Marlborough's next NHS dentist will not be in the George Lane surgeryFurther inquiries by marlborough.news have revealed some clarifications of the issues surrounding the ending of the current NHS dental contract for Marlborough - the Kennet River Dental Practice.
Any new provider will not be based at the George Lane surgery. The building is owned by partners in the practice and the GPs need more space for their primary care services. One of the partners told marlborough.news: "We are looking to use the extra space for more consulting rooms as we employ more clinical staff."
The population of the area is growing - especially taking into account the Marleberg Grange development on Salisbury Road. In addition the practice now has to provide a wider range of primary care services, some of which - like Stop Smoking Clinics - have been passed down from Wiltshire Council's public health portfolio.
The dental contract which ends on 31 December 2018 is held by the medical practice. It began in 2008 - and has run for two five-year contract cycles. It now has to be put out to an open tender by NHS England - the branch of the NHS which commissions dentistry. (The Kennet & Avon Medical Partnership is commissioned by the Wiltshire Clinical Commissioning Group.)
Set against many such NHS dental service contracts, the contract the Kennet River Dental Practice holds is a small one. NHS England pays a flat rate for each Unit of Dental Activity - which may be a check-up or a filling.
It has been difficult to run the dental service on that funding level. They have difficulties finding staff - last year two dental nurses 'went on to pursue other opportunities'. The contract only allows them to employ one dentist, so it is impossible to cover holidays and sickness: "We have no flexibility in staffing for the service."
The Kennet and Avon Medical Partnership could obviously not afford to run the dental service without income for the months until a new service began. And about six months with no NHS dental contract for Marlborough could save NHS England about £100,000.
In theory then, a new NHS dental service for Marlborough could be up and running within five or six months from the day the contract finishes.
But a letter to marlborough.news from Debra Elliott - Director of Commissioning at NHS England South West (North) - states: "Should the successful bidder have existing dental premises the mobilisation time for the service will be smooth and the service will start as soon as possible."
"However if the successful bidder requires new premises this may introduce a delay so we need to develop our plans around this. With this in mind we have allowed extra time to mobilise the new contract."
"In order to ensure provision of dental care to the residents of Marlborough we are making arrangements for patients with an urgent need to be able to access the Dental Access centres in both Wiltshire and Swindon and for those patients requiring routine dental care we are talking with other dental practices in the area to provide an interim service until the new service is up an running."
Establishing a new dental facility from scratch is not a quick or cheap option. The building needs many special features such as lead linings for X-rays and it has to meet strict regulations.
Unlike the provision of GP services, dental provision does not cover a set area and a set patient list. Marlborough.news understands that a new contract could be based outside the Marlborough area - in Devizes or even Swindon.