient charges. We

made 26 thousand refunds and refused 3

thousand refunds.

Year to March

2005 2004

opening on hand 4,856 3,298

received 30,131 36,911

completed 32,848 35,306

closing on hand 2,139 4,856

mean period to completion 21 days 38 days

patient charge refunds

During the year we completed 75 thousand

benefit eligibility checks in an average of 55

days each.

benefit eligibility checks

£000 £000

refunds made 1,489 1,702

refunds refused 680 566

Year to March

2005 2004

opening on hand 15,135 5,438

started 78,677 82,248

completed 75,645 75,551

closing on hand 18,167 15,135

mean period to completion 55 days 30 days

£000 £000

money received 194 65

From July 2003 to March 2005 we completed 137

thousand benefit eligibility checks.

In response to feedback from health bodies where concerns

are solely clinical we deal with them mostly as clinical

governance matters. PCTs have responded well to this

approach and we have had significant positive feedback

since we introduced the change in October 2001.

1.0

0.8

0.6

0.4

0.2

0.0

proportion of

claims checked

after N weeks proportion

• confirmed eligible

• confirmed not eligible

• eligibility unknown

1

weeks elapsed since selection 94

benefit eligibility checks

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Effectiveness

During the year we transferred payments to

dentists on average 27.9 days after receiving the

claim.

days

32

31

30

29

28

27

service level agreement

12 month centred moving average

1996 months 2006

During the year we received 45.6 million payment

claim documents and processed them so that

99.3 per cent of those paid were on the next

monthly payment for the claiming dentist.

per cent

100

99

98

service level agreement

12 month centred moving average

1996 2006

Over the year the error rate in item of service

payments was 0.02 per cent or about 200 in every

million.

per cent

100

99.5

claims turnround

claims throughput

service level agreement

12 month centred moving average

1996 2006

payment conformity to SDR

In conditions of unusually high uncertainty, with many leaving

and many switched to new work associated with Personal

Dental Services and formation of the NHS Business

Services Authority, our staff met and surpassed committed

service levels.

Prior approval

The number of prior approval applications received during

the year ending March 2005 was 443 thousand. This was

29 thousand fewer than in the previous year however the

number of resubmissions grew from 160 thousand in the

year ending March 2004 to 172 thousand. Applications not

referred for a dental reference officer examination of the

patient were returned to the dentist with a decision in an

average of 4.9 days.

Payment

During the year 73 million item of service and registration

claims were approved for payment. Associated payments

were made on average 27.9 days after receipt of the claim.

Our main measure of turnaround time, the twelve month

running average, had been stable at or just below the thirtyday

target for over three years. The reduction in turnround

time was in response to a new service target set by our

sponsors. All payment transfers to dentists were on the dates

prescribed. The proportion of claims approved during the

year in time for authorisation on the first available schedule

was above 99 per cent.

Helpdesks

The call profile on the main helpdesk has changed over the

past year reflecting new work for benefit eligibility checks and

patient charge refunds and for rapidly increasing personal

dental services. Main helpdesks are now merged. Additional

work accounts for the increase in call traffic on this desk,

from 192 thousand calls in year ending March 2004, to 205

thousand calls in year ending March 2005. For the fourth

consecutive year, the main helpdesk has met its service level

agreement. This year 93 per cent of calls were answered

within 15 seconds.

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‘Seven out of ten respondents say their contact with the DPB has been either excellent

or good.’

Patient survey, RBA Research Ltd. May to June 2004

Complaints management

We continue to be registered by the British Standards

Institute for CMSAS 86: 2000 Complaints Management. We

received 174 complaints during the year. The most frequent

complaint involved the nonpayment of claims. There were a

variety of reasons why claims were not paid on the same

month’s schedule. Although some were due to processing

delays at the DPB, some cases contained inappropriate

claims for treatment which required written clarification from

the dental practices. Other cases were submitted too late

after completion of treatment and were therefore not in

accordance with the regulations. All complainants are

surveyed after clearance. Of the 75 who responded to our

survey 28 viewed our response as not complete. We use

such feedback in our assessment of current practices and

look for ways of improving them.

With reduced numbers of patient examinations there were

fewer complaints about the Dental Reference Service but as

benefit eligibility checking increased this activity attracted

more complaints.

Quality systems

The British Standards Institute in their Continuing

Assessment Visit Report confirmed continuing certification

for OHSAS 18001, ISO 14001 and ISO 9001: 2000 as part of

an Integrated Management System. In addition we were

recertificated to the complaints management standard and

confirmed continuing certification to the Information Security

Management standard BS7799.

Customer survey

The main survey of patients was completed at the end of

June 2004 and a full report received at the end of July. The

survey found that the DPB is carrying out its duties

professionally and politely. The full summary is available on

our website at www.dpb.nhs.uk.

During the year we received 25 thousand payment

queries involving 79 thousand patients. On

average these were returned in 1.5 days.

12,000

10,000

8,000

6,000

4,000

2,000

0

work in progress

received

2001 quarters

2005

payment queries

There were fewer complaints about the DRS and

more about eligibility checks.

2005 2004 2003

complaints received 174 187 219

complaints cleared 171 183 211

responded in more

than 14 days 11 15 21

mean time to clear days 7 7 8

complainant dissatisfied

with response 28 19 33

complaints

Customer surveys show consistently the

importance attached to our help desks and the

high regard in which their service is held.

Response times are above industry standards

and mystery shopping shows continuing service

improvement.

main

desk

dental

payments

incoming calls 204,790 66,720

abandoned 0.4 pc 23.4 pc

average wait 9.5 seconds 24 seconds

within 15 seconds 92.5 pc 79.5 pc

helpdesk performance

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Controls assurance

As its accounting officer the Dental Practice Board’s chief

executive is responsible for the propriety and regularity of

public funds and assets vested in the Dental Practice Board.

This responsibility requires maintenance of a sound system

of internal control. The overriding principle involved is that in

all material respects public funds are applied to the purposes

intended by Parliament and that financial transactions

conform to the authorities which govern them.

Risk management

The Controls assurance management system (the Cams) is

now established as the method by which the DPB identifies

and manages risk. Internal audit have built reviews of the

risks identified within the Cams as part of the audit process.

Responsibility for the oversight of the adequacy of the Cams

falls to the Audit and risk management committee, a sub

committee of our board.

An important part of the Cams system is the service

incidents system. This early detection system is available to

all staff and enables anyone to raise a service incident when

encountering something of concern in their day-to-day

activities. Each service incident is referred to a manager who

is responsible for investigating the cause and reporting on

the action taken to prevent it occurring again. The pattern of

service incidents is used to evidence the likelihood and

impact of an identified risk. These are of particular

importance when monitoring the performance of our two

main suppliers, IBM and Astron. (Astron has since been

bought by RR Donnelley.) The recording process involved is

important as it builds an accurate record of what incidents

occurred and when, rather than relying on individuals’

memories of events.

Service incidents are reviewed through our Process Steering

Group and an assessment made as to whether a new risk

should be recorded or an existing one updated. The risk

registers themselves are reviewed at least once a year by

staff who have responsibility for each of the seven systems

which taken together cover the whole scope of our

responsibility: clinical governance; environmental

management; financial governance; health and safety;

information security; quality assurance; and probity.

The Cams has been designed to meet the requirements of

the NHS controls assurance framework as well as those

international quality standards to which we are registered.

These include Quality Management ISO 9001, Environmental

Management ISO 14001, Occupational Health and Safety

Management, OHSAS 18001, and Information Security

Management BS 7799. BSI Assessors for these standards

are now increasingly using the Cams system to base their

audits on.

Clinical risk

We examine but do not treat patients. Our main areas of

clinical risk are cross infection control and the disposal of low

grade clinical waste. Almost all DRS examinations are held in

20

15

incidents

10

5

0

comparison of critical and service incidents

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‘The internal audits sampled reflect a high level of control and monitoring of the process

and procedures.’

BSI Assessment Report: BS EN ISO 9001: 2002 – Quality Management System April 2005

the practitioner’s surgery. Internal procedures are in place to

protect against the risk of cross infection between patients

and dental reference officers. These procedures are regularly

monitored to check compliance. We use disposable sterile

instruments which removes the requirement to sterilise

reusable instruments.

Our disposal of the low grade clinical waste produced through

DRS activity and current developments in cross infection

control are all monitored and discussed at regular intervals.

Environmental management

Our major impact on the environment lies in our use of

utilities and consumption of paper and general waste to

landfill. To manage these risks we have set organisational

objectives to reduce consumption and generated waste and

we recycle wherever possible. In addition we are putting in

place further controls to ensure that environmental

considerations are included in all procurement decisions so

as to only purchase from sustainable sources where

practicable.

Our main environmental risks in terms of business continuity

are fire, power failure and unauthorised physical access.

These have a variety of controls in place such as back up

generators, fire detection systems, and access control and

security systems.

Financial governance

To safeguard our public funds from risk of fraud and other

forms of inappropriate payment we have controls in place

which are approved and monitored at board level, through

our Standing Financial Instructions and Systems of

Financial Control. To ensure compliance our internal audit

department monitors their effectiveness throughout the year

and external auditors audit our systems each year. The

Statement on Internal Control in our Annual Accounts

publicly states our policy and approach. The external

auditors report if this does not meet the requirements

specified by Treasury. We returned a nil fraud return for

2004/05. Administration account losses and special reports

are reported to the board and for 2004/05 administration

losses totalled £20.

Statements on corporate governance have also been

produced and are now reflected in our annual report and

accounts. In accordance with the requirements of the NHS to

safeguard public funds we have appointed a local counter

fraud specialist who is responsible for the promotion of an

antifraud culture and investigating any potential fraud

according to NHS guidelines.

Health & Safety management

Our major health and safety risks are injury due to trips and

falls, driving related risks, workstation related risks and risks

associated with contractors working on site for example

window cleaners, catering staff and building contractors. To

manage risks in all these areas regular risk assessments are

carried out, with any identified potential or actual hazards

addressed where possible. In addition to the statutory

requirements, all contractors are required to comply with our

local health and safety policies and systems.

One of our key health and safety risks is the increasing level

of driving staff are required to undertake to carry out their

duties. To control the risks associated with this, all staff who

drive over a certain number of miles on our business have

undertaken a defensive driving course. The aim of this

course is to highlight any potentially dangerous driving habits

and advise the individual on how to drive more safely.

Information Security

We continually update our information security procedures to

address increases in risk arising from changes in business

requirements and pervasive technology opportunities. The

increase in mobile working by staff and the increased

general availability of devices, such as memory sticks, PDAs

(Personal Digital Assistants) and wireless broadband, all

need appropriate control and countermeasures to ensure

information security.

Our registration to BS7799 has been successfully upgraded

to the latest version of the standard. We were the first NHS

organisation to achieve BS7799 registration, which requires a

continuous risk assessment and improvement cycle. Our

processes and computer systems are designed to satisfy

(continued overleaf)

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Controls assurance continued from page 11

NHS requirements for information confidentiality. UK

government eGIF standards are being specified for new

computer systems where there is a requirement to transfer

information to or from other organisations.

This year has seen a massive increase in the number of

attempted virus attacks on our computer systems, in

common with the rest of the world. However DPB systems

have remained secure from disruption by viruses due to

increased vigilance by staff and technical advances in antivirus

measures.

Our business continuity plans are regularly reviewed in line

with changing business requirements and are tested in

conjunction with our outsourcing partners. Increasing reliance

on electronic communication with stakeholders is bringing

extra requirements for resilience and availability of

communications links with our computer systems.

the Welsh Assembly Government specified in our service

level agreement (SLA). The specific areas of risk that

contribute to this broad risk category include the resourcing

of business processes in particular human resource and IT,

the accurate and timely delivery of those processes and the

ability to meet the changing needs of our stakeholders. A full

risk assessment has been carried out by the Modernising

Dentistry project team on the risks inherent in moving to a

new system of commissioning NHS dentistry in England and

Wales. Examples of controls in place to reduce these risks

are regular monitoring of our SLA, effective management of

our staff and IT systems and regular meetings with the

Department of Health and the Welsh Assembly Government.

We have adopted a process approach to the quality

management of our business. Top level processes have

been mapped to ensure quality improvements are made and

risks to those processes identified.

Quality assurance

Our principal quality risk is not meeting our organisational

objectives as agreed with the Department of Health and

Probity assurance

Our probity assurance management system is designed to

reduce the risk that public funds allocated to dental services

2,500

2,000

1,500

1,000

500

0

May-04 Jun-04 Jul-04 Aug-04 Sep-04 Oct-04 Nov-04 Dec-04 Jan-05 Feb-05 Mar-05 Apr-05

each colour represents a specific virus

E-mail virus detection

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‘The risk management system CAMS has progressed dramatically.’

BSI Assessment Report: BS EN ISO 9001: 2002 – Quality Management System April 2005

are used other than as intended by Parliament. Our starting

point is to estimate the risk inherent in any circumstance that

can be identified as giving rise to a possibility for an

inappropriate use of public funds and to evaluate the change

in these risks brought about by any procedure.

Risk assessments cover issues arising from the necessity for

and quality of care and treatment provided by dentists, the

accuracy of information provided by patients and dentists

and the validity and reliability of our systems and procedures

for calculating and making payments. Controls on

inappropriate payments include procedures for checking and

validating information received as part of the claim for

payment, random and targeted monitoring of the standard of

care provided and investigation of abnormal or suspicious

circumstances.

Quantifications of all the separate risks identified at various

stages of processing are brought together in a risk-control

matrix. This matrix sets out the impact of each control on

each risk. This allows us to compare risks and arrange our

activities taking into account their rank order. Risk

assessments are carried out to estimate the parameters

included in the matrix.

Raw risk is the risk assumed in the claims made to us before

taking account of our controls. Residual risk is the risk that is

estimated to remain after all the control measures have had

their full effect.

Risk assessments are generally subject to wide margins of

uncertainty. For example, the latest estimate of the risk of

making inappropriate payments relating to exemption from or

remission of patient charges has an associated uncertainty

ranging from 3 per cent to 18 per cent of all payments of this

kind. This estimate overlaps the range estimated in 1997

which was from 6 per cent to 13 per cent.

Our assessment of patient charge risk is based on checks on

a sample of 137 thousand claims in which there was a

declaration of exemption or of entitlement to remission. A

risk assessment provides evidence rather than fact. As we

have no reason to suspect our checks are invalid or that

claims checked may not be a fair sample of all claims of this

kind we assume that the results would be similar if all claims

were to be checked. We hold to this assumption but the way

we hold to it is not dogmatic or inflexible. Risk assessment is

not measurement.

For the accounting year to March 2005 the top risk

categories with their approximate residual risk ranges are:

patient charges

£11m to £67m*

radiographs £5m to £15m

fillings £4m to £10m

sealant restorations £2m to £8m

crowns, veneers, inlays £2m to £7m

dentures £1m to £7m

capitation £1m to £7m

orthodontic appliances £1m to £7m

continuing care payments £1m to £7m

non-surgical periodontal treatments £1m to £7m

extractions of special difficulty/

other oral surgery £1m to £7m

* refer to comment and graph on page 7

A previous risk assessment estimated that the raw risk of a

small radiograph being of clinically unacceptable quality

might be as high as one in four. A replication of the

assessment in 2005 has confirmed this finding, so it has now

been incorporated into the matrix as applying to all

radiographs.

In the accounting year to March 2006 we expect a great deal

to change in the way primary care dental services are

provided, in preparation for the new dentist payment

arrangements scheduled for implementation by April 2006.

There are likely to be major changes in the risks arising and

in the data that will be available to monitor those risks. Some

risks, such as those associated with patient refunds and

eligibility for free treatment may remain substantially

unchanged. As details of the new arrangements emerge we

are developing the changes necessary to the probity

assurance management system to ensure that we can

continue to provide relevant and cost effective probity

assurance activities based on patient surveys, record card

checks and agency checks, complementing the new

monitoring arrangements to be adopted by the DRS.

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Staffing

Voluntary early retirement and severance as a

result of redundancy continue to be the main

component in staff reduction.

at 31 March 2005 2004

permanent staff 290 338

full-time 233 274

part-time 57 64

on average during year to March 2005 2004

staff employed* 299 325

permanent 281 315

temporary and overtime 18 10

*full time equivalent

During the year 49 staff left and one joined. Most

leaving in recent years has been through

successive voluntary redundancy schemes.

Year to end

March leavers joiners total

2001

2002

2003

2004

staff numbers

2005

290

50 25 0 0 25

other redundancy other dental

staff turnover

416

390

354

338

We continue to enjoy the benefits of a stable and

long serving staff membership.

Year to March

2005 2004

staff at year end 290 338

full time 233 274

female 162 193

average age yrs 49 48

average service yrs 19 17

sickness absence pc 2.2 2.7

qualifications

level 4 and above pc 41 38

level 3 and above pc 81 75

10 year service index pc 80 81

10 year stability index pc 39 30

productivity index* 1,065 969

* 1965 = 108 1975 = 109 1985 = 142 1995 = 373

staff profile

Our staff worked throughout the year in the context of

considerable uncertainty about their future jobs and location.

Their response was to complete more work than ever before,

at higher service standards and they increased their

productivity by 10 per cent.

Employment

Permanent staff numbers continue to decline principally as a

result of early retirement and severance schemes as an

alternative to redundancy. A total freeze on recruitment is

currently in place. Following the retiming of introduction of

the new dentist payment arrangements more temporary staff

were utilised during the period. This was to ensure essential

services and SLA targets are maintained while the

preparations continue for the introduction of the new scheme.

Productivity

Our benchmark is to sustain staff productivity increases of

5 per cent a year taking one year with another. That figure

has been exceeded in almost every year since we set the

benchmark in 1987, sometimes by a considerable margin.

This year once again our staff achieved record productivity

levels. Their productivity rose by 10.1 per cent year-on-year

to another record high.

Taking into account all reasons for nonattendance including

holidays, staff availability at the main offices in Eastbourne

rose slightly from 80 to 81 per cent of all half day sessions.

The proportion of staff with one or more incidence of

unplanned absence was 62 per cent. Sickness absence was

down a little at 2.2 per cent. When comparing these figures

with other organisations it should be held in mind that we

have a very reliable recording procedure.

Attitude survey

The 2004 employee survey was carried out in-house,

breaking with a tradition of using external consultants. This

year’s response rate was 79 per cent, well above the NHS

average of 60 per cent. The survey identified good results in

terms of employee satisfaction in comparison with NHS

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‘The DPB has a rigorous training policy and training procedures.’

BSI Assessment Report: BS EN ISO 9001: 2002 – Quality Management System April 2005

averages with fewer staff considering leaving the

organisation and more employees receiving performance

reviews.

We exceeded once again our benchmark

productivity increase of 5 per cent year-on-year.

Areas highlighted include:

1,800

staff

dentists

21,000

Work Life Balance We were concerned that almost a

quarter of respondents felt that we are not committed to

helping staff balance their work and outside lives.

We are pursuing actively the Improving Working Lives

Standard and there is set up a joint working party with Staff

Side to ensure that we meet and surpass this standard. A

recent review of flexible working arrangements has increased

access to flexible working for those in management grades.

An action plan is in place to implement the Managers Code

of Conduct.

Equal Opportunities Following up on issues in the

previous year’s survey, confidence in the DPB’s policies for

dealing with unfair treatment has improved.

