Year-old NHS pilots welcomed as ‘positive step’

A cautious consensus of positivity surrounds the NHS dental pilots – one year on.
 
This was the general view as key players in UK dentistry met yesterday (Thursday) at the Westminster Health Forum Keynote Seminar to discuss ‘Dentistry 2012 – quality, access and regulation’.
 
Drawn from all interested stakeholders, speakers addressed the topics of regulation, the NHS dental pilots and the impact of the OFT report, included the BDA’s John Milne, chief dental officer Barry Cockcroft, chief executive of the Care Quality Commission, Cynthia Bower, Tony Donaldson, director of the Office of Fair Trading, and Safeer Butt, a dentist participating in the NHS pilot scheme.
 
John Milne, chair of the BDA’s General Dental Practice Committee opened proceedings and referred to a profession with low morale, but who viewed the pilots ‘in a positive light’.
 
He told the forum: ‘The growing consensus is that the contract should produce better outcomes for patients’ but he suggested that allowances should be made made for the inevitability of advanced care and questioned whether the government will fund this expanded scope.
 
A payment structure that works for practices and is fair is, he suggested, a massive challenge.
 
Safeer Butt, of S3 Dental in Eltham, London, revealed he had ‘mixed feelings’ over his experience of the pilots.
 
Safeer runs three practices with NHS contracts in excess of £1.5million and has two practices participating within the pilot scheme as a type 1 and modified type 2 practices.
 
He listed the challenges so far, including software issues and assessments that take so long, it was ‘no surprise the patient waiting list had increased’.
 
He revealed that, although his patients welcomed the extended appointment time and oral health education, to catch up with appointment he either needed to recruit or expect his team to take a pay cut and work harder.
 
He said: ‘Within a fixed-cost system, someone needs to take a pay cut. As it stands, that will need to be the performers. We have been penalised for not seeing enough patients.’
 
He concluded that ‘the contract will work but it needs more money in the system for this transition phase’.
 
Justin Ash, chief executive of dental corporate Oasis Dental Care and Eddie Coyle, head of clinical services and commissioning at Oasis, suggested that ICMs were having a massive impact in ‘clogging up the system’ but that oral health was improving.
 
Eddie explained that although, examinations and restoratives were down, preventive measures had increased by 50%.
 
Justin said: ‘Clinicians are positive overall of this direction of travel’ and that it had the potential to be superior to the current system.
 
He suggested it would now need investment at roll out of both money and clear communication and that there was a ‘tremendous opportunity to use therapists in this model.
 
He said: ‘Now is the time for hygienists to train up to become therapists.’
 
He added: ‘There is a chance here to have a world-class system – but it needs careful planning to turn potential into reality.’
 
Acknowledging the hiccups mentioned within the pilots – ‘clunky software’ and the impact of waiting times, CDO Barry Cockcroft told the forum that the ‘profession should be proud but not complacent’ and that the pilots were there to help identify problems and were ‘designed to learn’.
 
He concluded: ‘We must not move on until we have identitfied and dealt with these issues.’
 
Other speakers included Eric Rooney, consultant in Dental Public Health for NHS Central Lancashire, Dr Martin Fallowfield, new chair of the BDA’s principal executive committee, Nick Patsias, vice chair of the Federation of London Local Dental Committees, David Corless‐Smith, director of the Dental Law Partnership and the British Dental Health Foundation’s chief executive, Nigel Carter.

Also speaking was Evlynne Gilvarry, chief executive and registrar at the GDC and Cynthia Bower, chief executive of the CQC.
 
The proceedings were chaired by Lord Colwyn, vice chair of the All‐Party Parliamentary Group for Dentistry, and fellow member Baroness Gardner of Parkes.

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