NHS budget ‘shake up’ to improve dentistry


A big shake-up in the way the NHS dentistry budget is spent will deliver 'higher quality services and better health outcomes', officials have pledged.
The pledge came ahead of a major overhaul – beginning in April – of the way services are commissioned, with the abolition of primary care trusts (PCTs).
The job will be handed to a new NHS Commissioning Board (NHSCB), which will assume responsibility for all dentistry, including out of hours and urgent care.
High street practices, community dental services, plus dental services at general hospitals and dental hospitals, will all fall under the new body’s wing.
The board is expected to commission services based on a local 'needs assessment' carried out by public health teams, based in local authorities.
Ministers say all councils have received extra cash for their new public health role – despite protests that some wealthier areas have gained at the expense of poorer ones.
The NHSCB has tried to counter accusations of over-centralisation by setting up 27 ‘area teams’, but will still be 'one single organisation with one board'.
It said the teams would 'ensure close contact with patients, the public and key commissioning partners, as well as local contractors and providers'.
To add to the complexity, there will also be 23 new ‘commissioning support units’ around the country (CSUs), charged with contract negotiation and monitoring.
And local dental networks (LDNs) will be set up to bring together commissioners and clinicians at a local level and to 'promote innovation and best practice'.
The new set-up is also intended to deliver more consistent – and fairer – contracts, developed in close co-operation with the British Dental Association (BDA) and others.
Lastly, a working group will be set up to develop a framework for commissioning services from dental schools.
In a guide, the NHSCB described the overhaul as offering 'a unique opportunity to share excellence across England'.
It reads: 'The benefit of the NHSCB becoming a single commissioner for all dental services will be the ability to plan for and deliver more consistent standards, higher quality services and better health outcomes.
'A more consistent approach to commissioning and contract management will be implemented in order to deliver these improvements.
'In addition, by having the oversight and responsibility for commissioning all dental services for the population, the NHSCB will be able to ensure greater coordination between the different areas of dental care.'
During the bitter row over the Health and Social Care Act – and accusations of backdoor privatisation of the NHS – there were criticisms of the commissioning arrangements.
The Tory-led health select committee suggested the 211 new GP-led ‘clinical commissioning groups’ (CCGs) should be responsible, to provide greater local knowledge.
But the BDA supported national commissioning, arguing that PCTs had 'not been a huge success' because of an 'erratic approach'.
By parliamentary correspondent Rob Merrick

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