Pay, grading and performance We are making good

progress in the implementation of Agenda for Change and

have conducted a full review of all job descriptions and

personnel specifications. Over a quarter of employees have

already been assimilated onto new pay scales as a result of

the ongoing pay modernisation work. We expect to assimilate

all staff by the deadline of September 2006.

staff

1,200

600

0

1948

Ratio of GDS dentists to staff

1955 1965 1975 1985 1995 2005

10.5 8.4 7.8 9.1 23.1 69.9

staff productivity

2005

14,000

7,000

Four in five staff have at least one qualification at

or above level three.

national DPB DPB

target 2005 2004

level 4 and above 30pc 41pc 38pc

level 3 and above 60pc 81pc 75pc

Investors in People yes yes yes

new external qualifications achieved during the year

20 vocational

9 technical and professional

1 higher degree

staff qualifications

Over the last 20 years our staff structure has

changed markedly. What was a clerical factory is

now a much smaller professional organisation.

0

dentists

Development

We are committed to giving staff the chance to develop.

Following our reassessment to the Quality Management

Standard ISO9001:2000, British Standard Institute assessors

praised our work to implement the Knowledge and Skills

Framework, commenting that the organisation surpassed the

required standards for training and development to ensure

that all staff are competent.

staff

1,856

others

grade 5 and above

dental

681

290

1985 1995 2005

staff structure

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Economy and efficiency

Cash used during the accounting period was

within allocation and expenditure was within the

resource limit.

Cash is the money used to pay for employment and

purchase of goods, services and new assets, adjusted

for change in debtors and creditors and expressed net of

income.

£24.9m

Expenditure is the cost of acquiring short or long lived

benefit by cash payment or by incurring a liability,

expressed net of income.

£25.8m

Expense is the net operating cost to the public of

acquiring our services or using up assets provided

to us.

£25.9m

total cost

Cash utilisation was below net operating cost.

Year to March 2005

cash expenditure expense

£m £m £m

pay 11.9 11.9 11.9

pensions 1.6 2.6 2.6

employment 13.5 14.5 14.5

goods and services 11.6 11.6 11.6

new assets 0.3 0.3

depreciation 0.5

cost of capital (0.1)

income (0.6) (0.6) (0.6)

working capital 0.1

24.9 25.8 25.9

cost accounts

For nearly twenty years we have maintained downward

pressure on total and unit cost by a combination of market

testing, technology and staff productivity. Spectacular increases

in staff productivity have been taken largely as staff reduction

for which successive rounds of redundancy were necessary.

Economy

Our cash allocation for the year was £24.95 million of which

£24.60 million was intended for revenue payments and £0.35

million for the acquisition of capital assets. We utilised

£24.90 million cash.

Pension payments of £1.6 million in respect of retired staff

who left under voluntary early retirement schemes included

£0.3 million to buy out part of our commitment and reduce

costs in future years.

Compared with the accounting year to March 2004

expenditure on employment was higher by £2.5 million. There

were increases to pay rates from national awards and in

addition for dental staff from Agenda for Change but these

were more than offset by the employment of fewer staff

following another successful voluntary leaving scheme.

Three main factors more than account for the total increase.

One was the doubling of employer’s superannuation

contributions (increase of £0.6 million); another was the

increased use of agency staff in response to the retiming of

the new payment scheme for dentists (increase of £0.3

Cash used was below allocation due to timing of

capital expenditure projects.

Year to March

2005 2004

£m £m

pay 11.9 11.1

pensions 1.6 1.0

employment 13.5 12.1

goods and services 11.6 11.9

new assets 0.3 0.3

income (0.6) (0.4)

working capital 0.1 (0.2)

24.9 23.7

allocation 24.9 23.9

cash utilisation

million); the third was the provision for liabilities arising from

voluntary early retirements and severance on the grounds of

redundancy (increase of £1.7 million). Stripped of these

nonrecurring components employment costs remain on a

firm downward path.

Efficiency

Our benchmark for unit cost is 2 per cent a year reduction

after adjusting for inflation. In any period our performance

underlying cost can be distorted by the level of voluntary

early retirement and severance scheme costs. For the last

three years these costs were £3.7million, £0.9 million and

£2.6 million.

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‘The Information Security System was observed to be well controlled and managed.’

BSI Assessment Report: BS7799: 2002 – Information Security April 2005

The future

Looking ahead upward pressure on cost will come from

inflation. Aside from dental staff Agenda for Change should

apply some downward pressure on wages for at least a few

years. This effect will be in part offset by protection of some

salaries. There should also be some benefit from a fixed date

for introduction of the new dentist pay scheme. Formation of

the BSA may also help although for clarity our forecasts are

for a going concern. At the time of preparation of these

notes there are two items which may or may not appear in

our account for the year to March 2006. One results from the

decision to change the discount rate applied to liabilities from

3.5 per cent to 2.2 per cent. If this is to appear in our

expenditure account it will be as a new provision which we

estimate at £1.4 million. The other is the possibility that we

will raise a provision in respect of redundancy to take place

between April and September 2006. Our estimate is that the

provision will not exceed £1.0 million. This means there are

four possible expenditure accounts for next year (see table).

Net operating cost was £2.1 million higher due

mainly to the provision for redundancy costs.

Year to March 2005 2004

£m £m

pay 11.9 11.1

pensions 2.6 0.9

employment 14.5 12.0

goods and services 11.6 11.9

capital charges 0.4 0.3

income (0.6) (0.4)

net operating cost 25.9 23.8

Expenditure for the year was £25.8 million.

external

data capture

£1.4m (£1.2m)

expense

voluntary early

retirement

£2.6m (£0.9m)

finance and

operations

£7.5m (£6.5m)

four possible expenditure accounts for

the accounting year to March 2006

computing

£5.1m (£6.1m)

information

and probity

£2.5m (£2.1m)

A B C D

£m £m £m £m

dental reference

services

£6.7m (£7.0m)

pay 11.6 11.6 11.6 11.6

unwind discount 0.4 0.4 0.4 0.4

expenditure

restate discount 1.4 1.4

redundancy 1.0 1.0

employment 12.0 13.4 13.0 14.4

administration 11.1 11.1 11.1 11.1

Net operating cost for every £ authorised was 1.5p

including the DRS or 1.1p without the DRS.

3p

new capital assets 0.3 0.3 0.3 0.3

less income (0.5) (0.5) (0.5) (0.5)

2p

net expenditure 22.9 24.3 23.9 25.3

1p

0p

1949

expense per £ including DRS

expense per £ excluding DRS

merged with DRS in 1990

2005

unit operating cost

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‘It is clear that the DPB is carrying out its duties professionally and politely’

Patient survey, RBA Research Ltd. May to June 2004

We are a component of the wider NHS system for providing primary dental care. One of our functions is to promote the interests of dentistry in

the NHS. We do this in many ways including making ourselves available to all NHS dentistry stakeholders. In the picture above Patricia

Burtenshaw (Customer Liaison Manager) is seen answering the queries of two visitors to our stand at a recent conference.

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Modernising dentistry

The DPB modernising dentistry project team was originally

set up in September 2003. This team adopted the principles

of the PRINCE project management methodology with an

experienced senior manager as its project leader. The

project team remain responsible for updating the project risk

register and for monitoring all activities arising from

modernisation that impact upon the DPB and its

stakeholders. Some of the major elements of the project are:

• creation of an appropriate payment system for England,

Wales and Isle of Man;

• production of indicative budgetary information for PCTs

and dentists before new contract implementation;

• production of information for PCTs and dentists after the

new contract implementation;

• implementation and monitoring of field sites in

conjunction with the Modernisation Agency;

• organisation of roadshows for the PCTs on behalf of the

DH;

• input to working groups including patient charges review,

clinical pathways, base contract negotiations with the

BDA, professional advisory group and workforce review.

Finance and Operations

In particular we concentrated, in close liaison with the DH,

on building a payment system that will be able to pay

dentists in line with the new arrangements required by the

base contract minimum dataset. This payment system is

based on the existing software systems with some

automation and improvement for dentists and PCTs to the

input of data at the front end and retrieval of information at

the back end of the process. This system will be ready to

make payments in the appropriate way at the time the new

arrangements for dentistry are introduced including those for

the revised patient charge arrangements at any time from

April 2006. It should be noted that the level of manual

processing needed will be greater until April 2006 if the start

date is earlier than April 2006.

The faster take up of PDS schemes before full

implementation of the new contract was dealt with

appropriately by the DPB. We adjusted our existing systems

to cope with a rapid increase in PDS activity instigated by

PCTs. As PCTs need help in understanding existing PDS

and all existing and proposed new aspects of the GDS a

DPB-PCT liaison team has been in place to ensure that

adequate resources are available to support PCTs as they

assume responsibility for commissioning of dentistry locally.

PDS support has been provided to LHBs in Wales in line

with WAG guidelines.

Dental Reference Service

During the year 2004/05 the DRS has continued to support

the aims of the DH framework proposals set out in 2003 and

continues to prepare for the new role envisaged in those

proposals, namely to be in a position to provide clinical

governance and clinical quality support for PCTs and practices

when the proposed new dental contract comes into operation.

The initial project to prepare the DRS for its new role has

been carried to completion and new systems of monitoring

by surgery visits have been devised and piloted. In addition

all DROs have successfully completed the appropriate

training course and have attained the Certificate in Practice

Appraisal awarded by the Faculty of Dental Surgery of the

Royal College of Surgeons. Whilst the exact role which the

DRS will have in clinical governance has yet to be fully

defined, these pilots, together with other training programs

are equipping the clinical staff with the skills and knowledge

to carry our a broad range of tasks to meet future needs.

The increase in PDS activity has provided the opportunity to

scale up the piloting and involve a larger number of practices

in surgery visits. This is providing useful feedback which is

being used to refine the new methods of working.

The DRS continues to support PCTs by making dental

reference officers available to assist them with clinical issues

when setting up new PDS schemes and has also provided

clinicians to assist the Department of Health with work in a

number of areas.

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In addition to preparing for the future, normal monitoring

work in the GDS also continues, but it is inevitable that as an

increasing number of practitioners move into PDS and the

number of new style surgery visits increases, so the amount

of traditional GDS monitoring will decrease. The DRS will

however continue to maintain a position which will keep all

options open for the future.

Information and Probity

The Information and Probity Department has provided a

comprehensive service of information and advice in England

to the Department of Health, as policy maker, and to primary

care trusts and others responsible for the implementation of

the new arrangements. Similar support has been provided in

Wales to the Welsh Assembly Government and to local

health boards. This has included input through interorganisational

meetings and response to formal requests for

assistance in modelling the impact of changes to patient

charge regimes, to less formal activities such as the

development of a comprehensive enumeration of the

possible risks inherent in the proposed new arrangements.

information collected and stored in the DPB’s data

warehouse is close to completion. This facility will allow

authorised users to view, analyse and download any activity

data collected under their contracts as part of the new

arrangements.

An illustrative set of reports has been drawn up to reflect the

emphasis and content of the proposed base contract data

set and the likely new reporting style. These reports illustrate

particular choices of reporting level and statistical measures.

Activity summaries will provide a broad indication of activity

in terms of the number of providers, episodes and patients

within a health body and can also summarise salaries paid

and patient charges. It will be possible to demonstrate the

demographic and exemption and remission profile of

patients seen, together with episode length and their patient

charge status. In consultation with the Department of Health

and primary care trusts in England and the Welsh Assembly

Government and local health boards in Wales these reports

will be developed to provide a statistical tool for monitoring

contracts under the new arrangements.

The balance of potential risks to public funds under the new

arrangements are likely to be significantly different from

those under the current arrangements. With the reduction in

the range of information available from the Base Contract

Data Set, it will be more difficult to identify those risks. It is

probable, however, that problems arising from lack of

information about the availability and cost of treatment under

the NHS will feature more prominently when the new

payment arrangements are implemented and we are

planning to increase the number of patient audit

questionnaires and patient record checks in order to

continue to provide assurance to commissioners. The

checks on patient payment status will also be expanded. We

will provide any information gathered on risks to assist the

DRS to maximise the cost effectiveness of that service.

In future it may be possible uniquely to identify patients by

their NHS number or by the data set (surname, forename,

gender, date of birth) and patients seen in a period may be

counted profiled by age, gender, treatment received or

residency.

The project that will allow health bodies external access

under secure conditions via the internet to detailed

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Strategic management

Although legislation exists which provides for abolition of the

Dental Practice Board and we expect merger into the NHS

Business Services Authority we remain a statutory body and

we continue to manage and to account for the Dental

Practice Board as a going concern.

The Strategic Review we carried out in 2001 highlighted the

recent and ongoing change stemming from the

implementation of the NHS Plan. We stated our aim to be

flexible, innovative and adaptive in our response to these

changes in order to deliver our primary strategic goal:

To contribute to the implementation of dental

and other health strategies of the NHS.

current GDS and PDS requirements. In parallel we are

developing new and amending current systems to deliver the

requirements for payment, quality assurance, probity

monitoring and information services needed for the new

approach to commissioning NHS dentistry within England.

For Wales we are working closely with the Welsh Assembly

Government (WAG) to determine their requirements over the

next few years to ensure we are able to meet them.

Goal 2 We will provide an agreed level of assurance

with respect to the probity of the payment

system in order to prevent and detect

inappropriate payment, unnecessary treatment

or any other abuse within the GDS.

During 2002 three documents were published which

specifically moved forward the Modernising NHS Dentistry

strategy: NHS Dentistry: Options for Change; An Information

Technology Strategy for NHS Dentistry in 21st Century; and

Routes to Reform: A Strategy for Primary Dental Care in

Wales. We are playing an active role in the implementation

of all of these strategies.

We revised our strategic goals in 2003 in the light of these

developments. Our strategic goals are currently as follows:

Goal 1 We will operate any managed services as required

by the Department of Health to world class levels

of efficiency, effectiveness and economy.

One major challenge specifically for the period leading up to

April 2006 and the immediate period following, is to deliver

our current managed services in the area of dentist

payments, patient registration, prior approval and patient

refunds to the levels of quality we know our customers

expect whilst changing our business processes to deliver the

new requirements of the Department of Health for

implementation by April 2006.

Central to our strategy is the need to protect the interests of

patients, whilst also providing impartial and objective

assurance to the taxpayer that funding for NHS dentistry is

not being paid inappropriately. Central to the delivery of this

strategy is our probity assurance operation, which is

underpinned by the activities of the Dental Reference Service.

We have a well-developed ability to manage change and

have been building close working relationships with the

Counter Fraud and Security Management Service (CFSMS)

to enhance probity assurance in dentistry. This work will

continue within the current structure of dentist remuneration

until its replacement by April 2006. Processes relating to the

probity of exemption checks for patient charges will need to

continue post April 2006 and consideration is being given to

what is needed in the future.

Goal 3 We will provide an agreed level of assurance

with respect to the clinical quality of NHS

dentistry contributing towards achieving,

improving and reducing variation in the quality

of NHS dental care.

We will continue to invest where necessary in our current

payment systems to ensure they are able to deliver

(continued overleaf)

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Strategic management continued from page 21

We took on the management of the Dental Reference

Service (DRS) in 1991. Over the past seven years, we have

pursued a strategy of expanding this service in order to

provide enhanced levels of assurance on the clinical quality

of the GDS.

Modernising Dentistry and Routes to Reform both proposed

a variety of ways to deliver NHS dentistry in the future,

within England and Wales. Monitoring of all the proposed

options has been highlighted as a key requirement and the

DRS as a nationally based service of independent and

experienced clinicians is ideally placed to play a central role

in monitoring any of the proposed methods of delivery.

In Modernising Dentistry, the encouragement of larger

practices with a mix of dentists and professions

complementary to dentistry (PCDs) opens up the

possibilities of new approaches to clinical governance

reviews. These could take place as part of a practice based

review giving a more detailed picture of the clinical

standards of an entire practice rather than seeing individual

patients throughout the year examining them only on specific

aspects of their treatment.

and the agreed clinical pathways will be required using data

from patients’ dental electronic records.

Goal 4 We will provide open access to high quality,

reliable and relevant information on NHS dentistry

to policy makers at local and national level, dental

practitioners and all other interested parties.

The strategy document ‘An Information Technology Strategy

for NHS Dentistry in 21st Century’ sets out a clear

programme for delivering the IT support vital to the

successful implementation of Modernising Dentistry. We

have over ten years experience in developing and

implementing IT specifications for data transmission in

standardised formats. This has involved the setting up of a

wide area network and enabled the receipt of data from

many different practice management systems. Building on

this experience and combining it with our partnership with

our IT Services provider, IBM, we anticipate playing a major

role in the implementation of this strategy. As part of this

approach we are part of the Department of Health project

team responsible for implementing the Dental IT Strategy

which is now part of Connecting for Health.

We are working closely with the Department of Health,

Welsh Assembly Government and other health bodies to

develop alternative methods of examining patients to provide

more effective clinical governance and improve the patient

experience. We are expanding our service to Personal

Dental Services, according to the requirements of the

Department of Health and the Welsh Assembly Government.

We will also continue to monitor the GDS according to the

requirements of the Department of Health and Welsh

Assembly Government.

The implementation of electronic data interchange (edi) in

the early 1990s, which enabled dental practices to send us

claim forms electronically, has resulted in the development of

a good working relationship with dental system suppliers. A

move to web enabled transmission of data is being planned

proactively with the suppliers. It is anticipated that these

system suppliers will play a key role over the next few years

in providing the necessary systems within the dental practice

to enable the implementation of the Dental IT strategy. This

will relate particularly to the provision of information for

clinical pathways and the dental electronic health record.

We will contribute to the setting up of clinical pathways and

play a role in the maintenance and control of the

implementation of clinical pathway standards through

practice based systems. To ensure compliance with the

pathways, a comparison between treatments actually given

We will continue to develop our data warehouse to establish

it as one of our core operating systems. This system

enables us to store and analyse data to meet all types of

information needs for both local planning purposes and

national trend analysis and reporting.

22

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The plan to allow PCTs and LHBs direct access using web

technology to their data whenever they require it is near to

completion with the start of the roll out of the system due in

the first half of 2005/06. This will be done in accordance with

data protection legislation to fulfil our role as data custodian.

Goal 6 We will develop further our customer relations

and key partnerships with health organisations

to protect the interests of patients, health

professionals and taxpayers.

We will continue to develop our customer service

Any patient treatment data contained within the proposed

minimum data set will supplement the current patient

treatment data we have as a result of the GDS item of

service remuneration system and the PDS equivalent. The

processing of these data using the data warehouse will

enable us to provide clinical assurance on the new schemes

for the provision of NHS dentistry under Modernising

Dentistry/Routes to Reform. Analysis against the clinical

pathways once agreed and implemented will also be

possible to ensure their effective application.

Goal 5 We will meet our objectives within our agreed

level of funding which takes into account the

need to reduce, in the medium term, our unit

cost by 2 per cent per annum after adjusting for

inflation

We will continue to meet our financial objectives principally

through decreasing our permanent staffing levels by

redeployment of staff where possible and running voluntary

early retirement and severance schemes. We will continue

to improve our processes to ensure that our operational

effectiveness is not compromised by this strategy. Where

possible we will seek other more flexible ways of working to

meet the needs of our business. We will also seek other

opportunities to either increase income or decrease

operating costs working in particular with the other

organisations which are to form the NHS BSA.

performance to be the best in the public sector, seeking to

enhance further our customer interactions. We will work

closely with the Department of Health and the Welsh

Assembly Government to help develop and implement a

communications strategy for all stakeholders within dentistry

regarding the changes taking place in 2006.

