BDA says contract is failing patients after 10 years
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- Published: Friday, 01 April 2016 06:56
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A new survey from British Dental Association (BDA) shows that the payment system at the heart of NHS dentistry is failing patients in the most need. It shows that 93% of dentists say government targets standing in the way of treating patients in most need and leading NHS dentists have called on Prime Minister to put prevention at heart of service after ‘lost decade’
The findings which were released on the 10th anniversary (1 April 2016) of the imposition of the NHS contract that saw 1 million patients lose access to care and reveal significant problems across the service:
- 93 per cent of dentists report that chasing government targets is limiting their ability to care for high-needs patients who require complex or repeat treatment;
- 83 per cent say the system is holding them back from preventive work;
- Nearly 70 per cent state that the contract is now limiting their ability to take on NHS patients;
- Over 85 per cent state it is restricting the time they can spend with patients.
The government is now testing alternatives to the current contract, but remains wedded to models based on these discredited activity targets. Leading dentists have now called on the Prime Minister to honour past commitments and ensure prevention is at the heart of any reform package, see below.
Henrik Overgaard-Nielsen, Chair of the BDA’s General Dental Practice Committee, said: “The survey shows that those in most need have become the least welcome in NHS dentistry, thanks to a system that puts government targets before patient care. We are seeing the results of a conveyor belt model of provision that has left dentists without the time or the freedom to deliver the treatment their patients require.
“NHS dentists are still being forced to chase targets for curative treatment, rather than provide vital preventive care. This topsy-turvy system means dentists are paid the same for doing one filling or fourteen, and are routinely subsidising care for high-needs patients out of their own pockets. We receive financial penalties when we don’t hit targets, receive no compensation when we exceed them, and have no scope to take on new NHS patients, even when we have capacity.
“This lost decade of chaos, shortage and compromise has failed patients and practitioners. Sadly government has yet to show it’s willing to let go of these senseless targets. A watered down version of this failed contract isn’t progress. We call on ministers to live up to their rhetoric and put prevention first.”
Letter to Prime Minister
'We are writing as concerned NHS dentists. As you may know, 1 April 2016 marks 10 years since the introduction of the General Dental Services contract in England and Wales. A decade ago we were told it would improve access to NHS dentistry and put prevention at the heart of the service, but it failed on its own terms.
'In 2010 you pledged to “introduce a new dentistry contract that will focus on achieving good dental health, not simply the number of treatments achieved.” You took aim at the ‘perverse incentives’ in a system which forces colleagues to focus on hitting targets for curative treatment, rather than providing essential preventive care. It is not reasonable that only 56% of the population has access to NHS dentistry. Government must fund NHS care for those who need it, and set a contract that ensures that money is spent effectively.
'We know this government is working towards a reformed payment system and we want to continue to work with you. However we are clear that any successor to this failed contract has to make a definitive break with discredited activity targets and link as much payment as possible to preventive care. Your government is now testing two models for a reformed contract, both of which retain an emphasis on activity. We have a system that is failing dentists and their patients. A watered down version of the current contract will not represent progress.
'We are now calling for a commitment to ensure prevention is the clear focus for any reformed contract.
Signed
Henrik Overgaard-Nielsen Chair, General Dental Practice Committee,
Mick Armstrong Chair, British Dental Association
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