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Scottish Government must heed dentists’ concerns when developing a “new model of care” for dentistry

18 September 2019

BDA Scotland says the Scottish Government must consider dentists’ concerns when developing their new ‘model of care’ for dentistry, which is the next major phase of the Oral Health Improvement Plan

The plans include the introduction of an Oral Health Risk Assessment (OHRA) and a review of the Statement of Dental Remuneration (SDR) and BDA Scotland believes the proposed new arrangements will have major implications for dentists in Scotland. 

BDA Scotland representatives recently attended a Scottish Government event to discuss initial proposals for a new system and raise dentists’ concerns. In 2018, we called on the Scottish Government to ensure that any new OHIP initiatives were accompanied by appropriate new investment. 

The new arrangements will involve a patient-centred approach with the focus on prevention. The Scottish Government plans to use an “early adopters” model, to start in winter 2020/21, and the test phase will run for two OHRA cycles (four years in total) – so, it will be a gradual roll-out.

The proposals will be taken forward by several “design groups” - David McColl, Chair of Scottish Dental Practice Committee (SDPC), has joined the OHRA group, and Josephine Weir (SDPC) will join the group which will review the SDR. Scottish Government will run roadshows next spring to engage the wider profession and gather expressions of interest from practices who may want to be early adopters. 

David McColl, Chair of the Scottish Dental Practice Committee, said: 

"These new arrangements potentially represent a huge change for the profession in Scotland, and how NHS dentistry is delivered. While we welcome the new focus on prevention and the involvement of patients, the Scottish Government needs to recognise that any new system must be adequately funded. This means new money – not just a reallocation of the existing dentistry budget.” 

In a recent BDA Scotland survey of dentists:

  • Over 90 per cent of respondents had concerns that the Scottish Government will use the NHS dentistry budget to fund aspects of the OHIP
  • Three-quarters of respondents had concerns about the proposed introduction of an OHRA. There was some recognition of the benefits of an OHRA, but major concerns about whether sufficient additional funding would be available that reflect the time taken to carry out an assessment.
Respondents also cautioned against reducing the provision of dental treatment as a possible means of funding the new model:

  • Over 80 per cent had concerns about the possible introduction of a 24-month recall interval for dental checks. While there was some support among dentists for checks every 24 months for low-risk patients, most respondents favoured a shorter recall interval. Dentists emphasised the risk of oral cancer, and that oral health can change rapidly, therefore more frequent checks are essential.
  • Over three quarters had concerns about the proposed reduction in scale and polish treatments. While there were mixed views about the evidence of the clinical effectiveness of scale and polish treatments, most dentists were in favour of providing regular treatments as it helps to encourage good oral hygiene. There were also some concerns about the effect of reducing scale and polish treatments on dental practices’ finances. 
BDA Scotland will continue to press the Scottish Government to ensure it takes full account of dentists’ views and concerns as the proposals are developed.

The SDPC is convening a working group to build on its previous work on developing an OHRA and reviewing the SDR to ensure BDA members are represented in the discussions and on the new arrangements going forward.

BDA Scotland

BDA Scotland supports, represents and promotes, the interests of all dentists working in Scotland. Working with elected committee members, we negotiate on behalf of the profession on terms and conditions, and pay and contracts. Join us.