We have started building effective relationships with PCTs in

England and Local Health Boards in Wales and other dental

related organisations within the NHS to support the effective

delivery of primary care dentistry. Alongside this activity, we

will foster effective and co-operative relationships with other

key stakeholders in dentistry seeking opportunities to work

collaboratively to support the delivery to the patient of

effective dentistry during a period where the delivery models

are changing. We will also seek opportunities to gain new

work in the medical sector, leveraging the scale economies

which our operation provides to the NHS.

Our effective outreach programme highlighted in the

business plan will continue to be developed, including new

ways of engaging with patients, dentists and other key

stakeholders.

Goal 7 We will realise fully the potential of and value of

our staff to become a high performing learning

organisation achieving continuous improvement

of its own work.

The development of our IT systems offers the main potential

to reduce our ongoing operating costs. In line with any IT

strategy developed by the BSA we will propose a way

forward for us to migrate our existing and increasingly costly

legacy systems to more flexible and cost effective platforms.

We will meet the objectives in the NHS Plan and targets

contained within related documents including: NHS

Framework for Lifelong Learning ‘Working Together, Learning

Together’; Improving Working Lives (IWL) Standard;

Managing for Excellence in the NHS; Code of Conduct for

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Strategic management continued from page 23

NHS Managers; Equalities and Diversity; the NHS

Leadership Quality Framework; and NHS Leaders Career

Development and Planning Scheme. We will implement

Agenda for Change the new NHS pay system on time as

required by the Department of Health. We will create an

organisation in which the leadership is driven by values and

managers develop skills in relation to the needs of their role,

based on feedback from their teams. Staff will be more

involved in management of the organisation and they will

have clear career development paths and pay structures.

To encourage their continuing development we will implement

an e-learning strategy for staff including our management/

leadership development programme, the achievement of

qualifications and implementation of competency frameworks

to support the development of skills and knowledge.

We will identify talent and provide opportunity for staff to

prepare themselves for future senior and specialist posts.

Our staff will learn continuously and develop new skills and

knowledge and they will expand their roles by taking on

more responsibility.

In support of their new role in primary care dentistry all dental reference officers were successful in the training course for and were awarded

‘The Certificate in Practice Appraisal’ by the Faculty of General Dental Practice (UK). The photograph of the dental reference officers taken at

the award ceremony includes seated from the readers left: Patricia Langley (certificate programme leader); Clive Gibson (vice-dean of the

FGDPUK); Raman Bedi (chief dental officer for England); Mary Wyllie (chairman of the DPB); Rod Staines (chief dental adviser of the DPB);

Brian Mouatt (chairman of the FDI world dental development committee).

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Developments

During the year we learned that introduction of the new

payment scheme for dentists and dissolution of the DPB

followed by its merger into the new NHS Business Services

Authority will both happen in the period October 2005 to

April 2006. Setting aside all other considerations we would

not have chosen this coincidence of timing. An interval of up

to a year between the previously expected date for the new

payment scheme and the revised one has provided an

opportunity for widespread introduction of personal dental

services arrangements between dentists and primary care

trusts. Left to our own decisions we would have tried to avoid

administering these arrangements while preparing for the

new scheme and reshaping the DPB for merger into the

BSA. Taken together the implications of these developments

permeate and overshadow all our work.

Personal Dental Services

In line with the Department of Health policy of moving a

significant number of dental practices into PDS by April

2005, during the year we expanded our capability to set up,

implement and run PDS administration, payment and

information systems. This expansion took place alongside

the continuing need to run existing GDS administration,

payment and information systems, whilst at the same time

developing a new payment system to deal with the

forthcoming NHS dentistry arrangements associated with

local commissioning that are currently planned to be

implemented by April 2006. The PDS systems being

expanded are those that were designed for use as part of

the original pilot schemes. They would ideally be subject to

further development to add flexibility to them in terms of a

user friendly front end local data entry facility, a more

sophisticated suite of payment programmes and a better

management information system however the development

skills and resources available to us are also required for the

new payment system. As this remains the priority for the

Department of Health by April 2006, work on improving PDS

systems has been limited. We will keep these conflicting

business issues under review in the coming year and decide,

with the Department of Health and the Welsh Assembly

Government, where to concentrate development activities.

NHS dentistry payments

In 2004 the Department of Health signed off the

specification for the new payment system and certain

assumptions are included in that with regard to, amongst

other issues, patient charges and patient lists. If these

assumptions prove to be incorrect or cannot be confirmed in

detail during the early part of 2005/06 then the risk of the

new system not being ready in full by April 2006 grows

exponentially with time. In support of policy we are keeping

all realistic options open. At the time of writing all main risks

to implementation are set at amber. Monthly meetings are

being held with the Department of Health and regular

meetings with the Welsh Assembly Government to ensure as

much information as possible on policy is available

immediately to us and to our suppliers who are providing the

new system. If the full system is not ready greater manual

processing and more staff will be required and this may

mean a reprioritisation of our work in conjunction with the

Department of Health and the Welsh Assembly Government.

Non confirmation of the final detail of the new NHS dentistry

specification early in 2005/06 will threaten the practice

management system software suppliers’ ability to produce

their systems for dentists in time for April 2006. This might

lead not just to issues for us regarding greater than

anticipated manual processing rather than electronic

processing of the new system payment forms when they are

introduced but also to issues for some dentists in managing

their practices and filling out forms manually for a period of

time whilst the new or updated software is awaited.

NHS Business Services Authority

When we reported on the accounting year to March 2004 we

expected that some time during the following year the DPB

would be abolished and its role and functions taken on by a

new special health authority. In July 2004 the Department of

Health published ‘Reconfiguring the Department of Health’s

Arm’s Length Bodies’. It announced the intended merger of

The NHS Pensions Agency, the Prescription Pricing Authority

and the Dental Practice Board into a new NHS Business

Services Authority. Some functions of the NHS Counter

Fraud and Security Management Services were to be

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Developments continued from page 25

included. The driving principles of the merger are for the

new body to be more efficient, effective and economic.

In November 2004 the Department of Health published ‘An

Implementation Framework for Reconfiguring the DH Arm’s

Length Bodies’. Against a baseline of the accounting year to

March 2004 there is required to be across the whole ALB

sector by the accounting year to March 2008 a reduction of

one quarter in staff employed and cost reduction of £250

million. Since then we have produced for the Department of

Health a business and corporate plan that includes our

proposed contribution to that reduction which is by the

accounting year to March 2008 to reduce full time equivalent

employment from 311 to 215 and expenditure from £23.8

million to £22.0 million. We have committed also to meet the

reduced net operating cost target of £23.1 million set for us

by the Department of Health for the accounting year to

March 2006.

At March 2005 our permanent staff was the whole time

equivalent of 267 people. Taking into account those staff

leaving as a result of previous redundancy schemes we

expect to employ on 30 September 2005 the full time

equivalent of 233 staff. On the expectation that the new

payment scheme for dentists will be introduced by April 2006

we estimate that a redundancy scheme of around a dozen

full time equivalent staff, at an approximate cost yet to be

agreed with the Department of Health of up to £1 million,

will be necessary in the Autumn of 2005 to take effect in the

Spring and Summer of 2006 in order to meet our business

plan benchmarks of 2 per cent a year reduction on real unit

cost and 5 per cent a year improvement in staff productivity.

These figures are consistent with satisfying our commitment

to the NHS BSA.

We expect that the NHS BSA will be formed in Autumn 2005

and that the DPB will be dissolved and its role and functions

taken over by the NHS BSA on 1 April 2006. Our

commitment to the NHS BSA is for the accounting year to

March 2008 to employ, on average, no more than 216 whole

time equivalent staff and not to exceed £21.9 million

expenditure.

expenditure for the accounting years to March

2004 2005 2006 2007 2008

actual actual forecast forecast forecast

pay 11.1 11.9 11.6 11.1 11.0

pensions 0.9 2.6 2.8* 0.7 0.7

employment 12.0 14.5 14.4 11.8 11.7

goods and services 11.9 11.6 11.1 10.5 10.3

capital additions 0.3 0.3 0.3 0.3 0.3

before income 24.2 26.4 25.8 22.6 22.3

income 0.4 0.6 0.5 0.4 0.4

after income 23.8 25.8 25.3 22.2 21.9

wte staff at March 311 267 233 217 215

* includes new provisions of £1.0 million for redundancy and £1.4 million for change of discount rate, refer to pages 16 and 17.

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Management team

Pictured from the reader’s left: Rod Staines, Derrick Stirling and Chris Edmonds

Chris Edmonds BA MBA

Head of Finance and Operations

During the year Chris was responsible for managing the processing of all transactions arising from general and personal dental

services schemes. He leads our modernising dentistry project and is responsible for the DPB Helpdesk, finance, staff

development, quality assurance, internal audit of DPB operations and the development and implementation of improved working

methods. Before joining us in September 1998 Chris managed the Scottish Power clinical waste subsidiary and was with

Southern Water during privatisation. Born 1956.

Rod Staines LDS

Chief Dental Adviser

Rod is responsible for the management of the Dental Reference Service. Before joining the DPB in 1991, he had 25 years’

experience as a general dental practitioner during which time he was an LDC secretary, BDA branch secretary and member of

the Representative Board. Rod was a dental reference officer and senior dental officer prior to his appointment in September

2000 as chief dental adviser. He was for 10 years the vice-chairman of a charitable trust involved in the setting up of a care

home for the elderly in Oxford. Born 1941.

Derrick Stirling JP BSc Hons MSc FSS

Head of Information and Probity

Derrick is responsible for organising the DPB’s probity activities, the dental contracts department and for dental health

information. He has been responsible for the development of the probity assurance management system. Derrick joined us in

1996 after a long successful career with the government statistical service. He is a chairman magistrate on Brighton and Hove

bench. Born 1942.

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Financial statement

Funding

Before each accounting period we receive an indication from the

Department of Health, made without commitment, of the cash

allocated to us for the period. We must not exceed this amount.

for the year to March

2005 2004 2003

Net of expected receipts from recoverable value added

tax and other income our cash allocation was

£25.0m £23.9m £23.5m

After deducting recovered value added tax and other

income and allowing for movements in pension

provision, debtors, creditors and cash requirements for

agency payments cash used was

£24.9m £23.7m £23.5m

Economy

Accountability for public funds requires us to conduct our

operations economically. We must achieve in each accounting

period the lowest total cost consistent with the investment needed

by a going concern for continuous improvement in efficiency and

effectiveness.

Cash payments and liabilities incurred for employment,

bought in goods and services and for asset purchase

resulted, after deducting income, in expenditure of

£25.8m £23.8m £26.8m

Deducting asset purchase from expenditure then adding

depreciation on assets, impairments and capital charges

gave a net operating cost of

£25.9m £23.8m £26.6m

Efficiency

Accountability for public funds requires us to conduct our

operations efficiently. We must make continuous reductions in

unit cost.

During the year the number of payment application

documents processed to completion resulted in

documents dealt with of

46.2m 46.9m 46.4m

Dividing net operating cost by the documents dealt with

gave an average unit cost of

56.0p 50.7p 57.2p

John Taylor

July 2005

The above statement is derived from the statutory accounts of the Dental Practice Board for the year ended 31 March 2005

and from output figures. The statutory accounts can be found at annex 1.

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Governance

The Dental Practice Board is a body corporate whose

statutory origin is Section 37 of the National Health Service

Act 1977. The current statutory basis for the constitution and

purposes of the DPB is the Dental Practice Board

Regulations 1992.

The DPB has such rights and may do such acts only as are

authorised directly or indirectly by the statute creating it. These

include what is expressly stated in the statute or regulations

made under it and what is necessarily and properly required

for carrying into effect the purposes of its incorporation or

what may fairly be regarded as incidental to or consequential

on those things which are authorised by the legislation.

Accountability

The process of accountability to Ministers through the

Department of Health and the Welsh Assembly Government

includes an Annual Accountability Review, an Annual Report

and quarterly finance reviews.

At the Annual Accountability Review on 28 July 2004, chaired

by the Senior Departmental Sponsor, we accounted fully for

our activities and financial performance in the year to March

2004. The annual report and accounts were produced for the

year to March 2004 in a timely fashion. The draft of these

documents was seen and approved by the sponsor branch.

In line with the guidance associated with the management of

arms length bodies we sent to our Senior Departmental

Sponsor in December 2004 a corporate plan for the years to

March 2006 to 2009. This document contained the required

financial information and objectives for the period. Included

was a draft service level agreement with the Department of

Health and Welsh Assembly Government for the year to

March 2006. We presented at formal meetings with

representatives of the Senior Departmental Sponsor our

performance against targets during the year.

The board and its committees

The board of the Dental Practice Board conducts its affairs in

accordance with the Guidance on Codes of Practice for

Board Members of Public Bodies published by the Cabinet

Office (OPS) in January 1997.

There are normally eight board members: a chairman who

must be a dentist, a vice chairman and three others who

must be dentists, two other members who must not be or

ever have been dentists and the chief executive for the time

being. During the accounting year to March 2004 one member

who is a dentist resigned and has not been replaced. The

roles of chairman and chief executive are separate. The

chief executive is the only board member who is an employee

of the DPB and is the only executive board member. All other

board members are independent of the organisation.

Members are appointed by the Secretary of State after open

competition. Independent members are appointed for three

years with the possibility of reappointment. The chief

executive’s contract provides for one year’s notice.

The Audit and risk management committee comprises four

independent board members. This year they were Carol

Ferguson, David Ferns, Derek Spratt and Mary Wyllie. The

committee was chaired by Miss Ferguson who reported to

board meetings. Full minutes of the committee meetings are

circulated to all board members. The chief executive and the

head of finance and operations attend meetings. The audit

manager and the controls assurance executive report in

person to the committee. The role, constitution and duties of

the committee are consistent with the Department of Health’s

Audit Committee Handbook April 2001.

Representatives of the Comptroller and Auditor General

(C&AG), as our external auditors, attended committee

meetings to present their audit approach and findings. The

C&AG gave an unqualified opinion on our administration

accounts for the year ended 31 March 2005. Over the year,

the committee received and considered 36 reports from

Internal Audit.

The Remuneration committee had the same membership as

the Audit and risk management committee. This committee

was chaired by Mrs. Wyllie who reported to board meetings.

Minutes were circulated to all board members. The chief

executive and the head of finance and operations attended all

meetings. The committee advises the board on the remuneration

of senior managers and policy on staff pay where there is

discretion. The committee also advises the board on senior

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Governance continued from page 29

management appointments. In 2004/05 the committee

continued to take on the role given it in the senior management

pay (SMP) arrangements set out in the Health Service

Circular HSC 1998/017. During the year the committee

considered matters relating to the Whitley Council Pay awards,

local pay bargaining, senior managers’ contracts and pay and

board members’ remuneration. The committee was kept up

to date on progress to implement Agenda for Change which

supersedes Whitley arrangements with effect from October

2004 and must be implemented in full by September 2005.

The chairman of the board receives a salary in recognition of

2 days per week devoted to the Dental Practice Board. The

chief executive is a full time employee of the Dental Practice

Board. He has a contract providing for one year’s notice and

has agreed to a request to serve until at least 30 September

2005. Non-executive board members other than the chairman

receive daily sessional fees for the duties they perform.

Board members also receive reimbursement of travel and

subsistence expenses which are wholly and necessarily in

the performance of their duties. Where a board member

chooses to use their personal car a mileage allowance is

paid based on NHS national rates. For some categories of

vehicle this is in excess of the current Inland Revenue

mileage rate of 40p. The excess over 40p is treated as a

benefit in kind and taxed accordingly.

Employer's

Remuneration Pension Benefit

Contribution in kind

£ £ £

Chairman

Mary Wyllie 31,309 - 1,016

Chief Executive

John Taylor 101,881 14,263 -

Non-Executive Members

Ruby Austin 3,058 - 176

Carol Ferguson 1,000 - 75

David Ferns 2,905 - -

Sandeep Lakhanpaul 2,491 - 447

Derek Spratt 1,921 - 165

The chief executive was the highest paid employee.

The Joint consultative staff committee is chaired by the chief

executive. It met four times during the year. The committee is

made up of senior managers and staff representatives. It has

several subcommittees dealing with welfare, health and

safety and training amongst other subjects. Issues discussed

included relocation, creation of the NHS BSA, appointments,

promotion, subcommittee reports, policies and procedures

and strategy issues. In addition a staff suggestion scheme is

operated.

Audit manager’s report on corporate

governance

In accordance with the reporting arrangements set out in the

NHS Internal Audit Manual, our internal auditors prepare

quarterly reports for the Audit and Risk Management

Committee in which their activities are summarised. These

reports describe the major audit issues and compare

activities against the audit plan agreed by the committee at

the beginning of the year.

In addition, the Audit and Risk Management Committee

receive an annual report on the audit manager’s findings on

internal control. This report contains a clear statement of

assurance by the audit manager regarding the adequacy and

effectiveness of the risk management, control and

governance processes at the DPB.

Chief executive’s responsibilities

The Secretary of State has directed that the chief executive

should be the accounting officer for the DPB. As such he has

the responsibility for the propriety and regularity of the public

finances and must prepare a set of annual statements to show

that he has properly discharged these duties and

responsibilities.

Two statements by the accounting officer can be found in the

Annual accounts at pages 4 to 7 of annex 1 to this report.

• Statement of the board of the dental practice board and

chief executive’s responsibilities

• Statement on internal control 2004-2005.

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Members’ responsibilities

We have adopted, as a model, the Code of Best Practice for

Board Members of Public Bodies. This Code stipulates that

public bodies and their boards must at all times:

• observe the highest standards of propriety involving

impartiality, integrity and objectivity in relation to the

stewardship of public funds;

• maximise value for money through ensuring that services

are delivered in the most efficient and economical way,

within available resources, and with independent validation

of performance;

• be accountable to Parliament, users of services, individual

citizens and staff for the activities of the DPB, and the

extent to which key performance targets and objectives

have been met;

• in accordance with Government policy on openness,

comply with all reasonable requests for information from

Parliament, users of services and individual citizens.

External audit’s responsibilities

The Comptroller and Auditor General is our external auditor.

He has a statutory responsibility to express an independent

opinion, based on his audit work, on the DPB's financial

statements. He reports his opinion as to whether the

financial statements give a true and fair view and have been

prepared in accordance with relevant legislation, and whether

in all material respects the expenditure and income have

been applied to the purposes intended by Parliament. He

may also report to Parliament on the economy, efficiency and

effectiveness with which the DPB has used its resources.

Internal audit’s responsibilities

Internal audit have a responsibility to examine objectively,

evaluate and report on the adequacy of internal control as a

contribution to the proper, economic and effective use of

resources. Internal audit fulfil these responsibilities by

adherence to the mandatory NHS Internal Audit Standards.

Adherence to these standards assists the accounting officer

to ensure that internal control systems are being properly

reviewed.

Their work is undertaken in accordance with the reporting

arrangements set out in the NHS Internal Audit Standards.

