It is now six months since health minister, Lord Howe, speaking at the BDA Conference outlined a timetable for reform.
This summer there would be a consultation, followed in the autumn by proposals for new ‘prototype’ pilots.
Volunteer practices would start these in 2015/16, modified in the light of experience, before others were added over the years.
Change, the minister insisted, would be ‘evolutionary not revolutionary’.
During September, the Department of Health briefed the existing pilots on progress and the results of the summer’s consultation.
The timetable shows signs of slipping, with the first of the new pilot contracts not being in place until 2016.
This summer’s consultation yielded only 128 replies.
Emerging through this fog, however, certain likely changes are apparent:
- It will be a ‘reformed’ not a ‘new’ system; existing contracts will be kept, rather than all being put out to tender
- The ‘care pathway’ approach, with its emphasis on prevention, will form the basis of a reformed contract
- A dental quality and outcomes framework will form part of the remuneration package
- There will be a ‘blended’ remuneration package, balancing payments for access (capitation), activity and quality
- UDAs (units of dental activity) will go, although there will be some form of activity measure
- There will still be patients’ charges
- But, at present, it seems there will be little clarity on what is and what is not available under the NHS.
With any reformed contract unlikely to be in general use until 2020 or later, there is a need for the alternative dental contract, which the group of LDCs are proposing.
