Pilots extended until 2015

Pilots extended until 2015

Over 90 dental pilots have been extended until March 2015 the Department of Health has announced. It has also published Jimmy Steele's update on their progress. This report says that the new preventative approach is showing good clinical results. The focus over the next year will be to refine this approach. The BDA has commented that these issues require 'continued professional engagement'.

The BDA  comment went on to say "Also identified are repercussions for use of skill mix in dentistry, with the important role of DCPs, including Extended Duties Dental Nurses, in the delivery of the care pathway the pilots are trialling, noted. Such arrangements present particular challenges for smaller practices, the report warns."

The Evidence and Learning report shows two years of learning from NHS dental pilots.  The Department of Health says that the new preventative approach is showing good clinical results. Patients are assessed as having low, moderate or high risk of future disease; and across the pilots the percentage of patients classified as high risk is reducing as dentists help patients take better care of their teeth and gums. The Department comments "As well as improving oral health of patients the new approach has to work operationally for dental practices in the NHS. The focus over the next year will be to further refine the preventative approach, building on the learning to date and understanding how it can be effectively put to wider use."

Jimmy Steele, head of Newcastle University Dental School and author of the Evidence and Learning report said: "The dental pilots have been testing new preventative approaches to oral health and alternative ways for dentists to be paid for their work. This learning and evidence report shows a range of findings from the operation and clinical impact of a new pathway, to the effect of attendance and patient access. It has identified what has worked and what has not and, more importantly, has identified the important next steps towards successful reform".

Barry Cockroft, chief dental officer, said: "The oral health of the nation has been improving year on year with some of the lowest tooth decay rates in the world. Our dental pilots had been exploring how dentists can work with patients to create personalised care plans, hoping to avoid dental problems before they arise. The pilots are also playing a vital role in overhauling the dental contract, by looking at how we can shift dental care to a more preventative approach, paying dentists for good oral health rather than the number of procedures they do, This is why we've extended the dental pilots for another year, to make sure these new methods are well tested before being shared across the rest of the country."

In its press release the BDA says that the report identifies an overall health gain for patients at participating practices, but warns that many are struggling to maintain the number of patients they are able to see, particularly initially as patients undergo the detailed Oral Health Assessment that is being trialled. Some pilot participants also raised practical concerns around the software being used, pointing to the need to sometimes override the system, the large amount of colour printing involved in producing care plans and some of the language in the plans not being patient friendly. The BDA also highlights repercussions for use of skill mix in dentistry, with the important role of DCPs, including Extended Duties Dental Nurses, in the delivery of the care pathway the pilots are trialling, noted. Such arrangements present particular challenges for smaller practices, the report warns.

John Milne, chair of GDPC, commented: This is an interesting and useful report and I urge all those with a stake in the future of NHS dentistry in England to read it. It identifies a number of complex learning points that must be addressed by continued dialogue between the Department and the profession before wholesale reform can be implemented.It is important that engagement continues as all parties strive for new arrangements that work for practitioners and patients alike. The profession has endured the difficulties created by the 2006 contract for what feel like eight very long years and GDPC will continue to press hard for the delivery of new arrangements.”

The report can be found at:

https://www.gov.uk/government/publications/dental-contract-pilots-evidence-and-learning



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