Detailed plans are agreed annually with the Audit and risk

management committee and quarterly reports are prepared

in which their activities are summarised. These reports

describe the major audit issues and compare activities

against the audit plan agreed by the committee at the

beginning of the year. In addition, the Audit and Risk

Management Committee receive an annual report on the

audit manager’s findings on internal control. This report

contains a clear statement of assurance by our audit

manager regarding the adequacy and effectiveness of

internal financial controls at the DPB.

Fraud and corruption policy

We are committed absolutely to maintaining an honest, open

and well-intentioned atmosphere within the organisation; to

the elimination of fraud and any other form of wrongdoing

and to the rigorous investigation of any such cases. We have

a comprehensive Counter Fraud and Corruption Policy. In

addition we have in place procedures (in the form of

Standing Orders, Standing Financial Instructions and

procedure notes) designed to minimise the likelihood of the

DPB being a victim of fraud; a response plan to be followed

in the event of suspected fraud being reported; and guidance

notes issued by the Audit Commission have been given to all

staff. The audit manager is an Accredited Counter Fraud

Specialist. There were no instances of fraud or corruption

during the year.

Controls assurance

In response to HSC 1999/123 - Governance in the new NHS,

we appointed a controls assurance executive from 1 July

1999. Controls assurance is not seen as a purely financeorientated

initiative but one which adds real value to the DPB

by the review of its control environment in an open and

honest manner. The initiative offers the opportunity to

empower staff to become involved in developing and

monitoring the control environment in an efficient and

effective way. The DPB is in its sixth year of self-assessment

against the controls assurance standards. Both the

governance and the risk management standard require the

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Governance continued from page 31

organisation to assure itself of the adequacy of its risk

management system which the DPB has implemented

through the Controls Assurance Management System. A

report on the Cams is presented to the Audit and risk

management committee quarterly. The purpose of this report

is to assure the Board that risks have been identified and are

either adequately controlled or risk treatment plans are in

evidence to put in the necessary controls. From 2001/02

onwards all NHS bodies have been required to submit a

Statement on Internal Control as part of their annual financial

statement. This means that the Board of the DPB, as part of

its mandatory Governance responsibilities, needs to conduct

a review of the effectiveness of their systems of internal

control at least annually. Our statement on internal control

can be found on pages 5 to 7 of our annual accounts. The

statement has been recently approved by our board.

Special investigations

Each year the chief executive may ask our audit manager to

undertake a number of special investigations for and on

behalf of the board. These reviews vary enormously and may

include complaints from patients about the way in which

officers of the DPB have treated them; complaints from

dentists about decisions the DPB have made; through to

cases of suspected internal fraud or other wrongdoing.

These cases are particularly complex, difficult or sensitive. A

thorough and detailed analysis of all the relevant

circumstances is required. The purpose of these

investigations is to identify weaknesses in systems operated

by the DPB and to recommend action in order to improve the

efficiency and effectiveness of the service provided to the

taxpayer.

Declaration of interest

In accordance with the Code of Best Practice for Board

Members of Public Bodies, the chairman and other board

members are required to declare any personal and other

interests which may conflict with their responsibilities as

board members. A register is maintained by the head of

finance and operations containing details of relationships

with organisations likely to be involved with the DPB or NHS.

This register can be inspected by contacting the Head of

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Finance And Operations. Contact details can be found inside

the back cover of this report. We have adopted a policy

which stipulates that no employee will be permitted to

undertake business activities or other work where we

consider that this is incompatible with the public interests.

Key financial measures

All public servants are expected to observe the highest

standards of conduct and act with propriety, particularly in

the care and management of public funds.

Our key financial measures are of total and unit cost. They

are published at pages 16, 17 and 28 of this report.

Total cost is measured as (1) our cash allocation,

(2) cash utilised, (3) expenditure by cash payments and

liabilities incurred, (4) expense or operating cost,

(5) operating cost net of income generated.

Unit cost is measured as net operating cost divided by

counts of activity and output: dentists serviced, payments

made, documents processed, transactions processed and

£ fees authorised.

Accounting policies

The Chief Executive is the accounting officer with overall

executive responsibility for systems and financial activities.

His responsibilities are shown on page 4 of the first annex to

this report in the “Statement of the board of the Dental

Practice Board and chief executive’s responsibilities”.

The financial procedures, processes and responsibilities are

set out in the Standing Financial Instructions and Systems of

Financial Control. These documents are reviewed annually.

The Head of Finance and Operations provides financial

information and advice for the Board.

The accounts or financial statements have been prepared in

accordance with the Resource Accounting Manual issued by

Treasury. An operating cost statement has been used which

shows the net cost of operations of the Dental Practice

Board on an accruals basis.

Provision continues to be made for the cost of staff leaving


under the voluntary severance and early retirement scheme

at the time the decision is made and becomes binding on the

board and the employee. This is in advance of the date the

employee leaves.

Statement of principles

Statements of the principles on which policies guiding the life

of the DPB are based have been approved by the board and

agreed with staff side representatives. The statements are

published in the staff handbook available on our intranet.

Events

We successfully delivered three roadshows on behalf of the

Department of Health, aimed at PCT staff who will have

responsibility for commissioning NHS dental services.

Roadshows took place in London in May 2004 and in

Manchester and Birmingham during June 2004. In addition

to keynote addresses by Professor Raman Bedi, David

Hewlett, Barry Cockcroft and Tony Jenner, there were four

workshops focussing on specific issues including access,

engaging with dentists, delivering the new contract and

learnings from the GMS contract. Attendance at each

roadshow was over-subscribed and the feedback received

was positive.

This year we focussed on enhancing our presence at the

key dental exhibitions, and in particularly the British Dental

Association Annual Conference and Exhibition. Here we

worked with the Department of Health, the Modernisation

Agency and the National Primary and Care Trust

Development programme to join us on a combined stand

promoting the Modernising Dentistry Agenda. The stand

was visited by over 300 dentists to find out more about the

new arrangements for NHS dentistry. This was the highest

number of visitors ever to our stand at a BDA conference

exhibition. We also supported Department of Health

colleagues in putting on a presentation about the

‘Countdown to 2005’ as part of the BDA Conference fringe

programme.

As this arrangement proved to be so successful we will be

repeating it as this year’s BDA conference and exhibition

in May.

Process development

Development and implementation of new and improved

methods are overseen by three groups. A policy group of board

members and senior managers acts as a sounding board and

advisory group. A development group of senior and middle

managers identifies evaluates and develops new methods. A

change management board of senior managers controls

expenditure, sanctions implementation and monitors results.

Management systems

All organisations who were registered to the international

quality management standard ISO9001 (1994) were required

to adapt to the revised standard ISO9001: 2000 by December

2003. We were confirmed for transition in April 2003. This

means that our management system is now process based.

We continue to be registered to ISO14001 (environmental

management), OHSAS 18001 (occupational health and

safety), CMSAS86:2000 (complaints) and BS7799

(information security). We are also considering registration to

BS 15000 (IT service management standard). This promotes

the adoption of an integrated process approach to effectively

delivering managed services to meet the business and

customer requirements.

Staff development

We have a policy of continuing staff development in the

support of lifelong learning. Staff are encouraged to

demonstrate that they are qualified to carry out their work

through independent verification.

In this year, seven staff achieved NVQs and five other

academic qualifications under the DPB training policy

including one PhD. In addition, two members of staff

achieved NVQ unit accreditation and five staff acquired

relevant technical certificates. We are an EDEXCEL/BTEC

and OCR/AAT approved learning centre and are formally

recognised as an Investor in People. An additional Internal

Verifier was qualified during the year. During the year we

introduced the Staff Development and Recognition

Programme, a bespoke Level 3 qualification for DPB staff

validated by the Open College Network.

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Governance continued from page 33

In support of developing new systems of quality monitoring,

all 63 members of the Dental Reference Service achieved

the Faculty of General Dental Practice (UK) Certificate in

Appraisal of Dental Practices, with seven distinctions awarded.

Implementation of NHS Pay Modernisation through Agenda

for Change led to extensive development of job evaluators,

analysts and awareness programmes for all staff to help

support assimilation to the new pay system.

Feedback meetings are held for all staff on the outcome of

Accountability reviews and the chief executive meets all staff

in small groups to discuss whatever they wish. This is in

addition to monthly team briefings and written monthly

reports on DPB performance for all staff.

Equal opportunities

From the 2001 Census 96.6 per cent of Eastbourne travel to

work district residents are white which compares with 98.0

per cent of our staff. We are an equal opportunities employer.

Senior Management Pay

The pay envelope laid down for senior managers in 2004-

2005 was adhered to fully.

Disability policy

The Equal Opportunities policy in our employee handbook

makes clear our position on the employment and

advancement of disabled people clearly establishing the

principle of non-discrimination.

Since the introduction of the Disability Discrimination Act

1995 we have considered our position on the employment of

disabled people. We have made numerous alterations to the

premises to improve access and facilities for disabled people

providing for their full integration into our working

arrangements. We have made reasonable adjustments to our

disabled employees’ work where necessary, in line with the

employer’s duty under the Disability Discrimination Act.

The requirements of the Disability Discrimination Act are

included in the DPB’s staff policies.

Security policy

The provision of a secure environment for staff, visitors,

information and equipment is considered an essential

requirement for the delivery of high quality services. We

maintain registration to BS7799-2:2002, the British Standard

for Information Security Management, which requires a

continuous cycle of security risk assessment, planning and

improvement.

The standard is designed to ensure:

confidentiality - access to data is confined to those

with specific authority to access it;

integrity - all system assets are operating according to

specification, with no loss or corruption of data;

availability - information is delivered to the right person,

when it is needed.

Specific staff have responsibility for information security, data

protection, freedom of information and Caldicott

guardianship. As required we have nominated a board

member and member of staff to oversee our security

arrangements.

Better Payment Practice Code

We apply the code to all creditors with a target to pay within

30 days of receipt of goods or a valid invoice (whichever is

the later) unless other payment terms have been agreed with

the supplier. We report performance at note 2.4 on page 22

of our annual accounts.

Health, safety and welfare at work

We have implemented comprehensive policies to make

proper provision for the health, safety and welfare at work of

all our employees. These policies have been introduced in

accordance with the Health and Safety at Work Act 1974, the

Management Regulations 1999, the Disability Discrimination

Act 1995, the Display Screen Equipment Regulations 1992

and Improving Working Lives 2000. Promotion of these

policies is accepted as a corporate responsibility and we

employ specialists to advise and assist us. Our procedures

conform to the guidelines set out under OHSAS 18001.

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They are covered by our accreditation and monitored by the

British Standards Institute.

Environment

We recognise the need to achieve sound environmental

performance. We have adopted and implemented

comprehensive environmental management systems which

conform to the International Standard for Environmental

Management Systems ISO 14001: 1996. They are covered

by our accreditation and monitored by the British Standards

Institute.

European monetary union

In line with government requirements all new systems

development/enhancements consider the possibility of UK

entry into the single currency. It is now some years since an

initial assessment of the specific steps and timescales the

move to the Euro would involve was carried out.

Considerable IT changes and developments have taken

place in that time and the detail may have changed but the

underlying approach of a change over on a specific date

remains relevant.

Freedom of Information Act 2000

The full powers of the Freedom of Information Act came into

effect from 1 January 2005. By the end of March 2005, we

received six requests for information about our processes

and working procedures; two requests were from journalists,

two from members of the public, one from a local primary

care trust and one from the Dental Practitioners’ Association.

The types of information requested included:

• annual amounts paid to dental practices

• the discretionary fees guide

• the number of NHS procedures carried out in Eastbourne

during 2004

• probity operations information and our unit costs for

processing

• our staff suggestion scheme, and

• our business plans and budgets

In all but one of the requests we were able to release the

information or direct the enquirer to where they could find the

information.

Community involvement

We allow time for public service. Several members of staff sit

as magistrates and a Samaritan volunteer is allowed time

out. In addition there is a charitable give-as-you-earn scheme

and our Sports and Social Club organises charity fund raising

events.

Welsh language

In the first full year of our Welsh Language Scheme we have

successfully continued to produce all correspondence with

Welsh patients bi-lingually.

In April 2005 we took on responsibility for benefit eligibility

checks in Wales, and are working towards ensuring that all

related written and verbal communication with Welsh patients

can be carried out in Welsh as well as English The DPB’s

Welsh language scheme is being amended to reflect this

additional responsibility.

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Glossary

Agenda for Change

A new pay system for all NHS staff will ensure fair pay and a

clearer system for career progression. Staff will be paid on

the basis of the jobs they are doing and the skills and

knowledge they apply to these jobs. This reform is

underpinned by a job evaluation scheme specifically

designed for the NHS.

Arm’s length bodies (ALBs)

ALBs are stand-alone national organisations sponsored by

the Department of Health. The work they undertake ranges

from back office administrative functions to complex ethical or

clinical-related work. The first ALB to be established formally

was the DPB in 1948.

British Standards Institute (BSI)

BSI Management Systems operates world wide to provide

organisations with independent third-party certification of

their management systems, including ISO 9001:2000

(Quality), ISO 14001 (Environmental Management), OHSAS

18001 (Occupational Health and Safety) and BS 7799

(Information Security).

Counter Fraud and Security Management Service

(CFSMS)

The Counter Fraud and Security Management Service

(CFSMS) is a Special Health Authority, which has

responsibility for all policy and operational matters relating to

the prevention, detection and investigation of fraud and

corruption and the management of security in the National

Health Service.

Data Protection Act 1998

The Data Protection Act gives individuals certain rights

regarding information held about them. It places obligations

on those who process information while giving rights to those

who are the subject of that data.

Dental Reference Service (DRS)

The Dental Reference Service has monitored general

dentistry in England and Wales since 1927. It transferred to

working within the NHS in 1948 and for many years visited

surgeries to examine patients to monitor clinical quality and

confirm the probity of claims made for treatment. In 1990,

the DRS became part of the DPB and is now changing its

role to become more involved in clinical governance and

clinical quality support for health bodies and practices.

Freedom of Information Act 2000

The Freedom of Information Act 2000 gives people a general

right of access to information held by or on behalf of public

authorities, promoting a culture of openness and

accountability across the public sector.

General Dental Services

This is the main service through which NHS dental treatment

is provided.

Knowledge and Skills Framework

The NHS Knowledge and Skills Framework defines and

describes the knowledge and skills which NHS staff need to

apply in their work in order to deliver quality services.

Local Health Boards (LHBs)

Local Health Boards exist in Wales in order to improve the

health and healthcare of the local population. They were

established in 2003 to take over the responsibilities of the

Health Authorities in Wales and were given three quarters of

the NHS health budget in Wales.

Comptroller and Auditor General (C&AG)

The C&AG is the head of the National Audit Office (NAO),

which scrutinises public spending on behalf of Parliament and

is independent of government. The NAO audit the accounts of

all central government departments and agencies, as well as

a wide range of other public bodies, and report to parliament

on the economy, efficiency and effectiveness with which they

have used public money.

NHS Business Services Authority (NHS BSA)

The Health and Social Care (Community Health and Standards)

Act 2003 provides for the DPB to be abolished. It is expected

that a new NHS BSA will carry out our existing functions.

Personal Dental Services (PDS)

PDS was first piloted in 1998 and provides an opportunity for

dentists and health bodies to work in partnership and provide

dental services that meet local needs. The number of PDS

contracts has expanded to 4,500 dentists in more than 2,000

practices.

Primary Care Trusts (PCTs)

PCTs are free-standing statutory bodies in England

responsible for delivering better health and better care to

their local population. They receive budgets directly from the

Department of Health.

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DENTAL PRACTICE BOARD

ANNUAL ACCOUNTS 20042005

Annex one

DPB Annual Report and Accounts 2004-2005


Foreword

The accounts for the year ended 31 March 2005 have been prepared in accordance with a direction given by

the Secretary of State dated 20 December 2000 under section 98(2) of the National Health Service Act 1977

and in a format as instructed by the Department of Health with the approval of Treasury.

The Dental Practice Board was set up under its previous name of the Dental Estimates Board by the National

Health Service Act 1946. It now operates under the National Health Service Act 1977 (as amended) and

regulations made under that Act. The new name for the Board took effect in 1990 as a result of the Health and

Medicines Act 1988. The statutory duties of the Dental Practice Board are set out in the National Health

Service Act 1977 and an extract from S.37 states:

… for constituting a Board, to be called the Dental Estimates Board, of whom the Chairman and a majority of

the members shall be dental practitioners providing general dental services.

On 20 November 2003 the Health and Social Care (Community Health and Standards) Act 2003 which

provides for the Abolition of the Dental Practice Board under section 181 received Royal Assent. The notes

associated with the Act indicate that the assets, liabilities and staff (subject to consultation) will be transferred

under Section 11 of the National Health Service Act 1977 to a new Special Health Authority. However, in

October 2003 the Secretary of State announced the intention to review the Department of Health’s Arms

Length Bodies of which the Dental Practice Board is one. The role of the Dental Practice Board after abolition

is now described in a report published in July 2004 and named Reconfiguring the Department of Health’s Arms

Length Bodies (the review). This report outlined the intention of the Department of Health to reduce its number

of Arms Length Bodies and the Secretary of State announced that by 2007-2008 there will be a 50% reduction

reducing total expenditure by £0.5 billion and staff posts by 25%. As a result the intention is that the Dental

Practice Board, the NHS Pensions Agency and the Prescription Pricing Authority will merge soon to form the

NHS Business Services Authority.

Principal Activities

The main purpose of the Dental Practice Board as set out in the 2001 Strategic Review is:

… to contribute to improved dental health services by providing first class, cost effective services in payment

processing, information analysis, clinical monitoring and probity assurance.

The principal functions for the year covering England and Wales are:





approval of the fee claims, and applications for the prior approval of treatment, from dental

practitioners and the calculation and transfer of payments;

provision of dental health information;

monitoring the quality of dental treatment prescribed and provided;

preventing and detecting fraud and abuse.

Review of activities and performance against targets

The accounts report a net operating cost of £25.9 million which is £0.1 million below the resource limit agreed

with the Department of Health. This is an increase in net operating cost of £2.1 million from the previous year.

This increase is principally due to the year on year variance on expenditure on voluntary early retirement and

severance schemes which was £2.2 million in 2004-2005 compared to £0.5 million in 2003-2004.

The scheme run in 2004-2005 and its associated cost of £2.2 million is in respect of 37 (34.2 whole time

equivalents) who will leave in the period April 2005 to September 2005. Provision is made in the accounts for

the costs at the time the scheme is approved and becomes legally binding on the Dental Practice Board and

the employee.

During the financial year to 31 March 2005 the Dental Practice Board has been consulting with the Department

of Health and Welsh Assembly Government and preparing for the changes it is anticipated the Government’s

agenda for modernising dentistry will bring. The timescale for the implementation of the new National Health

Service arrangements for dentistry is currently stated as being by April 2006. In the interim period temporary

staff are being used to cover short term peak workloads associated with processing General Dental Services

and Personal Dental services claims at the same time as preparing new administrative systems for the new

contract. This incurred a cost in 2004-2005 of £0.3 million.

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Annex one


The expenditure with the IT Services contractor (IBM) of £5.1 million is a decrease of £1.0 million over

2003-2004. This is all within the terms of the contract which commenced on 1 January 2003, the Dental

Practice Board having negotiated reductions in the annual cost of the contract to reflect efficiencies promised at

the time by the supplier. IT projects necessary to support the Department of Health and Welsh Assembly

Government in the Modernising Dentistry initiatives resulted in expenditure of £0.9 million.

