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NHS dental reform ‘to end drill and fill’ regime

A new dental contract will focus on quality of care rather than just number of treatments, say ministers
WebMD UK Health News
Medically Reviewed by Dr Rob Hicks
dentist and patient

17th December 2010 - Plans to give people in England better access to NHS dentistry and improve the quality of care have been announced by the Department of Health.

Ministers say the plans will mark a first step towards a commitment to introduce a new dental contract which will mean dentists being rewarded for the quality of care they give patients rather than just the number of treatments they carry out.

Dentists’ leaders have welcomed the proposal as a positive move towards driving up standards.

The previous system, which was introduced by Labour in 2006, was based on paying dentists by the number of courses of treatment they carried out - sometimes dubbed ‘drill and fill’ - which failed to give better access to NHS dentistry as some dentists opted out of the system.

Quality of care

The coalition government wants to reverse the trend by paying dentists partly on the number of patients they see, but also on how satisfied their patients are with their treatment.

It also plans to implement measures for improving the oral health of schoolchildren.

Pilot schemes

Between 50 and 60 dentists will pilot three different models of NHS dental care from next April. Each model will vary slightly in order to provide information on how each aspect of the new treatment regime works.

“We want to give dentists the freedom to deliver high quality care and reward them for the outcomes they achieve for their patients, not justfor the volume of treatment delivered, as is the case now,” Health Minister Lord Howe said in a statement.

“This is about prioritising prevention. People need a dental service that helps them maintain good oral health and prevents decay, rather than one that is based solely on treatment.

“It is important that we get this absolutely right so that our reforms will give dentists the encouragement they need to provide a service that meets the needs of today’s population.”

New scheme more than four years distant

The model for the new dental contract was drawn up by Professor Jimmy Steele, who comments in a statement: “The complexities of redesigning and delivering a new dental contract should never be underestimated and we need to use the learning from the pilots, but there is now the real prospect for an NHS dental service which is good for patients, fair to dentists and aligned to oral health.”

If the trials are successful the Government plans to implement the new contract in April 2014.

Commenting on the proposals in a statement, Dr John Milne, Chair of the British Dental Association’s General Dental Practice Committee, says: “Today’s announcement is an important, positive step towards the goal of improving NHS dental care for patients across England. The current arrangements, which were implemented in 2006, have failed to promote preventive care for patients and have been deeply unpopular with dentists.

“The BDA has campaigned hard for a re-think and we are encouraged that the Department of Health is to begin testing new ways of delivering care. We are pleased that two principles that we believe are particularly important - quality of care and a continuing care relationship between practitioner and patient - are central to what is being piloted.”

Reviewed on December 16, 2010

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