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Engagement must fill in White Paper gaps
8th Oct 2010
NHS reforms will only succeed for dentistry if there is significant engagement with the profession as the many gaps in the proposals are filled in.
That's the verdict of the British Dental Association (BDA) in its response to the White Paper Equity and Excellence: Liberating the NHS.
It sees the BDA stress the value of both clinical leadership and local input.
The BDA responds positively to the suggestion that responsibility for commissioning primary dental care services be transferred from primary care trusts to a new national commissioning board.
The recent indication that Professor Jimmy Steele, author of an independent review of NHS dental services in England published last year, will continue to help shape new contractual arrangements for dentistry is also given a thumbs-up.
Concerns are raised about the lack of detail in the White Paper though, pointing to gaps in the proposals for both general dental practice and to questions about salaried and secondary care.
The BDA argues that salaried primary dental care services must also be commissioned by the national commissioning board with appropriate local input.
It also expresses anxieties about the transitional arrangements for dentistry.
Local skills and expertise, the understanding of populations' needs and the way that dentistry can meet them must not be lost in a period of structural uncertainty for many NHS employees. The BDA response also demands that the costs of NHS reconfiguration are transparent and that a budget is set aside for it so that patient care and front-line services do not suffer.
Dr Susie Sanderson, chair of the BDA's Executive Board, said: 'There are some interesting elements in the White Paper for NHS dentistry in England. The indication of new contractual arrangements and the centralisation of commissioning give an opportunity to improve NHS dental service for patients and dentists.
'Clearly though, there are some significant risks with the envisaged scale and pace of change. The immediate threat is that the period of transition we are entering will see expertise flood out of the NHS and we may already be seeing the beginning of a brain drain.
'The local dental expertise of Consultants in Dental Public Health, Dental Practice Advisers and Local Dental Committees is clearly very important and must be maintained during the transition period and in the new arrangements.
'We also see some quite significant gaps in the proposals. Engagement with the profession will be crucial as the detail is developed.'
The BDA response includes a number of further recommendations including the development of a strategy for dental information technology.
It is available here.
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