Dental access contract unsuitable, says GDPC

The ‘unnecessarily complex’ contracts for dental access funding make them risky and inappropriate for dental practice, the BDA’s General Dental Practice Committee (GDPC) has said today.

The final version of the ‘PDS+’ agreement has been amended by the DH following widespread criticism after an early release in September.

The contract – developed for the current round of dental access procurement – is published today and runs to nearly 50 pages and 17 schedules.

Chief dental officer Barry Cockcroft last week admitted to Dentistry that the ‘BDA will still have reservations’ about certain aspects, but saw no reason why PCTs cannot begin rolling out the template agreement from next week.

He also maintained that ‘this piece of work [Mike Warburton’s dental access programme] was going on beforehand and is NOT a replacement for Jimmy Steele’s review pilots’.

John Milne, chair of GDPC, said: ‘Although it must be an individual business decision, we advise dentists to think very carefully and seek advice before taking on one of these contracts as the dangers of breach are rife, and the consequences of breach may be very damaging to practices.’

‘The GDPC, advised by specialist lawyers, has spent more than four months explaining in detail to the DH why its proposed contract was unsuitable, one-sided and unsafe for practitioners.

The first version, based upon a medical model, was wholly unacceptable and we advised members not to sign it.  While DH has made some significant changes, we still do not feel that the contract is acceptable.’

Their main reasons include:
• The requirements are one-sided, leaving all the risk of a complex and untried payment mechanism with the dentist
• Fundamental new provisions such as the payment mechanism; the need to comply with new key performance indicators; and the ‘dental care assessment’ of patients should have been developed and piloted in conjunction with the wider profession through the implementation of the Steele review.
• The contract is over-specified and a large majority of the controlling provisions remain, leading to intrusive micromanagement. Practices will need to devote considerable resources to managing the contract and ensuring that the requirements are met.  For most practices, this will require a dedicated contract manager and for the contract value to reflect the risks and extra work required.

Members are advised to take specialist advice if considering bidding for access contracts.

The contract, which DH says is not actually mandatory for PCTs to adopt, is on the BDA’s website at www.bda.org.  BDA guidance notes will be available tomorrow.

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