Dental contract ‘not working’ says Welsh Assembly health committee

Dental contract ‘not working’ says Welsh Assembly health committee

Some NHS dentists are being discouraged from taking on patients in poorer parts of Wales because of how they are paid, an inquiry has found. Paying dentists the same regardless of the amount of work involved "makes little sense," said Dai Lloyd, assembly health committee chairman. He said current contracts "aren’t working" and a fresh start is needed.

The Welsh Assembly Health, Social Care and Sport Committee has published its report into the working of general dental services in Wales, under the 2006 contract which, with its UDAs, comes in for serious criticism.

The Committee made six recommendations:

  1. The Welsh Government should replace the current UDA targets with a new, more appropriate and more flexible system for monitoring outcomes to include a focus on prevention and quality of treatment, and to provide an update on the progress of these considerations to this Committee in six months.
  2. The Welsh Government should ensure the reinvestment of clawback money recovered by health boards back into dentistry services.
  3. The Welsh Government should undertake an evaluation to determine if the UK wide recruitment system effectively supports a strategy to increase the recruitment of those who are Welsh domiciled and the levels of retention of students generally following training.
  4. The Welsh Government should work with health boards to develop a clear strategy to ensure that the e-referral system for orthodontic services in Wales has a positive impact on ensuring appropriate referrals, prioritising patients and reducing waiting times.
  5. The Welsh Government should fund the ‘Designed to Smile’ programme sufficiently to enable children over 5 years old to receive the same benefits of inclusion as they did prior to the refocus of the
  6. The Welsh Government should build upon existing oral health improvement programmes to address and improve the oral health of older children and young teenagers in Wales.

Dai Lloyd AM, Chair of the Committee, said "Paying someone the same amount to deliver a course of treatment on a patient regardless of the amount of work involved makes little sense." He added "this Committee believes it is time to end the current arrangements and find a new way of making sure everyone in Wales has access to quality dental services regardless of where they are.”

CDO Wales Colette Bridgman told the committee she accepted that dentists faced difficulties in very high-need communities. "They find it difficult if they do the ethical, moral thing to see new patients, to accept all-comers and to provide the dentistry that’s required," she said.

BDA Wales has welcomed conclusions from the Committee that transformative change is needed in NHS dentistry in Wales - starting with binning the widely discredited target driven contract system.
Tom Bysouth, Chair of the BDA’s Welsh General Dental Practice Committee, said: "We want to thank the Committee for providing the unvarnished facts about NHS dentistry in Wales. Last year we told AMs that since 2006 the perverse incentives set out in our contract have hurt both patients and practitioners.
"On access and on care for our most deprived communities, this system has failed on every front, and has fuelled a collapse in morale among the profession. We are pleased this Committee recognises the need to consign this discredited system to the dustbin of history."

For full report see: http://www.assembly.wales/laid%20documents/cr-ld12528/cr-ld12528-e.pdf

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Anthony Kilcoyne
Last edited on 23.05.2019 22:39 by Anthony Kilcoyne
NHS dental contract failing public
To be fair Wales has thrown extra funding and initiatives at Practices compared to England, their NHS patient charges are lower and there's even FREE exams for under 25s and over 60s, free prescriptions for more categories etc, etc and yet, the CORE UDA based dental contract is STILL not fit for purpose - so how much worse does that make England's NHS dental contract then ???

Surely as a matter of informed consent even without the Montgomery latest rulings, the public should be told clearly and unambiguously up front ?!?

Yours observationally ,

Tony.

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