The Dental Reference Service is developing new ways of working to support the Modernising Dentistry

agenda. This has resulted in changes to the profile of costs during the year and savings have been achieved

although some of these may be short term as activity in some areas and consequently cost has been lower

during this preparation phase. Examples of savings in 2004-2005 are £0.1 million on postage and £0.2 million

on the dental chaperone service.

Income is increased by £0.1 million due to additional rent received from a local NHS Trust for the use of the

Eastbourne Property.

Capital expenditure at £0.3 million was as planned, with £0.1 million being spent on replacement vehicles and

£0.2 million on IT and furniture and fittings.

The Eastbourne property which is the Headquarters of the Dental Practice Board was valued as required every

5 years and the new valuations of land (£1.55 million) and buildings (£4.7 million) have been included in the

accounts giving an unrealised surplus of £2.4 million.

The Dental Practice Board measures its cost effectiveness by expressing its net operating cost as a unit cost,

based on the number of dentist claim form documents dealt with in the financial period. The standard is to

achieve a 2% reduction in cost per annum in real terms after adjusting for inflation, over each medium term.

Documents dealt with of 46.2 million result in a unit cost of 56.0p per document. This compares with 50.7p per

document for 2003-2004 and 57.2p in 2002-2003 the year on year variances principally attributed to the

phasing of expenditure on Voluntary Early Retirement and Severance schemes. The savings arising from

these schemes in the current year and in the past have allowed the Dental Practice Board to always achieve its

medium term targets. The savings that will be delivered in future years mean that the standard remains for

now a realistic target for the Dental Practice Board.

Going Concern

The balance sheet at 31 March 2005 shows net liabilities of £2,197,000 (31 March 2004 £3,785,000). The

figure shown at 31 March 2005 includes liabilities falling due in future years which, to the extent that they are

not to be met from the Dental Practice Board’s other sources of income, may only be met by future direct

funding from the Dental Practice Board’s sponsoring department, the Department of Health. This is because,

under the normal conventions applying to parliamentary control over income and expenditure, payments may

not be made by the Department of Health to the Dental Practice Board in advance of need.

Funding for 2005-2006, taking into account the amounts required to meet the Dental Practice Board’s liabilities

falling due in that year, has already been included in the Department of Health’s Estimates for that year, which

have been approved by Parliament, and there is no reason to believe that the department’s future sponsorship

and future parliamentary approval will not be forthcoming.

As outlined above it is expected that the Dental Practice Board will become part of a new NHS Business

Services Authority. The accounting policy in note 1.1 explains that where transfer of activities is between NHS

bodies they are not considered as ‘discontinued’.

It has accordingly been considered appropriate to adopt a going concern basis for the preparation of the Dental

Practice Board’s financial statements.

Directors

The Board of Directors is normally comprised of one executive member, the Chief Executive, John Taylor

BA Hons MBA CMgr FCMI and seven non-executive members including the Chairman.

The six non-executive members who served in the financial year are:

Mary Wyllie BDS DDPH RCS (Eng) - Chairman

Ruby Austin MBE MGDS RCS (UK)

Carol Ferguson MA CA

David Ferns BDS

Sandeep Lakhanpaul BDS

Derek Spratt BA

Annex one

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Foreword continued from page 2

A new non-executive member has not been appointed in view of the changes anticipated as a result of the Arm’s

Length Bodies review.

Details of the remuneration of the non-executive directors together with information in respect of senior executive

managers of the Dental Practice Board’s management team are given in a note to the accounts (Reference 2.3

on page 21).

Disabled Employees

The policy of the Dental Practice Board is to ensure that ability to do the job is the sole criterion for recruitment or

advancement consistent with the principle of fair and open competition. Disabled employees have equal

opportunities for training to develop new skills and advance their careers.

Equal Opportunities

The Dental Practice Board is an equal opportunities employer. This policy means that all employees have equal

opportunity for employment and advancement. There is no difference in treatment based on colour, race, national

origins, sex, marital status, sexual orientation, religion, politics, age or union affiliation.

Health, Safety and Welfare at Work

The Dental Practice Board recognises and accepts its responsibilities for the health, safety and welfare at work of

its employees.

The promotion of health, safety and welfare at work is an integral function and responsibility of executive

management and specialists are available to assist and advise them. A regular system of staff consultation is

maintained. Minutes of consultative meetings together with agreed policies and responsibilities are available to all

staff on the Dental Practice Board Intranet. Health, safety and welfare at work are continually assessed as part of

the Dental Practice Board’s Controls Assurance Management System which is outlined in the Statement of

Internal Control (Reference pages 5 to 7).

Major Incident Plan

The Dental Practice Board has a major incident plan in place which is fully compliant with “Handling Major

Incidents: An Operational Doctrine” and accompanying NHS guidance on major incident preparedness and

planning.

Payment Policy

The Dental Practice Board applies the Better Payment Practice Code and has again exceeded the NHS target of

95% paid within 30 days (Reference 2.4 on page 22).

Audit

The Comptroller and Auditor General is the appointed external auditor for the Dental Practice Board.

John Taylor 12 July 2005

Chief Executive

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Annex one


Statement of the Board of the Dental Practice

Board and Chief Executive’s responsibilities

Under the National Health Service Act 1977 and directions made thereunder by the Secretary of

State with the approval of Treasury, the Dental Practice Board is required to prepare a statement of

accounts for each financial year in the form and on the basis determined by the Secretary of State,

with the approval of Treasury. The accounts are prepared on an accruals basis and must give a true

and fair view of the Dental Practice Board’s state of affairs at the year end and of its net resource

outturn, recognised gains and losses and cash flows for the financial year.

The Accounting Officer for the Department of Health has appointed the Chief Executive of the Dental

Practice Board as the Accounting Officer, with responsibility for preparing the Dental Practice

Board’s accounts and for transmitting them to the Comptroller and Auditor General.

In preparing the accounts, the Board and Accounting Officer are required to:





observe the accounts direction issued by the Secretary of State, including the relevant

accounting and disclosure requirements, and apply suitable accounting policies on a

consistent basis;

make judgements and estimates on a reasonable basis;

state whether applicable accounting standards have been followed and disclose and

explain any material departures in the financial statements; and

prepare the financial statements on a going concern basis, unless it is inappropriate to

presume that the Dental Practice Board will continue in operation.

The Chief Executive's relevant responsibilities as Accounting Officer, including responsibility for the

propriety and regularity of the public funds and assets vested in the Dental Practice Board, and for

the keeping of proper records, are set out in the Accounting Officers' Memorandum issued by the

Department of Health.

To the best of my knowledge and belief, I have properly discharged the responsibilities set out in my

letter of appointment as an Accounting Officer.

John Taylor 12 July 2005

Chief Executive

Annex one

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Statement on internal control 2004-2005

1. Scope of responsibility

The Board is accountable for internal control. As Accounting Officer, and Chief Executive of this

Board, I have responsibility for maintaining a sound system of internal control that supports the

achievement of the organisation's policies, aims and objectives. I also have responsibility for

safeguarding the public funds and the organisation's assets for which I am personally responsible as

set out in the Accounting Officer Memorandum.

The Dental Practice Board is also accountable for delivery of services as defined in the Service Level

Agreements with the Department of Health and Welsh Assembly Government.

2. The purpose of the system of internal control

The system of internal control is designed to manage risk to a reasonable level rather than to

eliminate all risk of failure to achieve policies, aims and objectives; it can therefore only provide

reasonable and not absolute assurance of effectiveness. The system of internal control is based on

an ongoing process designed to:

• identify and prioritise the risks to the achievement of the organisation's policies, aims and

objectives,

• evaluate the likelihood of those risks being realised and the impact should they be realised, and

to manage them efficiently, effectively and economically.

The system of internal control has been in place in the Dental Practice Board for the year ended 31

March 2005 and up to the date of approval of the accounts.

The Board exercises strategic control over the operation of the organisation through a system of

corporate governance which includes standing orders, standing financial instructions and the

establishment of an Audit and Risk Management Committee.

3. Capacity to handle risk

Leadership & Accountability

The Dental Practice Board has an organisational management structure with clearly defined lines of

accountability. The ownership of risk has been defined throughout the management structure. The

accountability for managing risk at the Dental Practice Board is shown in the diagram below.

Management Review

Audit & Risk

Management Committee

Steering Group

Quality Finance Health & Safety

Information Security

Environment Probity Clinical

Department Managers

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Specific individual responsibilities are as follows:

The Chief Executive is accountable for having in place an effective system of risk management and

internal control.

The Board of the Dental Practice Board is responsible for monitoring the effectiveness of the

systems within the organisation.

The Audit Manager is the designated person with overall responsibility for auditing the Controls

Assurance Management System and for reporting its effectiveness to the Board.

The Business Development Manager is the designated person with overall responsibility for

implementing and managing the Controls Assurance Management System.

Individual managers have responsibility with regard to specific areas of corporate wide risk.

The Audit and Risk Management Committee have overall responsibility for ensuring that an

appropriate system is in place for the identification, assessment and control of risk.

Training

Senior managers from all areas have attended workshops run by external consultants to ensure an

understanding of risk management. Staff have also received training on specific areas of risk such

as Health and Safety and Information Security. All staff are trained to identify and manage risk in a

way appropriate to their authority and duties.

4. The risk and control framework

The Dental Practice Board has designed and implemented a web based Controls Assurance

Management System . The rationale of the Controls Assurance Management System is to create a

system that interlinks throughout the organisation highlighting all risks both at a local and corporate

level within seven interconnecting systems:








information security management,

probity assurance,

environmental management,

clinical governance,

financial assurance,

quality assurance,

health and safety management.

There have been clear responsibilities assigned for managing risk throughout the Dental Practice

Board and the creation of an intranet based Controls Assurance Management System has made risk

management a very open and accessible system for all members of staff.

Risk management is embedded in the activity of the organisation by virtue of robust organisational

and committee structures. The Dental Practice Board is committed to a strategy, which minimises

risks to all its stakeholders through a comprehensive system of internal controls, whilst maximising

potential for flexibility, innovation and best practice in the delivery of its strategic objectives. The

Dental Practice Board recognises it is impossible to eliminate all risks and that systems of controls

should not be so rigid that they stifle innovation and imaginative use of limited resources in order to

achieve its objectives.

The controls the Dental Practice Board has in place are designed to safeguard our principal functions

in supporting the Dental Services of the NHS within England and Wales, namely: the approval of

payment applications; calculating and transferring payments; preventing and detecting fraud and

abuse; providing dental health information.

Annex one

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Statement on internal control 2004-2005

continued from page 6

In addition, the Dental Practice Board will seek to eliminate and control all risks that have the

potential to:





harm its staff, visitors and other stakeholders including any harmful impact on the environment,

result in a loss of public confidence in the Dental Practice Board and/or its partner agencies,

result in the Dental Practice Board failing to meet its statutory duties,

have severe financial consequences preventing the Dental Practice Board from carrying out its

functions.

5. Review of effectiveness

As Accounting Officer, I have responsibility for reviewing the effectiveness of the system of internal

control. My review is informed in a number of ways. The head of internal audit provides me with an

opinion on the overall arrangements for gaining assurance through the Assurance Framework and

on the controls reviewed as part of the internal audit work. Senior managers within the organisation

who have responsibility for the development and maintenance of the system of internal control

provide me with assurance. The Controls Assurance Management System itself provides me with

evidence that the effectiveness of controls that manage the risks to the organisation achieving its

principal objectives has been reviewed. My review is also informed by the work of the external

auditors.

I have been advised on the implications of the result of my review of the effectiveness of the system

of internal control by the relevant internal mechanisms, including the Audit and Risk Management

Committee. A plan to address weaknesses and ensure continuous improvement of the system is in

place.

Ongoing assurance will be provided by the comprehensive mechanisms already referred to in this

Statement. These include:




Regular reports to the Board on the risks faced by the organisation and the controls in place to

manage them.

Reports on the annual assessment against the NHS Controls Assurance Standards.

Regular reports on the work of internal audit.

John Taylor 12 July 2005

Chief Executive

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The Certificate and Report of the Comptroller

and Auditor General to the Houses of Parliament

I certify that I have audited the financial statements on pages 10 to 32 under the National Health

Service Act 1977. These financial statements have been prepared under the historical cost

convention as modified by the revaluation of certain fixed assets and the accounting policies set out

on pages 13 to 18.

Respective responsibilities of the Board of the Dental Practice Board, Chief Executive and

Auditor

As described on page 4, the Board of the Dental Practice Board and the Chief Executive are

responsible for the preparation of the financial statements in accordance with the National Health

Service Act 1977 and directions made thereunder by the Secretary of State with the approval of the

Treasury and for ensuring the regularity of financial transactions. The Chief Executive is also

responsible for the preparation of the Foreword. My responsibilities, as independent auditor, are

established by statute and I have regard to the standards and guidance issued by the Auditing

Practices Board and the ethical guidance applicable to the auditing profession.

I report my opinion as to whether the financial statements give a true and fair view and are properly

prepared in accordance with the National Health Service Act 1977 and directions made thereunder

by the Secretary of State with the approval of the Treasury, and whether in all material respects the

expenditure and income have been applied to the purposes intended by Parliament and the financial

transactions conform to the authorities which govern them. I also report if, in my opinion, the

Foreword is not consistent with the financial statements, if the Dental Practice Board has not kept

proper accounting records, or if I have not received all the information and explanations I require for

my audit.

I review whether the statement on pages 5 to 7 reflects the Dental Practice Board's compliance with

Treasury’s guidance on the Statement on Internal Control. I report if it does not meet the

requirements specified by Treasury, or if the statement is misleading or inconsistent with other

information I am aware of from my audit of the financial statements. I am not required to consider,

nor have I considered whether the Accounting Officer’s Statement on Internal Control covers all risks

and controls. I am also not required to form an opinion on the effectiveness of the Dental Practice

Board's corporate governance procedures or its risk and control procedures.

Basis of audit opinion

I conducted my audit in accordance with United Kingdom Auditing Standards issued by the Auditing

Practices Board. An audit includes examination, on a test basis, of evidence relevant to the

amounts, disclosures and regularity of financial transactions included in the financial statements. It

also includes an assessment of the significant estimates and judgements made by the Chief

Executive in the preparation of the financial statements, and of whether the accounting policies are

appropriate to the Dental Practice Board's circumstances, consistently applied and adequately

disclosed.

I planned and performed my audit so as to obtain all the information and explanations which I

considered necessary in order to provide me with sufficient evidence to give reasonable assurance

that the financial statements are free from material misstatement, whether caused by error, or by

fraud or other irregularity and that, in all material respects, the expenditure and income have been

applied to the purposes intended by Parliament and the financial transactions conform to the

authorities which govern them. In forming my opinion I have also evaluated the overall adequacy of

the presentation of information in the financial statements.

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The Certificate and Report of the Comptroller

and Auditor General to the Houses of Parliament

continued from page 8

Going concern

In forming my opinion, I have considered the adequacy of the disclosures made in Note 1.1 of the

financial statements concerning the uncertainty of the future arrangements for the Dental Practice

Board’s assets, liabilities, contractual obligations and staff. In view of the significance of this

uncertainty to the financial statements I consider that it should be drawn to your attention, but my

opinion is not qualified in this respect.

Opinion

In my opinion:



the financial statements give a true and fair view of the state of affairs of the Dental Practice

Board at 31 March 2005 and of the net resource outturn, recognised gains and losses and cash

flows for the year then ended and have been properly prepared in accordance with the National

Health Service Act 1977 and directions made thereunder by the Secretary of State with the

approval of the Treasury; and

in all material respects the expenditure and income have been applied to the purposes intended

by Parliament and the financial transactions conform to the authorities which govern them.

I have no observations to make on these financial statements.

John Bourn

National Audit Office

Comptroller and Auditor General

157-197 Buckingham Palace Road

14 July 2005 Victoria

London SW1W 9SP

Supplementary statement by the Comptroller and Auditor General in respect of material

included at pages 1 to 36 of this Annual Report, not included with the financial statements to

which the audit opinion above relates

In respect alone of my responsibility under United Kingdom auditing standards to read the other

information included with financial statements on which I express an audit opinion, I have read the

additional information on pages 1 to 36, which was not included with the financial statements on

which I reached the audit opinion set out in my Certificate above, and considered whether it is

consistent with the audited financial statements. I have considered the implications for my audit

opinion if I have thereby become aware of any apparent misstatement or material inconsistencies

with the financial statements. I have not considered the effects of any events since the date of my

Certificate.

In this regard, my audit opinion on the financial statements is unchanged

John Bourn

National Audit Office

Comptroller and Auditor General

157 -197 Buckingham Palace Road

14 October 2005 Victoria,

London SW1W 9SP

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Operating Cost Statement for the year ended 31 March 2005

Continuing Operations

2004-2005 2003-2004

Notes £000 £000

Programme costs 2.1 26,443 24,227

Operating income 4 (568) (437)

Net operating cost 25,875 23,790

Net Resource Outturn 3.1 25,875 23,790

Statement of Recognised Gains and Losses for the year ended 31 Marc

2005

2004-2005 2003-2004

Notes £000 £000

Unrealised surplus on the indexation of fixed assets 11.2 294 309

Unrealised surplus on the valuation of fixed assets 11.2 2,394 -

Recognised gains for the financial year 2,688 309

The notes on pages 13 to 32 form part of this account.

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Balance Sheet as at 31 March 2005

31 March

2005

31 March

2004

Notes £000 £000

Fixed assets

Intangible assets 5.1 317 425

Tangible assets 5.2 7,183 4,587

7,500 5,012

Current assets

Debtors 6 1,139 822

Cash at bank and in hand 7 15 19

1,154 841

Creditors: amounts falling due within one year 8 (1,408) (1,199)

Net current liabilities (254) (358)

Total assets less current liabilities 7,246 4,654

Provisions for liabilities and charges 9 (9,443) (8,439)

Net liabilities (2,197) (3,785)

Taxpayers’ equity

General fund 11.1 (6,299) (5,240)

Revaluation reserve 11.2 4,102 1,455

(2,197) (3,785)

The notes on pages 13 to 32 form part of this account.

John Taylor 12 July 2005

Chief Executive

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Cash Flow Statement for the year ended 31 March 2005

2004-2005 2003-2004

Notes £000 £000

Net cash (outflow) from operating activities 12 (24,599) (23,385)

Capital expenditure and financial investment

(Payments) to acquire intangible fixed assets (18) (135)

(Payments) to acquire tangible fixed assets (325) (214)

Receipts from disposal of tangible assets 16 40

Net cash outflow from investing activities (327) (309)

Net cash outflow before financing (24,926) (23,694)

Financing

Net Parliamentary funding 11.1 24,922 23,695

(Decrease)/Increase in cash in the year 7 (4) 1

The notes on pages 13 to 32 form part of this account.

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Notes to the Accounts

1 Accounting Policies

The financial statements have been prepared in accordance with the accounts direction

issued by the Secretary of State for Health with the approval of Treasury. The

particular accounting policies adopted by the Dental Practice Board are described

below. They have been consistently applied in dealing with items considered material

in relation to the accounts.

1.1 Accounting Convention and accounts

This account is prepared under the historical cost convention, modified to account for

the revaluation of tangible fixed assets and stock where material, at their value to the

business by reference to their current costs. This is in accordance with directions

issued by the Secretary of State for Health and approved by HM Treasury.

