Many dentists facing clawback

The British Dental Association claims that new data reinforces concerns about the new contract.

The figures, obtained by a freedom of information request by the BDA, show that almost half (47.6%) of dentists in England and Wales failed to achieve 96% of their units of dental activity (UDA) target, the proportion required to avoid clawback of contractual payments, in the first year of the contract. Almost a third of dentists (32.7%) were not even able to complete 90% of their target.

Susie Sanderson, chair of the BDA’s Executive Board, said: ‘These figures highlight the significant number of dentists across England and Wales who were unable to achieve the UDA target they were set. Dentists in such a situation could be subject to financial clawback by primary care trusts, yet many targets set were unfair.

‘When dealing with such situations, it’s important that primary care trusts take a constructive, sympathetic approach. We know from our own research that many primary care trusts have shown understanding when examining end-of-year issues.’

The variability of primary care trusts’ approach to underachievement is illustrated by BDA research carried out earlier this year. That study found that, of the practices that had not achieved 96% of their target in the first year of the new contract, almost 40% were facing their primary care trust clawing back money paid to them. Almost 25% of respondents said their PCT had agreed to take no action. Just over 35%, meanwhile, said that their PCT had insisted that the uncompleted UDAs be performed in the 2007-08 contract year.

Susie Sanderson added: ‘To make sure that local communities receive the dental care they need, we would urge primary care trusts to work with dentists and follow the Department of Health’s own advice and consider more flexible ways of monitoring contract performance.

‘The BDA has long advocated the removal of UDAs as the sole indicator of dentists’ performance and argued for indicators that recognise, for example, numbers and type of patients seen, time spent with patients and the provision of additional services.’

Quentin Skinner, chairman of DPAS, the private dental plan administrators, said: ‘For those who have under-delivered by four per cent, the contract allows this to be made up by 31 March 2008 at the latest.  Such dentists will have to do perhaps four per cent more work for no more money, as well as coping with this year’s UDA contract numbers. A far cry from Rosie Winterton’s suggestion of “the same money for five percent less work”.

‘For those dentists who fell rather shorter of the mark, the future certainly looks bleak. Inevitably, these dentists will have to agree to a mixture of increased workloads for less money, as their Year two revenue is reduced by Year one clawback, money already spent on last year’s running costs and drawings. What a nightmare.

‘For those dentists who fall significantly short, with no particular extenuating circumstances, in addition to short-term catch-ups and revenue depleted by clawback, many of these dentists will find that they have no option other than to agree with the PCT to accept a smaller commitment for numbers of UDAs, for Years two and three and beyond April 2009. Thus they are in a position where, willy nilly, their NHS earnings will be forced downwards in a one-way only direction.’

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