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Flexible commissioning offers new framework with same old problems

NHS England's new framework on flexible commissioning has worthy aspirations to make the NHS more attractive to dentists and improve patient care, but a failed, underfunded contract will act as a brake on progress.

NHS England's new framework.

Officials implicitly acknowledge the barriers many practices could face making the most of these opportunities given rock bottom UDA-rates. While a minimum value was set in in 2022, the supporting documents stress "commissioners have an opportunity to go further to provide support to contractors that have lower indicative UDA values where this will deliver improved service provision."

Progress will therefore hinge on the largesse of commissioners, where core functions completed their transition to Integrated Care Boards (ICBs) as of 1 April 2023. So, we are reaching to out every ICB to engage meaningfully with their Local Dental Committees on the challenges ahead. Given the depth of gaps in areas like urgent and domiciliary provision it is hard to see how real progress can be secured without real investment.

Those conversations may offer some scope for needed progress. However flexible commissioning is clearly no substitute for fundamental reform to a broken system.

We are compiling a record of local commissioning schemes, which we will share with members in due course. We recommend that members have written contracts in relation to their participation in any local scheme and our advice team can provide guidance.