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Contract reform - the case for change

The current programme of contract reform was initiated to design a system to replace the much-criticised 2006 general dental services contract in England. Even before its implementatio​n, the BDA campaigned against the 2006 contract which is based on levels of activity (measured by units of activity or UDA) and with a banded patient charge system.

When the contract reform process was announced in 2011, the Chair of GDPC posed the following question:

"How can a system improve oral health, deliver prevention, provide continuing care and advanced treatment, whilst paying dentists adequately, fairly, and provide an environment where all this can be achieved with minimal perverse incentives from any direction to enable the patient, the government and the profession to have confidence for the future?"

The GDPC continues to monitor the contract reform process and uses these central tenets in its approach.

The GDPC has long been clear that the following principles are important for a contract reform process.

What's important for the profession?What's important for patients?
  • Improved patient outcomes

  • Fair remuneration

  • Job security

  • Current benefits are preserved

  • Ability to transfer contracts (goodwill)

  • Financial stability in transition stage

  • Access to quality care

  • Access to urgent care

  • Improved oral health outcomes

  • Good experience

  • Clarity of what the NHS will provide

  • Simple charging system

The current contract reform elements of capitation and activity alongside quality and outcomes drew upon the work of Professor Jimmy Steele in his 2009 report.