With the prospect of time-limited contracts hanging in the air for NHS contract holders, understandably the topic has been of much debate within the industry. Practice Plan brought together a group of opinion leaders and dentists to share their views.
Judith Husband kicked off the discussion: ‘I’ve lived with one for the last few years. There is no way you can invest in a practice when you have a contract that is three or five years long. With a three-year contract, 1.5 years in the practice suddenly feels destabilised. It is difficult on the staff and clinicians. I think emotionally, and in terms of practicalities of investment, they are very difficult to manage and live with.’
Eddie Couch: ‘Time-limited contracts will be introduced but I think when will depend on the devolution agenda. When the Local Dental Committee started having conversations with the Manchester devolution panel, the people on the panel initially suggested that they were probably going to look at dentistry on an annual basis. They had no idea what effect that would have. It’s a ridiculous situation.’
David Houston: ‘As an acquisitional practitioner, how could I go to my lender and say I need to borrow a sum of money over a 25-year payment period but actually I’ve got a piece of paper than says I’ve only got five years’ worth of income to pay that back?’
Andrew Lockhart-Mirams: ‘My take on it is that when time-limited contracts are brought in, the NHS won’t be able to change existing contracts. So let’s say if you have 20 contracts, the 21st may be time-limited. But a new, single-handed practitioner could never agree to a time-limited contract because they could never borrow against it or fund it. That’s my personal view.’
David: ‘The only way I could see that working is if you centralised services, as you would be less risk-exposed. You could accept a PDS-type contract tacked on to the side of what had already been paid for by your GDS-type contracts. Centralisation might actually suite the government because the so-called small practices would die a death.’
Eddie: ‘They’re basically saying if we can put competition into the dental marketplace, patients are going to benefit. But since they will have to pay the patient charge in my practice or someone else’s, I don’t see the patient benefit in that.’
Closing the debate, Judith said: ‘We also have to look at the capacity commissioners have to manage contracts. They are being expected to do more for less, so having one huge provider in one area has advantages – so they think!’
Do you agree that this is where the dental profession is heading? Why not have your voice heard by taking part in the latest NHS Confidence Monitor? The fourth NHS Confidence Monitor survey is now live, offering all dental professionals – whether in NHS or private practice – the opportunity to share their views on the future of NHS dentistry. To take part and share your thoughts, visit
www.surveymonkey.com/r/PracticePlanNHSConfidenceMonitor4 before the closing date of 31 July 2016. The survey should take approximately three minutes of your time.
For detailed results from the last three surveys, visit www.nhsdentistryinsights.co.uk. Here you can also access the discussions from the previous Insights Panel, made up of key opinion leaders and experts from the dental profession who explore and debate the significance of the survey results and their implications for the future of NHS.