Dental access remains top priority for PCTs

Significant challenges remain for the commissioning of dentistry in England despite the growing experience of commissioning staff and consensus on priorities.

That’s according to the 2010 British Dental Association (BDA) Local Commissioning Survey.

The survey was carried out two years ahead of the winding down of primary care trusts (PCTs) and the transfer of responsibility for dental commissioning passing to the national commissioning board in 2012.
Access to care remains the top priority for primary care trust (PCT) dental commissioning leads, according to the research which found that 89% of PCTs had it as one of their top three priorities.

This echoes the findings of research by the BDA in 2009. Next comes quality, which appeared in the top three concerns of just over a quarter (28.4%) of PCTs.

Oral health, orthodontics, prevention and performance management were all also cited as top three priorities by at least one-in-ten respondents.
The research sought insight into the experience of PCT dental commissioning staff commissioning and the level of support they enjoyed from strategic health authorities (SHAs), revisiting themes addressed by the 2009 research.

In 2009, just 29% of PCT respondents agreed they received contracting help or advice from their SHA.

This year’s survey found that 61% receive performance monitoring advice, 46% contracting advice and guidance and 18% receive support with their dental strategy.

Just over six in ten PCTs reported that they found the commissioning support they received helpful.
The growing experience of dental commissioning staff is noticeable.

Less than 10% of those surveyed had been in their role for under a year, according to the 2010 survey, while more than a quarter had served for such a short period in 2009.

But many of the commissioning leads, questioned this year, said they did not have an adequate workforce.

Almost three-quarters said they needed additional support, with 18% declaring they did not benefit from the expertise of a consultant in dental public health.
The research also identified significant under spending of dental budgets. Just under a fifth (16.4%) of PCTs said they had spent less than 95% of their ring-fenced dental budgets in 2009/10, although it is not clear whether the remaining funds were completely unspent or diverted to non-dental spending.
John Milne, chair of the BDA’s General Dental Practice Committee, said: ‘This research illustrates the challenges that persist with the commissioning of primary dental care and underlines some of the issues the national commissioning board will face when it assumes its duties.
‘It is clear that whoever is responsible for commissioning dental care must be properly supported and have access to appropriate expertise. The experience and knowledge of consultants in dental public health and dental practice advisers are particularly valuable in helping PCTs provide effective care to patients.

‘This study stresses the gradual accumulation of experience by PCTs. Arrangements for the handover of commissioning responsibility must seek to ensure that experience is not lost. 
‘Given that access to dental care remains the top priority for dental commissioners, it is very concerning that a significant number of PCTs did not spend all of the funding they were allocated for dentistry.’

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