| Synopsis: |
In April 2006 the Department of Health reformed the General Dental Service. Primary Care Trusts (PCTs) were given the power to commission dental services, the patient charging system was simplified, and under the terms of a new dental contract dentists were remunerated according to the number of Units of Dental Activity (UDA) completed.The Department issued a number of criteria for success: patient experience; clinical quality; NHS commissioning; and, improving dentists' working lives."Dental Services (HC 289-1)" assesses how far they have been met. Various measures of access to dental services indicate that the situation is deteriorating.These include: the numbers of dentists working for the NHS and the number of courses of treatment provided has fallen slightly; the total number of patients seen by an NHS dentist between December 2005 and December 2007 has fallen by 900,000 compared with the two years up to March 2006; access is uneven across the country; the introduction of the new charging system has simplified the system for patients but problems remain; and, the new contract was meant to improve preventive care but dentists claim it fails to provide the time and the financial incentive to do so.These also include: the number of complex treatments - including laboratory work, root canal treatments - has fallen markedly whilst the number of tooth extractions has increased (The reason for the decline in the number of complex treatments has not been explained satisfactorily); PCT commissioning of dental services has been poor; and, the new remuneration system based on UDAs has proved extremely unpopular with dentists.It is extraordinary that the Department did not pilot or test the UDA payment system before it was introduced in 2006. The Committee makes a number of recommendations for improving dental services.The accompanying "Dental Services - Volume II: Written Evidence (HC 289-II)" (ISBN 9780215513434) is available to buy separately. |