The Dental Practice Board makes payments to dentists on behalf of the General Dental

Services and Personal Dental Services for both England and Wales. The financial

statements for this expenditure for England are not separately published, as the

expenditure is incorporated into the summarised accounts of the Primary Care Trusts.

The General Dental Service expenditure for Wales is published separately and the

Personal Dental Services expenditure for Wales is included in the accounts of the Local

Health Boards.

These accounts deal with the operational and administrative costs of the Dental

Practice Board in providing services for General Dental Services and Personal Dental

Services in England and Wales.

Acquisitions and Discontinued Operations

Activities are considered to be 'acquired' only if they are acquired from outside the

public sector. Activities are considered to be ‘discontinued’ only if they cease entirely.

They are not considered to be ‘discontinued’ if they transfer from one NHS body to

another.

Going Concern

As discussed in the Foreword the Dental Practice Board is part of the Arm’s Length

Bodies review announced by the Secretary of State for Health. In the event that the

assets, liabilities, contractual obligations and staff of the Dental Practice Board are

transferred to another NHS body the activities would not be considered as

‘discontinued’. The Accounting Officer of the Dental Practice Board therefore considers

it appropriate to prepare the 2004-2005 financial statements on a going concern basis.

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1.2 Income

1.3 Taxation

Income is accounted for applying the accruals convention. The main source of funding

for the Dental Practice Board is Parliamentary grant from the Department of Health

from Request for Resources 1 within an approved cash limit, which is credited to the

general fund. Parliamentary funding is recognised in the financial period in which it is

received.

Operating income is income which relates directly to the operating activities of the

Dental Practice Board. It principally comprises fees and charges for services provided

on a full-cost basis to external customers, as well as public repayment work, but it also

includes other income such as that from investments. It includes both income

appropriated-in-aid and income to the Consolidated Fund which HM Treasury has

agreed should be treated as miscellaneous income. Where income is received for a

specific activity which is to be delivered in the following financial year, that income is

deferred.

The Dental Practice Board is not liable to pay corporation tax. Expenditure is shown

net of recoverable VAT. Irrecoverable VAT is charged to the most appropriate

expenditure heading or capitalised if it relates to an asset.

1.4 Capital Charges

The treatment of fixed assets in the account is in accordance with the principal capital

charges objective to ensure that such charges are fully reflected in the cost of capital.

The interest rate applied to capital charges in the financial year 2004-2005 was 3.5%

(2003-2004 3.5%) on all assets less liabilities, except for cash balances with the Office

of the Paymaster General , where the charge is nil.

1.5 Fixed Assets

a Capitalisation

All assets falling into the following categories are capitalised:

i

ii

iii

Intangible assets where they are capable of being used for more than one year and

have a cost, individually or as a group, equal to or greater than £5,000.

Purchased computer software licences are capitalised as intangible fixed assets

where expenditure of at least £5,000 is incurred.

Tangible assets which are capable of being used for more than one year, and they:

- individually have a cost equal to or greater than £5,000;

- collectively have a cost of at least £5,000 and an individual cost of more than

£250, where the assets are functionally interdependent, they had broadly

simultaneous purchase dates, are anticipated to have simultaneous disposal

dates and are under single managerial control; or

- form part of the initial equipping and setting-up cost of a new building, ward or unit

irrespective of their individual or collective cost.

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Valuation

Intangible fixed assets

Intangible fixed assets held for operational use are valued at historical cost. Surplus

intangible assets are valued at the net recoverable amount.

The carrying value of intangible assets is reviewed for impairment at the end of the first

full year following acquisition and in other periods if events or changes in circumstances

indicate the carrying value may not be recoverable.

Tangible fixed assets

Tangible fixed assets are stated at the lower of replacement cost and recoverable

amount. On initial recognition they are measured at cost (for leased assets, fair value)

including any costs such as installation directly attributable to bringing them into

working condition. They are restated to current value each year. The carrying values

of tangible fixed assets are reviewed for impairment in periods if events or changes in

circumstances indicate the carrying value may not be recoverable.

i

Land and buildings excluding dwellings

Valuations are carried out by the District Valuer of the Valuation Office Agency at

five yearly intervals in accordance with FRS 15. Between valuations price indices

appropriate to the category of asset are applied to arrive at the current value. The

buildings indexation is based on the All in Tender Price Index published by the

Building Cost Information Service (BCIS). The land index is based on the

residential building land values reported in the Property Market Report published

by the Valuation Office. The valuations were carried out in accordance with the

Royal Institute of Chartered Surveyors (RICS) Appraisal and Valuation Manual

insofar as these terms are consistent with the agreed requirements of the

Department of Health and HM Treasury. In accordance with the requirements of

the Department of Health, the asset valuations were undertaken in 2004 as at the

prospective valuation date of 1 April 2005 and have been included in these

accounts at 31 March 2005.

The valuations have been carried out primarily on the basis of Depreciated

Replacement Cost for specialised operational property and Existing Use Value for

non-specialised operational property. In respect of non-operational properties,

including surplus land, the valuations have been carried out at Open Market Value.

The value of land for existing use purposes is assessed to Existing Use Value.

The valuations do not include notional directly attributable acquisition costs nor

have selling costs been deducted, since they are regarded as not material.

To meet the underlying objectives established by the Department of Health the

following accepted variations of the RICS Appraisal and Valuation Manual have

been required:

- specialised operational assets have been valued on a replacement rather than

a modern substitute basis;

- no adjustment has been made to the cost figures of operational assets in

respect of dilapidations; and

- additional alternative Open Market Value figures have only been supplied for

operational assets scheduled for imminent closure and subsequent disposal.

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ii

iii

iv

c

Operational equipment is valued at net current replacement costs through annual

uplift by the change in the value of the Gross Domestic Product (GDP) deflator.

Equipment surplus to requirements is valued at net recoverable amount.

Assets in the course of construction are valued at current cost, using the index as

for land and buildings. These assets include any existing land or buildings under

the control of a contractor.

All adjustments arising from indexation and five-yearly revaluations are taken to the

Revaluation Reserve. All impairments resulting from price changes are charged to

the Statement of Recognised Gains and Losses. Falls in value when newly

constructed assets are brought into use are also charged there. These falls in

value result from the adoption of ideal conditions as the basis for depreciated

replacement cost valuations.

Depreciation and Amortisation

Depreciation is charged on each individual fixed asset as follows:

i

ii

iii

iv

v

Intangible assets are amortised, on a straight line basis, over the estimated lives of

the assets.

Purchased computer software licences are amortised over the shorter of the term

of the licence and their useful economic lives.

Land and assets in the course of construction are not depreciated.

Buildings are depreciated evenly on their revalued amount over the assessed

remaining life of the asset as advised by the District Valuer. Leaseholds are

depreciated over the primary lease term.

Each equipment asset is depreciated evenly over the expected useful life:

Years

Furniture and fittings:

Furniture 10

Soft furnishings 7

Transport Equipment 7

Information Technology:

Mainframe information technology installations 8

Office information technology 5

1.6 Donated Fixed Assets

The Dental Practice Board does not have any Donated Fixed Assets.

1.7 Stocks and work in progress

The Dental Practice Board does not normally recognise stocks.

1.8 Losses and special payments

Losses and special payments are charged to the relevant functional headings, including

losses which would have been made good through insurance cover had the Dental

Practice Board not been bearing their own risks (with insurance premiums then being

included as normal revenue expenditure).

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1.9 Pension costs

Past and present employees are covered by the provisions of the NHS Pension

Scheme. The Scheme is an unfunded, defined benefit scheme that covers NHS

employers, General Practices and other bodies, allowed under the direction of the

Secretary of State, in England and Wales. As a consequence it is not possible for the

Dental Practice Board to identify its share of the underlying scheme liabilities.

Therefore, the scheme is accounted for as a defined contribution scheme and the cost

of the scheme is equal to the contributions payable to the scheme for the accounting

period. The total employer contributions payable in 2004-2005 were £1,243,000

(2003-2004 £626,000).

The Scheme is subject to a full valuation by the Government Actuary every four years

which is followed by a review of the employer contribution rates. The last valuation took

place as at 31 March 2003 and has yet to be finalised. The last published valuation

covered the period 1 April 1994 to 31 March 1999. Between valuations the

Government Actuary provides an update of the scheme liabilities on an annual basis.

The latest assessment of the liabilities of the Scheme is contained in the Scheme

Actuary report, which forms part of the NHS Pension Scheme (England and Wales)

Resource Account, published annually. These accounts can be viewed on the NHS

Pensions Agency website at www.nhspa.gov.uk. Copies can also be obtained from

The Stationery Office.

The conclusion of the 1999 valuation was that the scheme continues to operate on a

sound financial basis and the notional surplus of the scheme is £1.1 billion. It was

recommended that employers’ contributions remain at 7% of pensionable pay until 31

March 2003 and then be increased to 14% of pensionable pay with effect from 1 April

2003. On advice from the actuary the contribution may be varied from time to time to

reflect changes in the scheme’s liabilities. Employees pay contributions of 6% (manual

staff 5%) of their pensionable pay.

NHS bodies are directed by the Secretary of State to charge employers pension costs

contributions to operating expenses as and when they become due. Until 2002-03 HM

Treasury paid the Retail Price Indexation costs of the NHS Pension scheme direct but

as part of the Spending Review Settlement, these costs have been devolved in full. For

2003-04 the additional funding was retained as a Central Budget by the Department of

Health and was paid direct to the NHS Pensions Agency and the employers’

contribution remained at 7%. From 2004-05 this funding was devolved in full to NHS

Pension Scheme employers and the employer’s contribution rate rose to 14%.

The Scheme is a "final salary" scheme. Annual pensions are normally based on 1/80th

of the best of the last 3 years pensionable pay for each year of service. A lump sum

normally equivalent to 3 years pension is payable on retirement. Annual increases are

applied to pension payments at rates defined by the Pensions (Increase) Act 1971, and

are based on changes in retail prices in the twelve months ending 30 September in the

previous calendar year. On death, a pension of 50% of the member's pension is

normally payable to the surviving spouse.

Early payment of a pension, with enhancement, is available to members of the Scheme

who are permanently incapable of fulfilling their duties effectively through illness or

infirmity. Additional pension liabilities arising from early retirement are not funded by

the scheme except where the retirement is due to ill-health. For early retirements not

funded by the scheme, the full amount of the liability for the additional costs is charged

to the Operating Cost Statement at the time the Dental Practice Board commits itself to

the retirement, regardless of the method of payment.

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A death gratuity of twice final years pensionable pay for death in service, and up to five

times their annual pension for death after retirement, less pensions already paid,

subject to a maximum amount equal to twice the member’s final years pensionable pay

less their retirement lump sum for those who die after retirement, is payable.

The Scheme provides the opportunity to members to increase their benefits through

money purchase Additional Voluntary Contributions (AVCs) provided by an approved

panel of life companies. Under the arrangement the employee can make contributions

to enhance their pension benefits. The benefits payable relate directly to the value of

the investments made.

1.10 Research and Development

The Dental Practice Board does not incur Research and Development expenditure.

1.11 Foreign exchange

Transactions which are denominated in a foreign currency are translated into sterling at

the exchange rate ruling on the date of each transaction, except where rates do not

fluctuate significantly, in which case an average rate for a period is used.

1.12 Leases

Assets held under finance leases and hire purchase contracts are capitalised in the

balance sheet and are depreciated over their useful lives or primary lease term.

Rentals under operating leases are charged on a straight line basis over the terms of

the lease.

1.13 Provisions

The Dental Practice Board provides for legal or constructive obligations that are of

uncertain timing or amount at the balance sheet date on the basis of the best estimate

of the expenditure required to settle the obligation. Where the effect of the time value

of money is significant, the estimated risk-adjusted cash flows are discounted using the

Treasury’s discount rate of 3.5% in real terms.

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2.1 Programme costs

2004-2005 2003-2004

Notes £000 £000 £000

Non-executive remuneration 43 42

Salaries 2.2 11,811 11,056

Early retirement and severance scheme

New scheme 9 2,180 546

Provision no longer required 9 (68) (81)

Unwinding of discount 9 466 410

2,578 875

IT services contractors 5,100 6,074

Bureau keying 1,402 1,243

Reference Service Support

357 500

contract

Postage, stationery and

1,039 1,154

telephone

Capital:

Depreciation and

5 486 465

amortisation

Impairments 5 10 -

Capital charges interest (147) (135)

Loss on disposal 5.4 10 1

359 331

Maintenance of equipment and

364 374

premises

Transport, travel and

548 579

subsistence

Rent and rates 407 96

Furniture and equipment 423 446

Professional fees and outsourced

1,223 557

services

Heat, light and power 100 72

Hire and leasing 17 18

Auditor's remuneration: audit fees* 97 99

Auditor's remuneration: other fees - 5

Training 84 103

Other administration costs 491 603

26,443 24,227

* The audit fee represents the cost for the audit of the underlying financial

statements carried out by the Comptroller and Auditor General. The audit fee also

covers work in respect of General Dental Services and Personal Dental Services

payments made by the Dental Practice Board where the expenditure is

incorporated into the summarised accounts of the Primary Care Trusts.

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2.2 Staff numbers and related

costs

Permanently

employed 2004-2005 2003-2004

staff Other Total Total

£000 £000 £000 £000

Salaries and wages 9,291 455 9,746 9,601

Social security costs 812 10 822 829

Employer contributions to NHSPA 1,243 - 1,243 626

11,346 465 11,811 11,056

The average number of employees during the year was:

Permanently

employed 2004-2005 2003-2004

staff Other Total Total

Number Number Number Number

Total 281 18 299 325

Expenditure on staff benefits

The Dental Practice Board provides Dental Reference Officers with cars for the

performance of their jobs which involves clinical duties throughout England and Wales.

Where an officer elects to have personal use of the car they make a monthly payment for

this privilege. Under current Inland Revenue rules this results in a taxable benefit of

£74,000 (2003-2004 £70,000).

Retirements due to ill-health

During 2004-2005 there were no early retirements from the Dental Practice Board on the

grounds of ill-health (2003-2004 Nil).

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2.3 Salary and pension entitlement of senior managers

2004 - 2005 2003 – 2004

Benefits

Benefits

Other in kind Other in kind

Salary remuner. (rounded to Salary remuner. (rounded to

in £5,000 in £5,000 nearest in £5,000 in £5,000 nearest

bands bands £hundred) bands bands £hundred)

Name and title £000 £000 £00 £000 £000 £00

Chairman:

M Wyllie 30 - 35 Nil 10 30 – 35 Nil 10

Chief Executive:

J Taylor 100 - 105 Nil Nil 90 – 95 Nil Nil

Non-Executive members:

R Austin Nil 0 – 5 2 Nil 0 – 5 2

N Entwistle* N/A N/A N/A Nil 0 – 5 Nil

C Ferguson Nil 0 – 5 1 Nil 0 – 5 1

D Ferns Nil 0 – 5 Nil Nil 0 – 5 4

S Lakhanpaul Nil 0 – 5 4 Nil 0 – 5 4

D Spratt Nil 0 – 5 2 Nil 0 – 5 1

* Resigned 29 April 2003

Total accrued

pension

Employer’s

Real increase at age 60 at contribution to

in pension and 31 Mar 2005

Cash

Cash Real increase stakeholder

related lump

& Equivalent

Equivalent in Cash pension

sum at age related lump Transfer Transfer Equivalent (rounded to

60 (bands sum (bands Value at Value at Transfer nearest

of £2,500) of £5,000) 31 Mar 2005 31 Mar 2004 Value £hundred)

Name and title £000 £000 £000 £000 £000 £00

Chief Executive

J. Taylor 12.5-15 150-160 N/A** N/A* N/A* 9.4

* *Over age 60

As Non-Executive members do not receive pensionable remuneration, there are no entries in

respect of pensions for Non-Executive members.

Benefits in kind paid to the Chairman and Non-Executive members are mileage allowances paid in

excess of the Inland Revenue's approved mileage rates.

Non-executive members who are also Dentists may receive General Dental Services payments in

line with the Statement of Dental Remuneration or Personal Dental Services under contracts with

Primary Care Trusts for England or Local Health Boards for Wales. The Department of Health and

Welsh Assembly Government set the policy for these payments.

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Cash Equivalent Transfer Value

A Cash Equivalent Transfer Value (CETV) is the actuarially assessed capital value of the pension

scheme benefits accrued by a member at a particular point in time. The benefits valued are the

members’ accrued benefits and any contingent spouse’s pension payable from the scheme.

A CETV is a payment made by a pension scheme or arrangement to secure pension benefits in

another pension scheme or arrangement when the member leaves a scheme and chooses to

transfer the benefit accrued in the former scheme. The pension figures shown relate to the benefits

that the individual has accrued as a consequence of their total membership of the pension scheme,

not just their service in a senior capacity to which disclosure applies.

The CETV figure, and from 2004-2005 the other pension details, include the value of any pension

benefits in another scheme or arrangement which the individual has transferred to the NHS pension

scheme. They also include any additional pension benefit accrued to the member as a result of their

purchasing additional years of pension service in the scheme at their own cost. CETV are

calculated within the guidelines and framework prescribed by the Institute and Faculty of Actuaries.

Real Increase in CETV

This reflects the increase in CETV effectively funded by the employer. It takes account of the

increase in accrued pension to inflation, contributions paid by the employee (including the value of

any benefits transferred from another scheme or arrangement) and uses common market

valuation factors for the start and end of period.

2.4 Better Payment Practice Code - measure of compliance

Number £000

Total bills paid 2004-2005 3,022 14,257

Total bills paid within target 3,016 14,236

Percentage of bills paid within target 99.8% 99.9%

The Late Payment of Commercial Debts (Interest) Act 1998

No interest or compensation for debt recovery costs was paid under the legislation (2003-2004 Nil).

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3.1 Reconciliation of net operating cost to net resource outturn

2004-2005 2003-2004

£000 £000

Net operating cost 25,875 23,790

Net resource

outturn 25,875 23,790

Revenue resource

limit 25,994 23,800

Und

Under spend against limit 119 er 10

3.2 Reconciliation of gross capital expenditure to capital resource limit

2004-2005 2003-2004

£000 £000

Gross capital expenditure 322 349

Net Book Value of assets disposed (26) (41)

Net capital resource outturn 296 308

Capital resource limit 350 500

Under/(Over) spend against limit Ur 54 192

4 Operating Income

Operating income analysed by classification and activity, is as follows:

Appropriated

in aid 2004-2005 2003-2004

£000 £000 £000

Programme income:

Fees & charges to external customers 568 568 386

Interest received - - 51

Total 568 568 437

Interest was received during 2003-2004 on a rates rebate, in respect of the property at

Eastbourne, covering a number of years

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5.1 Intangible Fixed Assets Software

Licences

£000

Gross cost at 31 March 2004 623

Additions - purchased 18

Disposals (19)

Gross cost at 31 March 2005 622

Accumulated amortisation at 31 March 2004 198

Provided during the year 126

Disposals (19)

Accumulated amortisation at 31 March 2005 305

Net book value as at 31 March 2004 425

Net book value as at 31 March 2005 317

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5.2 Tangible Fixed Assets

Buildings

excl. Transport Information Furniture

Land dwellings Equipment Technology & fittings Total

£000 £000 £000 £000 £000 £000

Cost or Valuation at 31 March 2004 1,110 2,876 1,079 482 597 6,144

Additions - purchased - - 139 90 75 304

Impairments - - - - - -

Indexation 82 228 23 - 11 344

National revaluation exercise* 358 1,596 - - - 1,954

Disposals - - (171) (85) (6) (262)

Gross cost at 31 March 2005 1,550 4,700 1,070 487 677 8,484

Accumulated depreciation at 31 March 2004 - 325 524 169 539 1,557

Provided during the year - 88 157 87 28 360

Impairments - - 10 - - 10

Indexation - 27 12 - 11 50

National revaluation exercise* - (440) - - - (440)

Disposals - - (150) (80) (6) (236)

Accumulated depreciation at 31 March 2005 - - 553 176 572 1,301

Net book value as at 31 March 2004 1,110 2,551 555 313 58 4,587

Net book value as at 31 March 2005 1,550 4,700 517 311 105 7,183

*Accounting instructions issued by the Department of Health require accumulated depreciation to be Nil at

31 March 2005.

The Dental Practice Board does not hold any assets under finance leases nor donated fixed assets.

