BDA Information Request Highlights Problems With Target-Driven Contract, UK

Main Category: Dentistry
Article Date: 16 Nov 2007 - 1:00 PDT

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Data obtained by a freedom of information request by the British Dental Association (BDA) reinforces concerns about the new dental contract. The figures show that almost half (47.6 per cent) of dentists in England and Wales failed to achieve 96 per cent of their units of dental activity (UDA) target, the proportion required to avoid clawback of contractual payments, in the first year of the contract. Almost a third of dentists (32.7 per cent) were not even able to complete 90 per cent of their target.

Susie Sanderson, Chair of the BDA's Executive Board, said:
"These figures highlight the significant number of dentists across England and Wales who were unable to achieve the UDA target they were set. Dentists in such a situation could be subject to financial clawback by primary care trusts, yet many targets set were unfair.

"When dealing with such situations, it's important that primary care trusts take a constructive, sympathetic approach. We know from our own research that many primary care trusts have shown understanding when examining end-of-year issues."

The variability of primary care trusts' approach to underachievement is illustrated by BDA research carried out earlier this year. That study found that, of the practices that had not achieved 96 per cent of their target in the first year of the new contract, almost 40 per cent were facing their primary care trust clawing back money paid to them. Almost 25 per cent of respondents said their PCT had agreed to take no action. Just over 35 per cent, meanwhile, said that their PCT had insisted that the uncompleted UDAs be performed in the 2007-08 contract year.

Susie Sanderson continued:
"To make sure that local communities receive the dental care they need, we would urge primary care trusts to work with dentists and follow the Department of Health's own advice and consider more flexible ways of monitoring contract performance. The BDA has long advocated the removal of UDAs as the sole indicator of dentists' performance and argued for indicators that recognise, for example, numbers and type of patients seen, time spent with patients and the provision of additional services."

Notes:

1. The data obtained by the BDA is based on information on 8,507 contracts. Three-hundred and sixteen contracts were excluded from analysis because they represented either expanding practices who delivered more than 150 per cent of their target or contracts where no target was commissioned but UDAs were delivered anyway (typically prison contracts, out-of-hours services, etc). The figures in this release are based on analysis of the remaining 8,191 contracts.

2. 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.

British Dental Association

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