Failing New Dental Contract Needs To Be Overhauled, Says British Dental Association

Main Category: Dentistry
Article Date: 08 Apr 2007 - 0:00 PDT

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The British Dental Association (BDA) demands an urgent response by government to the overwhelming consensus that its NHS dentistry reforms are failing.

In a letter to Chief Dental Officer of England Barry Cockcroft, Chair of the BDA's General Dental Practice Committee Lester Ellman cites the weight of evidence against the new contract generated by last week's BDA conference to mark the first anniversary of the reforms.

"The strength of this evidence means I must now write to you to urge you to reconsider the current dental contract. Our concerns go beyond the significant transitional difficulties experienced over the past year and we can now demonstrate that the new system is in need of fundamental reform," writes Dr Ellman.

Dr Ellman, who is due to meet the CDO next week, identifies three key demands:

1. Remove the Units of Dental Activity - the currency of the new contract - as the only way of measuring performance.

2. Pay Primary Care Trusts directly the whole of their commissioning budget, to avoid uncertainties in patient charge revenue collection.

3. Allow long term business stability by permitting dentists to transfer their NHS contracts to new owners, thus maintaining the goodwill value of practices.

Dr Ellman also calls for the government to re-examine with the BDA the findings from the Personal Dental Services pilots, an alternative model for general dental practice trialled over a seven year period before the introduction of the current system.

"Having conducted these pilots, the government has a responsibility to evaluate them properly to see if there is a way of using this experience to establish a system that will work in the long term interests of patients, practitioners and tax-payers."

1. The British Dental Association (BDA) is the professional association for dentists in the UK. It represents over 20,000 dentists working in general practice, in community and hospital settings, in academia and research, and in the armed forces.

2. The BDA's Dentistry: the way forward conference was held at the BDA's London headquarters on Wednesday, 28 March.

3. The BDA research was carried out in February and March 2007 and is based on a 41% response rate to a survey of 1,500 dentists in England and Wales. Early research findings show that 85% of dentists believe that the new contract has not improved access to NHS dentistry for patients, 97 % think the new contract has not removed dentists from the 'treadmill and 93% feel that the new system does not encourage a more preventive approach to care. Ninety-five per cent of those surveyed said that they were now less confident about the future of NHS dentistry than was the case two years ago.

4. Personal Dental Services pilots were introduced by the National Health Services (Primary Care) Act 1997. Fifteen pilots began in October 1998; a further 24 followed in October 1999. A third wave began in 2000. PDS pilots were established to trial new ways of delivering NHS dental care. Features of these pilots included an introduction of growth funding to allow dental practices to provide care to additional patients. Some PDS pilots trialled 'drop-in' centres to address local access problems. It also promoted preventive care. Key elements of what became the new dental contract in April 2006, including the target-driven system UDAs and the banded system of patient charges, were not trialled by the PDS pilots. PDS proved popular with dentists and around one-third out of 8000 practices in England had applied to become PDS schemes.

http://www.bda.org

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