5.3 Net Book Value of land and buildings

The net book value of land and buildings at 31 March 2005 of £6,250,000 (31 March 2004

£3,661,000) is all freehold. This is the Eastbourne property which is the headquarters of the Dental

Practice Board. The property was revalued during the year in accordance with the guidance detailed

in note 1.5 (b)(i) on page 15.

5.4 Profit / loss on disposal of fixed assets

2004-2005 2003-2004

£000 £000

Loss on disposal of computer assets (5) -

Loss on disposal of motor vehicles (5) (1)

(10) (1)

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6 Debtors

2004-2005 2003-2004

Amounts falling due within one year £000 £000

NHS Pensions Agency 2 -

Department of Health 250 -

Dental Vocational Training Authority 34 17

Welsh Assembly Government 51 14

Prepayments 317 362

Other debtors 485 429

1,139 822

The Dental Practice Board makes payments on an ongoing basis on behalf of the Department of

Health and the Welsh Assembly Government in respect of Electronic Data Interchange grants to

dentists and Continuing Professional Education for dentists, the NHS Pensions Agency in respect

of Widows’/Widowers’ Pension and the Dental Vocational Training Authority. These payments

are either funded in advance or subsequently reimbursed. These paying agency activities result

in debtor or creditor balances. Amounts due to the Dental Practice Board at 31 March 2005 in

respect of these activities totalled £80,000 (2003-2004 £31,000). Amounts due from the Dental

Practice Board are shown in Note 8 Creditors.

Additionally in 2004-2005 the Dental Practice Board made payments on behalf of the Department

of Health principally in relation to the recruitment of dentists from overseas which gave rise to a

debtor of £250,000 at 31 March 2005.

7 Analysis of changes in cash

At 31 Change At 31

March during March

2004 the year 2005

£000 £000 £000

Cash at Office of the Paymaster General - 2 2

Cash at commercial banks and in hand 19 (6) 13

19 (4) 15

8 Creditors 2004-2005 2003-2004

Amounts falling due within one year £000 £000

NHS Pensions Agency 379 257

Department of Health 1 21

Capital creditors - 21

Tax and social security 309 269

Other creditors 293 173

Accruals 423 455

Deferred income 3 3

1,408 1,199

As described in Note 6 Debtors, the Dental Practice Board acts as a paying agent and these

activities result in debtor and creditor balances. At 31 March 2005 creditors in respect of paying

agency activities totalled £1,000 (2003-2004 £21,000).

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9 Provisions for liabilities and charges

Agenda Pensions for

for former

Change staff Total

£’000 £’000 £000

At 31 March 2004 - 8,439 8,439

Arising during the year 43 2,180 2,223

Utilised during the year - (1,617) (1,617)

Provision no longer required - (68) (68)

Unwinding of discount - 466 466

At 31 March 2005 43 9,400 9,443

Expected timing of cash flows: £000 £000 £000

Within 1 year 43 1,417 1,460

1-5 years - 3,844 3,844

Over 5 years - 4,139 4,139

43 9,400 9,443

The Agenda for Change provision relates to back pay due to staff for the period from 1 October

2004 arising from the NHS job evaluation programme. Job evaluations for all posts are due to be

completed by 30 September 2005.

The pension provision relates to all staff who left the Dental Practice Board under voluntary

severance and early retirement schemes where the cost has not been capitalised, i.e. a payment

made to the NHS Pension Agency in respect of the liability. The provision is in respect of all early

retirements where the decision has been made in the year to 31 March 2005 or earlier years and

includes retirements planned for 2005-2006 of £2,153,000 (2003-2004 – retirements planned for

2004-2005 of £2,972,000).

There were no provisions for legal claims or clinical negligence.

10 Movements in working capital other than cash

2004-2005 2003-2004

£000 £000

(Increase)/Decrease in debtors (Decrease) (317) 5

Increase/(Decrease) in creditors (excluding capital creditors) Increase) 230 161

Increase

(Decrease) (87) 166

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11 Movements on reserves

2004-2005 2003-2004

11.1 General Fund £000 £000

Balance at 31 March 2004 (5,240) (5,049)

Net operating costs for the year (25,875) (23,790)

Net Parliamentary funding 24,922 23,695

Transfer of realised profits/losses from revaluation reserve 41 39

Non-cash items: capital charges interest (147) (135)

Balance at 31 March 2005 (6,299) (5,240)

11.2 Revaluation Reserve £000 £000

Balance at 31 March 2004 1,455 1,185

Indexation of fixed assets 294 309

Revaluation of fixed assets 2,394 -

Transfer to General Fund: realised revaluation (41) (39)

Balance at 31 March 2005 4,102 1,455

12 Reconciliation of operating cost to operating cash flows

2004-2005 2003-2004

Notes £000 £000

Net operating cost before interest for the year (25,875) (23,790)

Adjust for non-cash transactions 2.1 359 331

Adjust for movements in working capital other than cash 10 (87) 166

(Increase)/Decrease in provisions ) 1,004 (92)

Net cash (outflow) from operating activities (24,599) (23,385)

13 Contingent liabilities

At 31 March 2005, there were no known contingent liabilities. (2003-2004 Nil).

14 Capital commitments

At 31 March 2005, the value of capital commitments was Nil (2003-2004 £21,000).

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15 Commitments under operating leases

Expenses of the Dental Practice Board include the following in respect of hire and operating lease

rentals

2004-2005 2003-2004

£000 £000

Hire of plant and machinery 16 18

Other operating leases 128 130

144 148

Commitments under non-cancellable operating leases:

2 -

2003 - 04 03

Other leases £000 £000

Operating leases which expire:

within 1 year 77 27

between 1 and 5 years 16 98

after 5 years 24 23

117 148

Operating lease commitments include rentals in respect of 24 properties used for dental examination

of patients. Prior to 31 March 2005, notice was given on 19 of these properties, where government

lease arrangements exist, effective from 1 April 2005. Under the government leases the Dental

Practice Board remains liable for the ongoing cost until an alternative tenant is found. Notice has

also been given on 5 properties where there are commercial leases where exit strategies are in the

course of being finalised. Operating lease commitment figures are shown to the end of the lease or,

where earlier, the lease termination date if this has been formally agreed with the landlord.

16 Other Commitments

On 1 January 2003 the Dental Practice Board entered into two seven year contracts, one with IBM

UK Ltd for computing services and one with Astron Document Management Ltd. (formerly Hays

Commercial Services Ltd) for data capture services. The computing services contract involves

payments of £31.9 million over the seven years and is subject to increases in line with inflation. The

data capture contract involves payments of £7.8 million over seven years and adjustments are

dependent on the volumes processed. Both contracts have arrangements within them whereby after

4 years or more, on giving formal notice, the Dental Practice Board can make termination payments

to terminate the contracts.

17 Losses and special payments

Losses or special payments approved during 2004-2005 amounted to £20 (2003-2003 £15).

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18 Related Parties

The Dental Practice Board is a body corporate established by order of the Secretary of State

for Health.

The Department of Health and Welsh Assembly Government are regarded as controlling

related parties. During the year the Dental Practice Board has had a significant number of

material transactions with the Department of Health and Welsh Assembly Government, and

with other entities for which they are regarded as the parent including:

- Strategic Health Authorities, NHS Hospital Trusts and Primary Care Trusts for the use of their

facilities for dental clinics;

- The NHS Pensions Agency;

- The Dental Vocational Training Authority where the Dental Practice Board provides paying

agency services; and

- The NHS Counter Fraud and Security Management Service who carry out checks to ensure

patients are exempt from paying NHS charges.

During the year none of the Dental Practice Board members or members of the key

management staff or other related parties has undertaken any material transactions with the

parties listed above.

The Dental Practice Board Chairman and a majority of non-executive members are required to

be dental practitioners and may receive payments in respect of General Dental Services or

Personal Dental Services. The officers have the same influence over the amount of these

payments as any other dental practitioner and do not gain additional influence as a result of

their appointment.

The Chairman Mary Wyllie and non-executive members Ruby Austin, David Ferns,

Sandeep Lakhanpaul are dental practitioners. The gross payments from General Dental

Services and Personal Dental Services for these officers were all in the band of below

£200,000.

19 Post balance sheet events

From 1 April 2005 HM Treasury changed the discount rate used in calculating provisions from

3.5% to 2.2%. This change will result in an increase in our provisions of approximately

£1,400,000, which will be charged to the Operating Cost Statement in 2005-2006. National

funding of NHS commissioners will be increased by the total estimated effect to offset this

charge.

The Dental Practice Board is part of the Department of Health’s Arms Length Bodies review

and details of proposed future changes are given in the Foreword.

20 Financial Instruments

FRS 13, Derivatives and Other Financial Instruments, requires disclosure of the role that financial

instruments have had during the period in creating or changing the risks an entity faces in

undertaking its activities. Because of the way the Dental Practice Board is financed, the Dental

Practice Board is not exposed to the degree of financial risk faced by business entities. Also

financial instruments play a much more limited role in creating or changing risk than would be

typical of the listed companies to which FRS 13 mainly applies. The Dental Practice Board has

no powers to borrow or invest surplus funds and financial assets and liabilities are generated by

day-to-day operational activities rather than being held to change the risks facing the Dental

Practice Board in undertaking its activities.

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As allowed by FRS 13, debtors and creditors that are due to mature or become payable within

12 months from the balance sheet date have been omitted from all disclosures other than from

the currency profile.

Liquidity risk

The Dental Practice Board's net operating costs and capital expenditure are financed from

resources voted annually by Parliament and it is not, therefore, exposed to significant liquidity

risks.

Interest-rate risk

All the Dental Practice Board's financial assets and financial liabilities carry nil rates of interest and it

is not, therefore, exposed to interest-rate risk.

Foreign currency risk

The Dental Practice Board has no foreign currency income or expenditure and it is not, therefore,

exposed to foreign currency risk.

Fair values

A comparison, by category, of book values and fair values of the Dental Practice Board's financial

assets and liabilities as at 31 March 2005 is as follows:

Book

Basis of

value Fair value

fair

£000 £000 valuation

Financial assets

Cash 15 15

Total 15 15

Book value

equals fair

value

Financial liabilities

Creditors over 1 year:

Voluntary severance and early retirements 7,983 7,983

Total 7,983 7,983

Book value

equals fair

value

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21 Intra-government balances

Debtors: Creditors:

Amounts Amounts

falling due falling due

within one within one

year

year

£000 £000

Balances with other central

682 442

government bodies

Balances with NHS Trusts - 2

Balances with bodies external to government 457 1,007

At 31 March 2005 1,139 1,451

Debtors: Creditors:

Amounts Amounts

falling due falling due

within one within one

year

year

£000 £000

Balances with other central

358 578

government bodies

Balances with NHS Trusts - 19

Balances with bodies external to government 464 602

At 31 March 2004 822 1,199

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DENTAL PRACTICE BOARD

SERVICE LEVEL AGREEMENT

For the year to March 2006

The Department of Health and the

Welsh Assembly Government

and

The Dental Practice Board

This document will be subject to change by DH/WAG/DPB/BSA

during the year when plans for implementation of the new

arrangements for NHS dentistry and for the creation of the new

Business Services Authority are finalised

THE DEPARTMENT OF HEALTH

WELLINGTON HOUSE

133 – 155 WATERLOO ROAD, LONDON SE1 8UG

Annex two

DPB Annual Report and Accounts 2004-2005


SERVICE LEVEL AGREEMENT BETWEEN

THE HEALTH DEPARTMENT FOR ENGLAND

AND THE WELSH ASSEMBLY GOVERNMENT

AND

THE DENTAL PRACTICE BOARD

FOR THE ACCOUNTING YEAR TO MARCH 2006

For the agreed allocation for expenditure as defined by the ALB review team for the accounting

year to March 2006 of £23062k with provision for capital expenditure of £340k and a cash limit

of £24100k the Dental Practice Board undertakes to deliver the services set out in this

agreement within the framework of the current business plan with separate figures for England

and Wales, where appropriate. In 2005/06 additional revenue resource cover of £1400k may

be required for an accounting adjustment necessary as a result of the revaluation of the DPB

pension provision and £1000k as a transition cost for a leaving scheme which will help to ensure

the DPB meets its financial targets set by the ALB review team for 2008/09.

For each service, the standards of accuracy and timeliness the DPB undertakes to meet are

defined and the DPB commits to achieve these cost effectively, pursuing a continuing

programme of cost reduction, with the target that costs reduce in line with the targets set by

the ALB review team.

To achieve the standards of service defined in this service level agreement the DPB applies the

following risk and quality frameworks: Controls Assurance Management System (the CAMS)

which incorporates the requirements of NHS Controls Assurance, Quality Management ISO

9001, Environmental Management ISO 14001, Occupational Health and Safety Management

OHSAS 18001, Complaints Management CMSAS 86:2000 and Information Security Management

BS 7799. All the British and International standards listed are externally audited on a regular

basis by the British Standards Institute.

Throughout this document, average is to be understood as arithmetic mean. Unless otherwise

qualified, average refers to the twelve-month period to March 2006; days are calendar days.

Unless specified otherwise, standards involving amounts of work mean that one seventeenth of

the amount will be for Wales.

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CONTENTS

Page

Section 1: Form of Agreement and Associations

Part 1 Form of Agreement 3

Part 2 Period of Agreement, Review and Renewal 3

Part 3 Monitoring and Reporting 4

Part 4

Data Protection Act 1998, Freedom of Information

Act 2000 and the Computer Misuse Act 1990 4

Part 5 Instructions and Variations 4

Section 2: Service Specification

Part 1 Prior Approval 5

Part 2 Authorisation 6

Part 3 Registration 7

Part 4 Payment 8

Part 5 Personal Dental Services 9

Part 6 Probity 10, 11

Part 7 Dental Reference Service 12

Part 8 Data Services 13

Part 9 Customer Relations 14

Part 10 Financial Data 15

Part 11 Accountability 16

Part 12 Staff 17

Section 3: Protocol

Part 1 Fraud Definition 18

Part 2 Responsibilities 18, 19

Part 3 Dental Case Profile 20

Section 4: Signatures 21

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SECTION 1 - FORM OF AGREEMENT AND ASSOCIATIONS

1 Form of Agreement

1.1 This agreement is made between the Secretary of State 1 and the Dental Practice

Board ["the DPB"] 2 .

1.2 Bodies with an interest in the DPB include the Department of Health, Welsh

Assembly Government, Primary Care Trusts, Local Health Groups, Local Health

Boards, NHS Counter Fraud & Security Management Services, NHS dentists

providing General Dental Services or performing Personal Dental Services.

1.3 This document forms the framework required of the Department of Health as a

means of monitoring the delivery of the functions of its Arms Length Body (ALB),

the Dental Practice Board 3 . It has been prepared with reference to the

Department's "Guide to Managing the Relationship between the Department and

its Arm's Length Bodies.”

1.4 It is agreed that the DPB will undertake the work specified in Part 2 in

accordance with the Conditions specified in Part 1 and shall provide all

information as required in accordance with Parts 2 and 3.

2 Period of Agreement, Review and Renewal

2.1 The Agreement shall take effect on the Commencement Date, being 1st April

2005 and shall terminate on the Completion Date, being 31st March 2006.

2.2 The Agreement shall be valid for a period of 12 months, shall be subject to annual

review and subject to the agreement of all Parties, may be amended, terminated

and / or renewed following the completion of the Agreement and prior to the

commencement of any further Agreement.

1

For Health; the relevant Directorate of the Department of Health is the Specialist Health Services Directorate of the

Department of Health, of Wellington House, 133-155 Waterloo Road, London SE1 8UG.

2

Compton Place Road, Eastbourne, East Sussex BN20 8AD.

3

The DPB is established under section 37 of the NHS Act 1977.

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3 Monitoring and Reporting

3.1 The DPB shall send quarterly reports to DH and the WAG, in accordance with

the requirements laid out in this SLA.

3.2 DH or the WAG may call upon the DPB for further reports from time-to-time

on any aspect of the Service Specification and the DPB shall furnish them within

an agreed timescale.

4 Data Protection Act 1998, Freedom of Information Act 2000 and the Computer

Misuse Act 1990

4.1 The DPB shall ensure that the handling and security of the policies relating to

data and information controlled or possessed by it conform with the law, in

particular the Data Protection Act 1998, Freedom of Information Act 2000 and

the Computer Misuse Act 1990.

5 Instructions and Variations

5.1 Except in a case of urgency, all instructions shall be made in writing.

5.2 When the matter is urgent, an instruction may be made orally, but shall be

confirmed in writing as soon as practicable after the event and in any event as

quickly as is reasonably possible.

5.3 Any variations to the agreement of association shall be agreed with the

Department of Health.

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SECTION 2 - SERVICE SPECIFICATION

1 Prior Approval

1.1 To receive, examine and give or withhold approval to proposed treatment plans.

1.2 Prior Approval requests not chosen for dental officer reference will be examined

and a response dispatched on average within 6 days of receipt by the DPB [daily

sample of returns].

1.3 Maintain the overall proportion of cases (1 in 25 cases) examined by a dentist,

identify any undesirable trends in dentists’ prescribing patterns and report to

quarterly meeting.

1.4 On average prior approval requests chosen for dental officer reference shall be

dispatched to dentists within 75 days of receipt by the DPB [analysis of returns].

1.5 A system of monitoring prior approval will be used to provide alerts if dentists’

work patterns are varying significantly. This will be reviewed and reported on at the

quarterly meeting.

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2 Authorisation

2.1 To receive, examine and give or withhold approval to payment claims from

dentists under item of service, capitation and continuing care provisions.

2.2 Over the year 990 in every 1,000 or more processed approved payments are to

be authorised for payment on the first available schedule and not more than 1 in

2000 shall miss the second schedule [analysis of approved claims].

2.3 No fewer than 9,985 in 10,000 approved payments shall be authorised at the

correct amount and no fewer than 9,985 in 10,000 shall be correctly recorded

[sample of verified payments].

2.4 Written payment queries shall be cleared or where necessary returned with an

enquiry on average within 2.75 days of receipt by the DPB. All queries shall be

cleared within 10 days [monthly sample of returns].

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3 Registration

3.1 To maintain a registration system for patients under the age of 18 and for adults

under the terms of the capitation and continuing care arrangements.

