In 2011, we set up a shadow evaluation group to monitor the pilot sites' learnings.
The General Dental Practice Committee is clear that the following prinicples are important for a reformed contract:
|What's important for the profession?||What's important for patients?|
Improved patient outcomes
Current benefits are preserved
Ability to transfew contracts (goodwill)
Financial stability in transition stage.
What we like so far
Basic principles of preventative care are being given more prominence
Dentists and patients alike have shown that there is general approval for the RAG rating system (red, amber green)
Patient satisfaction appears to have increased. They feel more empowered and knowledgeable about improving and maintaining their oral health
There has been wide involvement of interested parites, not least the 90 pilot practices
Feedback appears to be being take on board, for example DQOF could be a possible tool to minimise neglect
Our concerns so far
We have identified the following issues which must be resolved:
Time and access pressures
In the first wave of the pilots appointment book problems became apparent. This was a combination of spending the required time with the patient on the oral health assessment and juggling the demands of the IT system. Patient-access times increased.
Practice viability and sustainability
As the issue of access becomes clear, the issue of clawback arises
The computer systems were reported to be inadequate but feedback has led to the system providers making changes.
Pilot sites have reported both positive and negative impact on their practice's skill mix. In some pilot sites associates have been identified as having uncertain futures. The model allows for an associate to be replaced with a DCP and we have concerns about dentists become de-skilled.
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