Return to PDS on the cards?

The British Dental Association and pressure group Challenge have both stepped up their demands for an overhaul of the government’s NHS dentistry reforms.

As previously reported, calls for Units of Dental Activity (UDAs) to be scrapped were made at a major conference organised by the BDA last week to mark the first anniversary of the new contract.

Now Lester Ellman, chair of the BDA’s General Dental Practice Committee, has written to England’s chief dental officer Barry Cockcroft, citing the weight of evidence against the reforms.

‘The strength of this evidence means I must now write to you to urge you to reconsider the current dental contract. Our concerns go beyond the significant transitional difficulties experienced over the past year and we can now demonstrate that the new system is in need of fundamental reform,’ writes Dr Ellman.

Dr Ellman, who is due to meet the CDO next week, identifies three key demands:

1. Remove the Units of Dental Activity – the currency of the new contract – as the only way of measuring performance.

2. Pay Primary Care Trusts directly the whole of their commissioning budget, to avoid uncertainties in patient charge revenue collection.

3. Allow long-term business stability by permitting dentists to transfer their NHS contracts to new owners, thus maintaining the goodwill value of practices.

Dr Ellman also calls for the government to re-examine with the BDA the findings from the Personal Dental Services (PDS) pilots, an alternative model for general dental practice trialled over a seven-year period before the introduction of the current system.

‘Having conducted these pilots, the government has a responsibility to evaluate them properly to see if there is a way of using this experience to establish a system that will work in the long-term interests of patients, practitioners and tax-payers,’ he adds.

John Renshaw, a founder member of Challenge, proposed during last week’s debate that all parties should revisit the earlier Personal Dental Services (PDS) pilot studies to see if the problems encountered in them could be remedied.

With that call now being echoed by the BDA, a Challenge statement released today read: ‘It is gratifying to see Challenge’s ideas being so enthusiastically adopted by our trade union representatives.

‘PDS was popular with almost all of the dentists who took part in it and patients appeared to be satisfied with the care they received, access certainly improved. The problem that caused the greatest trouble to the Department of Health was dwindling patients’ charge revenue (PCR). This led to the pilots being abandoned prematurely. If the problem of PCR could be managed better, it is possible that the earlier PDS model could be used again.’

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