Concessions to be made on contracts

The government is to make concessions to dentists’ leaders over the details of controversial access contracts.

The Department of Health will shortly announce changes to the draft contracts developed by the dental access team led by Dr Mike Warburton, and released by some PCTs to the general profession.

It follows calls by the British Dental Association (BDA) for its members not to sign the contracts over concerns that their contents are too restrictive and controlling.

The DoH wants to put about 150 contracts out to tender aimed at tackling access and inequality problems across the country.

Susie Sanderson, chairwoman of the BDA’s executive board, said it was concerned that under the draft plans, which were modelled on medicine rather than dentistry, the contracts would ‘revert back to the PCT after five years’ by default.

Usually, contracts are brought to an end only with the agreement of the dentist or where there has been a breach.

Dr Sanderson said: ‘To have a contract where you have to give it all up after five years doesn’t fit with the dentist’s business model, which includes having to fund all the expenses.’

There were also concerns about the way the contracts blended Units of Dental Activity and Key Performance Indicators, which the BDA feared were based on targets including ‘the throughput of bodies’ rather than ‘genuine measures of quality’.

Dr Sanderson said there were concerns that the recommendations of the Steele Report, which had been well received by the profession, would be lost in the focus on the new access contracts.

She said: ‘We must make sure we do as [Professor Jimmy] Steele suggested – take 18 months or a couple of years to pilot his proposals, and make sure they work. This is not something you can deliver overnight.’

Liberal Democrat health spokesman Norman Lamb, speaking during a Parliamentary debate on NHS dentistry, said of the dental access programme: ‘It appears that the Department of Health is up to its old tricks again of not collaborating and of imposing an approach against the wishes of the profession.’

However, the final access contracts will be amended from the drafts, including changes to the five-year clause.

It is understood the DoH has made some changes to the terms of the contracts after listening to the BDA’s concerns.

The DoH believes primary care trusts are keen to start tendering for services.

The implementation of the Steele report will be discussed with dentists’ leaders in the next few weeks and the DoH will stress the access contracts are not an attempt to supersede it.


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