New proposals have been published giving dentists the opportunity to pilot new ways of working and to improve patient care.They come from a steering group, led by the Chief Dental Officer, Dame Margaret Seward.
‘The NHS Dentistry: Options for Change’ draws on earlier Dentistry Modernisation Steering Group reports, and has also been influenced by a workshop held in June 2001 between the Department of Health and the British Dental Association, when the problems of the present system of NHS dentistry were examined, likely drivers for change considered and ideas discussed about possible future models of oral care.
Also influential was a recent Commons Health Select Committee investigation which found that the system of remuneration in the general dental services was a main factor for dissatisfaction amongst both professionals and patients.
Their key proposal on remuneration is that a menu of ways of paying dentists should be tested, including salary, capitation and simplified, modernised fee scale options. The possibility of a basic practice allowance may also be considered. The recommendation is to try out these models in demonstration sites and, if successful, roll them out across the service. It is thought unlikely one method will fit all circumstances.
Another important proposal is that the direct association between payments to dentists and the types of treatment offered to patients needs to be removed. Treatment should be offered which is clinically appropriate, according to agreed protocols.
The group also recommend replacing check-ups with an oral health assessment, which would focus on prevention of disease, lifestyle advice, the discussion of any necessary treatment options and date of the next assessment.
Also recommended is better use of Information and communication technology (ICT), a move to larger practices, using the skills of a range of staff including professionals complementary to dentistry, and development of ‘the dental team’, so that all of the professionals in the dental practice can contribute to improved patient care.