NHS to reward U.K. dentists for quality, not quantity, of care

Dec 16, 2010

The U.K. Department of Health is working to develop a new dental contract that will improve the quality of patient care and increase access to National Health Service (NHS) dental services, with an additional focus on improving the oral health of schoolchildren.

The new contract will be based around capitation, registration, and quality, according to the agency. This means that, for the first time, U.K. dentists will be rewarded for the quality of care they deliver for patients rather than the number of treatments carried out.

The new focus on quality -- and guidelines on how to deliver it -- is intended to support dentists in improving the oral health of their patients, while the focus on registration will give patients the security of continuing care.

Three different models will be piloted in 50-60 areas across England starting in April 2011. Each model will be slightly different to provide information and evidence on various aspects of the proposals and better inform the development of a new national contract.

"We want to give dentists the freedom to deliver high-quality care and reward them for the outcomes they achieve for their patients, not just for the volume of treatment delivered, as is the case now," said Health Minister Lord Howe in a press release. "This is about prioritizing prevention. People need a dental service that helps them maintain good oral health and prevents decay, rather than one that is based solely on treatment."

"It is important that we get this absolutely right so that our reforms will give dentists the encouragement they need to provide a service that meets the needs of today's population," he said.

The development of a new NHS dental contract built around capitation, registration, and quality marks an enormous step forward for NHS dentistry, added Jimmy Steele, DDS, chair of oral health services research at the Newcastle University School of Dental Sciences and lead author on a 2009 report that scrutinized the NHS dental services and made several recommendations for improving them.

"The complexities of redesigning and delivering a new dental contract should never be underestimated, and we need to use the learning from the pilots, but there is now the real prospect for an NHS dental service which is good for patients, fair to dentists, and aligned to oral health," he said.

The British Dental Association (BDA) also expressed support for the new initiative.

"This announcement is an important, positive step toward the goal of improving NHS dental care for patients across England," said John Milne, chair of the BDA's General Dental Practice Committee. "The current arrangements, which were implemented in 2006, have failed to promote preventive care for patients and have been deeply unpopular with dentists. These pilots must be afforded sufficient time for their impact on oral health to be properly understood, and the results from them must be fully evaluated."