NHS dentistry pilots ‘need time’ to succeed

Proposals that will help improve outcomes for dental patients were published by the Department of Health today.

The plans mark the first step towards a significant NHS White Paper commitment to introduce a new dental contract that will improve the quality of patient care and increase access to NHS dental services, with an additional focus on improving the oral health of schoolchildren.

The new contract will be based around capitation, registration and quality.

Basing it on capitation means that, for the first time, dentists will be rewarded for the quality of care they deliver for patients rather than the number of treatments carried out.

The new focus on quality – and guidelines on how to deliver it – is intended to support dentists in improving the oral health of their patients, while the focus on registration will give patients the security of continuing care.

Three different models will be piloted in around 50-60 areas across England starting in April next year.

Each model will be slightly different in order to provide information and evidence on various aspects of the proposals; this will help better inform the development of a new national contract.

Health Minister Lord Howe said: ‘As set out in the NHS White Paper, we are committed to delivering a new contract for NHS dentistry.

‘We want to give dentists the freedom to deliver high quality care and reward them for the outcomes they achieve for their patients, not just for the volume of treatment delivered, as is the case now.

‘This is about prioritising prevention. People need a dental service that helps them maintain good oral health and prevents decay, rather than one that is based solely on treatment.

‘It is important that we get this absolutely right so that our reforms will give dentists the encouragement they need to provide a service that meets the needs of today’s population.’

Professor Jimmy Steele, who headed up the independent review of NHS dentistry and who was a member of the National Steering Group that developed the proposals, said: ‘The development of a new NHS dental contract built around capitation, registration and quality marks an enormous step forward for NHS dentistry.

‘The complexities of redesigning and delivering a new dental contract should never be underestimated and we need to use the learning from the pilots, but there is now the real prospect for an NHS dental service which is good for patients, fair to dentists and aligned to oral health.’

The British Dental Association has welcomed the announcement that the government is exploring ways of moving away from the target-driven basis of the current dental contract and instead focusing on prevention and quality of care.

Dr John Milne, chair of the BDA’s General Dental Practice Committee, said: ‘Today’s announcement is an important, positive step towards the goal of improving NHS dental care for patients across England.

‘The current arrangements, which were implemented in 2006, have failed to promote preventive care for patients and have been deeply unpopular with dentists.

‘The BDA has campaigned hard for a re-think and we are encouraged that the Department of Health is to begin testing new ways of delivering care. We are pleased that two principles that we believe are particularly important – quality of care and a continuing care relationship between practitioner and patient – are central to what is being piloted.

‘Getting the detail of these changes right will be crucial to their success. These pilots must be afforded sufficient time for their impact on oral health to be properly understood and the results from them must be fully evaluated. It will also be crucial that input from the profession is taken into account and that meaningful engagement continues as the pilots crystallise into permanent changes.’


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