We hope that interim changes to the discredited NHS dental contract will offer a boost for patients and practitioners but this is not the wholesale change required to save the struggling NHS dental service.
We have been working hard to influence this package for some years and will continue to demand clarity over several important areas of ambiguity. We are already seeking answers on key questions and will be offering a free webinar to outline the changes and take your questions on Thursday 15 January.
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, which are typically under-remunerated or even delivered at a loss under this contract. The proposals act on our 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 mandates practices to provide a level of urgent care, at an improved rate.
But as we all know a decisive break from Units of Dental Activity 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.
We need a response proportionate to the challenges we face. The new Adult Oral Health Survey reveals 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 nation’s oral health gap will only widen unless the government offers urgency and ambition.
And this package has no new money behind it. We have 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.
“These are the biggest tweaks this failed contract has seen in its history” says General Dental Practice Committee Chair Shiv Pabary.
“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.”
