The British Dental Association has stated its hope that interim changes to the discredited NHS dental contract will offer a boost for patients and practitioners but stressed this is not the wholesale change required to save the struggling service.
The changes to the 2006 contract include a new time-limited ‘care pathway’ for higher needs patients, that is set to provide fairer pay for more clinically complex cases, that are typically under-remunerated or even delivered at a loss under this contract. The proposals act on BDA calls for dentists to be paid for activity that helps prevent oral disease and decay. They also introduce new payments to support clinical audits and peer reviews at practice level to help improve quality, and mandate practices to provide a level of urgent care, at an improved rate.
The professional body stresses a decisive break from this target-based contract remains key, and these changes do not constitute a final destination for NHS dentistry in England. Ministers have promised to deliver fundamental contractual change within this Parliament.
News comes as the new Adult Oral Health Survey revealed decay rates among adults have surged to levels not seen since the 1990s, with decades of oral health gains wiped out. More than four in 10 people (41%) had obvious signs of rotten teeth when examined, up from 28% in 2009 and similar to levels in 1998 - tracking the cumulative impact of austerity and the failed dental contract which was imposed in 2006. The BDA says the nation’s oral health gap will only widen unless the government offers urgency and ambition.
This package has no new money behind it. The BDA has stressed that the success of longer-term reform will hinge on adequate investment both to ensure the financial sustainability of dental practices and restore care to millions. The dental budget has remained effectively static in cash terms since the onset of the Coalition Government, with savage real terms cuts leaving the typical practice delivering routine NHS treatments like checkups or dentures at a financial loss. BDA analysis of the Government’s GP Survey by Ipsos suggests that unmet need for NHS dentistry in England currently stands at nearly 14m, or well over 1 in 4 of the adult population.
Shiv Pabary, Chair of the British Dental Association’s General Dental Practice Committee, said:
“These are the biggest tweaks this failed contract has seen in its history.
“We do hope changes can make things easier for practices and patients in the interim, but this cannot be the end of road.
“We need a response proportionate to the challenges we face, to give NHS dentistry a sustainable future.”
ENDS