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Learning from the pilot
26th Sep 2011
The media coverage of the launch of the dental contract pilots on 1 September was really positive. It was really good to see dentistry portrayed in such an upbeat way.
Any payment system will have inherent incentives within it and our challenge is to minimise the negative and maximise the opportunities to drive positive ways of working. The history of dental payments in this country has shown us many of the risks.
The government is committed to a focus on quality and capitation and this is central to the construction of the pilots. Within this framework ,we hope to gather the learning that will help us to address how to construct a balanced system of financial incentives
A huge amount of work has gone into the development of these pilots. Their aim is to allow us to test out different aspects of a possible new contract. The early signs are good.
I have visited many practices involved in the process and the enthusiasm for the culture change, where reward is based on quality of outcome as well as numbers of patients, underpinned by a care pathway approach, is encouraging.
I myself was involved in the piloting of capitation for adults between 1998-2002 and understand the potential for positive outcomes but this is complex work and we need to ensure that the process is evaluated robustly.
The system needs to deliver for all parties, for dentists a fair income and reasonable workload which allows them to deliver high quality care to their patients. For the public, the need to have confidence that the system offers them security of access to care that delivers good oral health and for the taxpayer they need to have confidence that the system delivers these outcomes whilst at the same time offering value for money.
Having successfully developed legislation to make the pilots legal and supported providers and the NHS in agreeing local variations to contracts, the focus is now moving towards drawing out the learning and high quality evaluation of the pilots and then further engagement in implementing the lessons learnt.
For me personally, it was good to see dentists presenting such a positive image of the profession and really engaging in the process.
The significant improvement in overall access to services over the last couple of years has not attracted major media interest but the media interest in the improvement in the delivery of evidence-based prevention has been really good and will play a significant part in educating the public as to what they should expect from a quality NHS dental service.
My deputy, Sue, and I are hoping to visit all the pilots over the next few months and the direct feedback we will receive is an important part of the exciting development process we are now engaged in.
Author
Barry Cockcroft
Barry Cockcroft is chief dental officer for England – and an ardent Bolton Wanderers fan.
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