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Published: Tuesday, 26 May 2020 09:20

Written by News Editor

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In a letter to GDPs in Wales the chief dental officer, Colette Bridgman, signalled that UDA targets will be removed from NHS dental contracts during the period July to September. Each patient will have an Assessment of Clinical Oral Risk and Need (ACORN) and a personalised annual care plan. Those with greatest need will be the priority in the first phase.

The CDO’s letter[i] outlines the plan for the restoration of dental services across Wales. The objective is to explain what is proposed and to give dental teams in Wales time to prepare. She says that the plan ‘does present an opportunity to re-shape services and respond to some of the shortfalls of the current NHS contract, that have been articulated in the past’.

From July 1 to September 20, 2020, practices in Wales with NHS contracts will receive 90% of their Annual Contract Value. The letter explains: ‘This reflects the reduced material and laboratory expenses, but we acknowledge that PPE could also present an additional cost, so we have provided an uplift from the current level of 80%’.

It continues: “We intend to remove the Units of Dental Activity (UDA) targets from NHS dental contracts during this period. These targets will cease to be the contract delivery or performance measure that we use in Wales. This process will cut the link between ‘treatment’ activity and payment. As such, it will move service provision towards a model based on the ‘care’ of the ‘practice population’ of patients, rather than one that incentivises clinical ‘treatment’ intervention and repeated recall visits over a given year.”

In return for this practices with NHS contracts will be expected to:

1. Open for more than remote telephone contact and urgent care from 1 July 2020
2. Observe the COVID-19 Standard Operating Procedures (SOPs)attached to the letter
3. All NHS patients in the ‘practice population’ will receive one Assessment of Clinical Oral Risk and Need (ACORN) before March 31, 2021 in phases according to need
4. All patients will receive the appropriate level of evidence-based preventive intervention and care, based on their need
5. All patients will receive any necessary non-AGPs
6. All patients requiring urgent and non-urgent AGPs will continue to be referred to the Urgent Dental Centres or designated dental practices for treatment
7. All staff (e.g. associate dentists and dental care professionals) who deliver NHS care, will be retained and their pay will be protected at previous levels to reflect their NHS work.

The CDO concludes: “We can deliver radical change in how we provide primary dental care in Wales and in doing so, ensure the sustainability of the dental sector throughout this transitional period, both in clinical and economic terms. The reduced throughput of patients will allow for a slower more considered care-based approach to dentistry. It will give more time for the dental team to concentrate on prevention and personalised advice; as well as the provision of effective non-AGP treatment at first. In time, a considered re-provision of AGP treatment will resume driven by need and patient engagement rather than targets.”

[i] https://awfdcp.ac.uk/content/files/CDO-Letter-Restoration-of-dental-services.pdf

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