3.2 A ratio of the number of active patient registrations to the number of active patient

identities shall not exceed 1.023 [quarterly survey of all registrations].

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4 Payment

4.1 To make transfer payments by BACS or, where agreed payable orders, to each

dentist contract each month and similarly to make associated payments to

primary care trusts, local health boards and local dental committees.

4.2 Payment claims received by the DPB shall, on average over the year be not less

than 27.5 or more than 28.5 days from day of receipt to day of payment. In any

calendar month, the average age shall not be more than 1 day outside those limits

[analysis of approved claims].

4.3 All payment transfers shall be in accordance with the prescribed schedule of

payment dates agreed between the Department of Health and the Welsh

Assembly Government and the General Dental Services Committee.

4.4 The DPB provided the Department of Health and the Welsh Assembly

Government, for sign off by the DH by the end of September 2004, a full

specification of the new payment system needed by April 2006 to pay dentists

under the new arrangements. The specification reflected the policy decisions

that have been made up to that point in time. From 1 st October 2004 to 30 th

September 2005 to build, test and implement that system ready for live running

by April 2006 as specified advising the Department of Health and the Welsh

Assembly Government through a strict change control system of the implications

on the payment system of any changes to policy that they want to make.

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5 Personal Dental Services

5.1 To carry out the activities specified in the Secretary of State's "Directions to the

Dental Practice Board concerning functions relating to Personal Dental Services Pilot

Schemes". To summarise:

1) To collect and check information from all Personal Dental Services (PDS)

pilots and produce statistics and reports for

a) the lead officer for each pilot scheme

b) the lead PCT for the pilot scheme

c) the Department of Health, Dental Statistics branch

as specified in the directions. Monthly activity reports to be provided within

10 days of the end of each calendar month.

2) Where requested to do so and as may be specified by the pilot scheme's

lead PCT in an individual Service Level Agreement (SLA) between the DPB

and that PCT:

a) to monitor the provision of PDS (involving previous GDS

practitioners)

b) to carry out probity monitoring, subject to any necessary

collaboration from the lead PCT

c) to provide advice and support to pilots experiencing difficulty in the

electronic submission of activity reports

d) to make payments to providers of PDS

e) to recover overpayments

f) to operate a prior approval system

g) to report on the operation of these services to the lead PCT.

Dental Reference Officer examination of patients may be included in such a

SLA.

The same provisions will be afforded to any scheme approved by the WAG.

5.2 To develop the new PCT/LHB Liaison Team, as appropriate, to meet the needs of

the expansion of PDS and to evolve the team ready to support PCTs/LHBs under

the new contract.

5.3 To work with the Department of Health and the Welsh Assembly Government, in

particular to keep the effectiveness of these services under review and to develop

new systems in order to support changes in policy.

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6 Probity

6.1 To provide an agreed level of assurance with respect to probity of the payment

system and to monitor activity in the General Dental Services and the Personal

Dental Services in order to prevent and detect potential fraud, unnecessary

treatment or any other abuse. To provide such information as may be requested

by the NHS Counter Fraud and Security Management Service (CFSMS) for Risk

Measurement, and the Dental Fraud Team (DFT) in specific cases of suspected or

alleged fraud.

6.2 Where an allegation of fraud by a dentist is made to the DPB, from any source,

the allegation to be passed immediately to the DFT, in accordance with agreed

procedures.

6.3 Where the DPB have doubts, in respect of a dentist, about the correctness of

any claim and payment under the SDR they may clarify, amend or disallow the

claim in accordance with paragraph 2.1 of section 2 of this SLA and commence

enquiries by one or more of the following methods:

a) obtaining samples of patient records from the dentist to do comparison

checks between recorded information and claim information

b) issuing questionnaires to patients to seek confirmation of treatment

received

c) using the Dental Reference Service to make clinical examinations

6.4 Where the DPB enquiries, made under paragraph 6.3, raise a suspicion of

incorrect claiming, to refer the matter to the DFT in writing, within 14 days.

6.5 To refer to the appropriate authorities, in accordance with agreed procedures,

any information that raises a question of abuse that is not fraud related.

6.6 Practitioners will be assessed in accordance with the principles of the risk

management system and those deemed of higher risk, including individual high

earning dentists, shall be subject to enhanced monitoring by the DPB according

to the level of risk. Any suspected fraud or abuse uncovered will be reported to

the DFT.

6.7 Treatment patterns and earnings will be analysed and over the year at least 18

risk assessments shall be carried out, covering various GDS activities to refine

and develop the risk management system or identify areas of concern. Areas of

concern and trends identified by risk assessment projects will be reported to the

CFSMS and in the quarterly report to the Department of Health and the Welsh

Assembly Government.

6.8 To select, process and check the eligibility of 70,000 claims per year for

exemption or remission of dental charges as agreed with CFSMS. CFSMS will

determine the categories of exemption and numbers to be selected for eligibility

check from time to time after consultation with the DPB. To administer penalty

charges in line with current guidance provided by CFSMS.

6.9 To scrutinise one per cent of all Continuing Professional Development (CPD)

claims authorised in the financial year to 31st March 2006 and seek confirmation

of:

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a) the proportion of NHS earnings in relation to total earnings and

b) the qualifying activities and courses attended in respect of verifiable CPD

claimed.

6.10 To advise the Department of Health and the Welsh Assembly Government on

emerging probity trends in general dental matters.

6.11 Without agreement with the DFT the DPB should not:

a) enter into negotiations regarding repayment of fees or remuneration that

may have been made incorrectly

b) visit, or otherwise contact, dentists except to clarify clinical issues and/or

for educational purposes, service providers or patients to verify claim

details outside normal dental reference procedures unless part of a postpayment

monitoring programme which has been agreed with the DFT

c) undertake targeted dental reference examinations for dentists who are

under investigation by the DFT.

6.12 The DPB will be notified by CFSMS where referrals for fraud, that involve the

GDS and PDS, are made directly to the DFT.

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7 Dental Reference Service

7.1 To provide professional dental examination and related services throughout the

GDS and to carry on continuous surveillance so as to provide an agreed level of

assurance in respect of clinical quality.

7.2 The Dental Reference Service (DRS) will undertake to develop and implement a

framework to meet the requirements for clinical assurance by April 2006. The

aim shall be to provide a similar level of assurance in respect of dental activity in

England and Wales.

7.3 The precise mix of work delivered will depend upon monitoring needs as the

year progresses. Quarterly meetings will be held with the Sponsor Branch, the

Chief Dental Advisor and the Head of Information and Probity.

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8 Data Services

8.1 To provide dental information to the Secretary for State for Health for England and

the Minister for Health and Social Services in the Welsh Assembly Government and

for policy makers, primary care trusts and practitioners as may be required. The

data services department to establish a proactive role in identifying and alerting the

Department of Health and the Welsh Assembly Government to emerging trends in

dentistry and remuneration patterns.

8.2 To provide information on a regular basis which shall as a minimum include:

a) manpower and workforce information by PCT/LHB, region, age, sex, status

and country of qualification

b) earnings and registration information by PCT/LHB and summarised at

national level

c) treatment information showing the number and associated expense of each

treatment item by country and age of patient

d) information derived from the DRSG population for workforce, treatment,

earning and registration data

e) data on registrations, treatment types, number of dentists and gross fees to

be updated on a quarterly basis on the DPB website within 1 month of the

end of the quarter

f) a digest of statistics and orthodontic summaries to be published annually

within 2 months of the end of the reference period.

The above information, where required monthly, to be provided within 7 days of the

end of the month and, where required quarterly, to be provided within 2 months of

the end of the quarter.

8.3 To meet ad hoc requests from the Department of Health and the Welsh Assembly

Government within agreed timescales. To collaborate on information services for

regions, strategic health authorities, PCTs, LHBs, dental research or commercial

enquiries whilst continuing to meet the requirements of the Department of Health

and Welsh Assembly Government.

8.4 Information requests to the dental data e-mail address to be acknowledged within 2

days of receipt and acted upon within 7 days of receipt.

8.5 To work with the Department of Health, the Welsh Assembly Government, primary

care trusts and local health boards to clarify information needs.

8.6 To provide dental information for policy makers, primary care trusts and

practitioners.

8.7 To support and, where required, contribute to the implementation of the Dental IT

strategy within Modernising Dentistry and provide by the end of June 2005 to all

Primary Care Trusts, Local Health Boards and dentists as specified by the

Department of Health and the Welsh Assembly Government the prescribing profile

information for the financial year 2004/05.

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9 Customer Relations

9.1 To contribute to dental health services by providing information about GDS and

its administration to stakeholders.

9.2 To provide an annual report for the Senior Departmental Sponsor, in accordance

with DH central finance guidance and guidance on managing Arm’s Length Bodies,

and in addition translated into the Welsh language for the Welsh Assembly

Government. Distribution to be agreed with the departmental sponsor.

9.3 To make available an induction course on administration of the GDS for parties

of vocational dental practitioners, by arrangement.

9.4 To provide speakers and other contributors for appropriate events, whenever it

is reasonable, to further the interests of the General Dental Services and

Personal Dental Services.

9.5 19 in every 20 complaints received to be acknowledged in writing within 24

hours of receipt and all within 72 hours. A final response to be made, in writing,

within 14 days of receipt of the complaint or an explanation given for the delay.

In the absence of a full response an indication to be given of when a response can

be expected.

9.6 To distribute the Statement of Dental Remuneration to all GDS practitioners.

9.7 During the year to undertake a survey on customer satisfaction of Primary Care

Trusts, Local Health Boards, dentists and patients on a rotating three-year cycle.

To consider what action to take in response to the findings and to implement an

appropriate improvement programme.

9.8 To undertake to answer at least 90 in every hundred incoming calls, to its main

helpdesk, within 15 seconds. To monitor call-handling quality through regular

quality monitoring programmes, achieving a score of 75 per cent or higher.

9.9 To provide a quarterly magazine (Dental Profile) which will be distributed free to

GDS & PDS dentists. A monthly bulletin on the changes planned for dentistry

(Countdown) shall also be distributed free to GDS dentists. The cost of

distribution of Countdown shall lie with the Dental Practice Board but this may

be renegotiated at their instigation with the Department of Health and the Welsh

Assembly Government during the term of this Service Level Agreement.

9.10 To organise workshops, roadshows and events for dentists, PCTs, LHBs and

patients, in partnership with other organisations as appropriate.

9.11 To distribute copies of the Dental Practitioners Formulary on request.

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10 Financial Data

10.1 To provide valid and reliable information for in-year monitoring, periodic accounts

and public expenditure surveys.

10.2 To prepare on request such financial data and forward projections relating to the

DPB administration costs as the Department of Health and the Welsh Assembly

Government may require.

10.3 To prepare regular cash flow reports for GDS expenditure in terms of gross fees

authorised and payment transfers, including monthly reports on funding

requirements, to be submitted to the Department of Health and Welsh Assembly

Government by the 22nd day of the previous month and reports of payments made

to dentists by the 8th working day of the following month.

10.4 To submit year-end accounts for DPB administration and the GDS to the

Department of Health and the Welsh Assembly Government in accordance with the

format and timetable determined between the two.

10.5 To provide forecast out-turns as requested. To provide on request, or at least

quarterly, in-year reports of administration expenditure against agreed budget plans.

10.6* To provide "paying agency" services to the Dental Vocational Training Authority, the

Department of Health and the National Centre for Continuing Professional

Education of Dentists (NCCPED)

10.7* To provide management information as required by the Department of Health and

NCCPED and to manage cash funds received for their account: payments to be

made within 5 working days.

10.8 To assist with financial management aspects of delegation of Department of Health

(NCCPED) functions.

10.9 To provide "paying agency" services to the Department of Health and Welsh

Assembly Government for EDI grants to dentists.

*Consideration may need to be given to charging at cost for these items.

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11 Accountability

11.1 To stand prepared to provide an adequate and timely account of management of

the DPB in response to any request from the Department of Health, the Welsh

Assembly Government, the National Audit Office or any Parliamentary body.

11.2 As soon as is reasonably practicable after the end of the financial year, but no

later than 3 months, to prepare and submit a draft full stewardship manifesto and

business planning account for the Secretary of State for Health for England and

the Minister for Health and Social Services in the Welsh Assembly Government,

drawing attention to any matter of which the other parties should be aware, to

be considered at an Annual Accountability Review.

11.3 Papers for the Annual Accountability Review, which have been approved by the

Board, to be submitted to the sponsoring departments at least 4 weeks before

the agreed date of the Annual Accountability Review.

11.4 The final Report to be submitted to the Department of Health by 30 September

2005.

11.5 The Service Level Agreement to be formally discussed at the January 2005

quarterly meeting.

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12 Staff

12.1 To undertake a staff survey annually.

12.2 To consult staff on issues of concern identified by the staff satisfaction survey and

consider what action to take in response.

12.3 To adhere to equal opportunity policies in recruitment procedures and in the

development and management of staff.

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SECTION 3 - PROTOCOL

1 Fraud Definition

1.1 It is not possible to form an opinion as to whether fraud has occurred until such

time as apparent anomalies have been tested and investigated to consider what

independent evidence there is about the matters under issue.

1.2 Deciding when an individual piece of information, or a combination of different

pieces of information, raises a suspicion of fraud is a matter of judgement.

1.3 For example, a dental practice manager leaves a practice and immediately reports

and suggests details of why it is believed that a dentist may be committing a

particular fraud. If the facts of the dentist’s claims seem to support the

information given, then it may be reasonable to say that the allegation that has

been made should be considered as a potential fraud.

1.4 If, on the other hand, the claims submitted by the dentist do not indicate the

characteristics suggested as being part of the fraud then it may not be reasonable

to consider the matter as a potential fraud. It may be that the practice manager

has been sacked and is seeking to “make mischief”.

1.5 One or all of the following factors may be an indicator of fraud in their own right,

or in any combination:

a) anomalies within the types, frequencies or number of claims made under

the SDR

b) patient questionnaire replies indicate treatment that may be at variance

with what has been claimed

c) dental reference service examinations indicate treatment that may be at

variance with what has been claimed

d) patient questionnaire replies to point of service checks where evidence

indicates that the patient paid a fee although the FP17 or EDI information

indicates that exemption had been claimed

e) a higher than normal rate of patients who cannot be traced or who fail to

answer questions

f) concerns raised by omissions or anomalies within dental records

submitted to the DPB.

2 Responsibilities

2.1 The DPB has a responsibility to consider all the information available that may

give rise to a suspicion of fraud and will consider:

a) whether anomalies are isolated and infrequent, or many and frequent

b) the risk (previously) associated to particular types of claim under the SDR

c) whether patterns or amounts of claiming fall outside normal claim

patterns without known reason.

and to refer all cases giving rise to a suspicion of fraud to the DFT within 14 days.

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2.2 The DPB should not seek explanations from dentists about past claims other than

as part of a post payment-monitoring programme, which has been agreed in

accordance with this SLA.

2.3 When the information has been received as a result of these enquiries the DPB

may conclude that:

a) there is no reason to suspect there is any remaining fraud, error or

clinical issue - the DPB to take no further action, or

b) there are only clinical issues involved. DPB to instigate appropriate action

under disciplinary or other procedures.

2.4 All formal referrals to the DFT to be by letter and authorised by the DPB's head

of information and probity. The letter to set out the matter(s) of concern, giving

notice of the dental profile and analytical data to follow. The information to be

provided within 14 days of the referral letter.

2.5 Referrals to health bodies, relating to the contractors under enquiry, will be

copied to the DFT at the same time as the referral. The DPB to provide advice

on consequences for patient detriment or loss of public funds and to keep this

scope under review.

2.6 Allow the DFT direct access to files in relation to activities carried out on

contractors in question.

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3 The Dental Case Profile

3.1 The dental case profile will contain the following information:

a) full contractor personal information, such as full names, date of birth,

country of qualifications and GDC number and registered home address

b) all contractual information relating to the contractor/s in question (both live

and terminated contracts) – i.e. contract numbers, practice addresses and

contact telephone numbers

c) details of primary concern(s) giving rise to the referral to the DFT, including

all linked contractors

d) summary of all alerts received in respect of the dentist in question (from

whatever source) and of the probity enquiry history and a list of documents

retained in the probity file

e) summary of dental reference history reports including numbers of patients

selected and results where examinations were achieved

f) summary of previous referral to HA/PCTs/LHBs, GDC or police and

outcomes, where known, and including any recorded periods of suspension

or erasure

g) associates, partners, assistants' details as above, where applicable.

3.2 Additional information to be provided on request and to a timetable agreed on a

case by case between the DFT manager and the DPB:

a) copies of enquiry evidence obtained from checks (patient record cards,

questionnaires, DRO reports that form part of the case referred)

b) copies of required documents from the probity file

c) subject to availability, the names and addresses of patients selected for DRO

examination where appointments were not kept by patients

d) relevant claims data from April 1998

e) copies of the contractor's annual prescribing profiles

f) copies of monthly payment schedules

g) fee assignment details, such as bank account details (including number and

sort code) and copies of all signed agreements held on file at the DPB for all

linked and related contractors, as appropriate

h) details of all earnings for all contracts relating to the practices concerned for

all linked dentists for a five-year period, where applicable

i) name/s of software used by contractors transmitting claims by EDI and

names of suppliers if known

j) list of all contracting health body details (addresses and telephone numbers)

for all contracts concerned

k) archived dental reference officer reports including contemporaneous notes

for adverse-coded results, where available.

3.3 Information to be provided on a case by case basis:

a) where agreed between DFT and DPB, the DPB to arrange an immediate

hold on destruction of all claims forms (paper, scanned/ imaged or EDI).

DPB to provide original documents as requested.

b) a list of patient registration details (both live and lapsed registrations).

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SECTION 4 - SIGNATURES

Signed: .................................................................

Date: .................................................................

for the Department of Health for England

Signed: .................................................................

Date: .................................................................

for the Welsh Assembly Government

Signed: .................................................................

Date: .................................................................

for the Dental Practice Board

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Further information & contact points

Annual Report and Accounts

Head of Finance and Operations 01323 433463

Dental Profile magazine

Public Relations 01323 433395

NHS General Dental Services and

Dental Reference Service

Helpdesk 01323 433550

open Monday to Friday 8.00 am – 6.00 pm

Email: helpdesk@dpb.nhs.uk

Dental Payments

Helpdesk 01323 433553

open Monday to Friday 8.00 am – 6.00 pm

Email: dentalpayments@dpb.nhs.uk

Declaration of interest register

Head of Finance and Operations 01323 433463

Facsimile number

Helpdesk for NHS General Dental Services 01323 433222

Other enquiries 01323 433517

DPB website

www.dpb.nhs.uk

Email: webmaster@dpb.nhs.uk

Welsh language

A copy of this report is available in Welsh

Mae copïau o’r adolygiad hwn ar gael yn Saesneg

Publications

DPB Helpdesk 01323 433550

GDS statistical data

Data Services Branch 01323 433218

Dental Practice Board

Compton Place Road

EASTBOURNE

East Sussex

BN20 8AD

DPB Research Unit

External Projects department 01323 433512

Complaints about the services provided by

the Dental Practice Board

DPB Helpdesk 01323 433550

Email: complaints@dpb.nhs.uk


Dental Practice Board Eastbourne BN20 8AD

Telephone 01323 433550 Fax 01323 433517

www.dpb.nhs.uk

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