Change or decay? NHS dentistry’s choice

Most dentists believe that if only Governments put adequate funding into NHS dentistry, it could deliver a high quality comprehensive service for all.

But they won’t, so it can’t.

Last week a paper was published by the think tank Reform, which challenged this view that is prevalent across the NHS.

It was co-written by Professor Paul Corrigan and went by the snappy title of: Going with change: Allowing new models of healthcare to be provided for NHS patients.

Professor Corrigan was once an adviser to health ministers and the prime minister, Tony Blair, as was the new head of NHS England, Simon Stevens.

Although dentistry was not mentioned in the report, many of the ideas could well be applicable to our profession.

The report opens by saying that the NHS is in the grip of two crises, funding and quality.

Many would agree with this, that something must be done, but that change is ‘too difficult’.

This tinkering with services and putting off change, the authors say, is storing up trouble for the future.

The authors look at case studies from various industries, especially retail, which have been faced with the challenges of cost and quality.

They have changed their business models to produce more products for less money.

I believe dentistry can learn from this thinking.

Like general practitioners, we work largely in a fragmented ‘cottage-industry’ of small practices.

Like the small high-street grocer, butcher and fishmonger, it is an inefficient model and doomed to extinction.

The future of NHS dentistry lies in larger organisations that can provide integrated care across a wide range of services, with tasks being carried out by those best qualified to do them.

This may mean an expansion of corporates, but not necessarily.

The report mentions ‘alliance contracts’, where the commissioner contracts with an ‘alliance’ of practices to deliver services.

Such an approach will require more imaginative commissioning by NHS England and dentists prepared to work with local colleagues rather than in competition.

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