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Dentists fear quality for special care patients

NHS England must overcome a series of challenges if it is to safeguard the provision of high quality dental care for special care patients

That’s the warning from the British Dental Association (BDA) in a new publication published this week.

The report identifies concerns around the funding and resourcing of services, the provision of facilities and in leadership, arguing that predictions of an increase in the number of people living with long-term illness, impairment and disability in Great Britain underlines the importance of safeguarding investment in salaried services.

It calls for budget allocations to be based on the historical cost of service provision, rather than recent PCT budgets, which in some areas have been set aside as a result of national cost-saving exercises, creating a postcode lottery where some services have become underfunded.

The report also presses for the continued development of flexible commissioning and contractual arrangements that are responsive to the unique needs of salaried services’ patient cohort, and for guarantees that salaried services will have access to appropriate premises.

Additionally, it advocates appropriate clinical leadership of salaried dental services, arguing that the appointment of non-dentally qualified managers presents challenges in patient care and in maintaining clinical governance standards that can lead to the provision of sub-optimal treatment.

Dr Peter Bateman, chair of the BDA’s salaried dentists committee, said: ‘We have seen encouraging signs of engagement with salaried services in recent times and were particularly pleased that the pilots for a new dental contract for general dental services were expanded earlier this month to include salaried sites.

‘But nonetheless NHS England has inherited a series of challenges that it must work with the profession to overcome. BDA members in salaried services have reported a wide range of concerns that this report articulates, including damage to patient care as a result of non-dentists being appointed to manage services and their budgets being regarded as soft targets for cost-cutting.

‘It is important that NHS England quickly grasps the scale of the task for which it has assumed responsibility. Salaried dentists are looking to the new body to ensure their work caring for some of society’s most vulnerable patients is properly funded, resourced and led.’

The publication, Commissioning Salaried Primary Dental Services for vulnerable adults and children: a vision for the future, is available on the BDA website.

Its publication follows a BDA survey of salaried dentists that identified serious concerns about services. Almost three-quarters of the dentists surveyed felt that the service in which they worked was understaffed, with many reporting that the situation was threatening the quality of care for patients.

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