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Dentists to trial payment by quality rather than 'drill and fill'

New dental payment system aims to boost patient care and improve access to NHS dentistry
WebMD UK Health News
Medically Reviewed by Dr Keith David Barnard
dentist and patient

12th April 2011 - NHS Dentists are to be paid for the quality of the treatment they provide rather than the number of treatments carried out under a scheme to be piloted in England this summer.

The Government says 62 dental practices, drawn from across the country and representing different types of practices, have signed up to test a new dental contract which was announced by the Department of Health last December.

Ministers say they hope the new system will improve patient care and allow more people to access NHS dentists.

End to 'drill & fill'

Under the previous contract, which was introduced by Labour in 2006, dentists were paid by the number of courses of treatment they carried out - a regime sometimes referred to as ‘drill and fill’ - which failed to give better access to NHS dentistry because some dentists opted out of the system.

The coalition Government said the 'fee per item' system paid dentists for the treatment they carried out and gave no incentive to carry out any preventative dentistry.

Quality of treatment

Under the new proposals, dentists in England would be paid according to the number of patients registered with them (a capitation system), how many they provide care for and the quality of the dental care they give.

Health minister Lord Howe said in a statement: "We all want good teeth and good oral hygiene. That’s why we want our dentists to get paid for the quality of treatment they provide rather than for the number of treatments, as is the case now.

“This approach is not only better for patients, but also a better use of NHS resources.

“It is important that we take our time to get this absolutely right. We want our reforms to give dentists the encouragement they are looking for to provide a service that meets the needs of today’s population, and which fosters positive habits from an early age.”

The changes will also restore the right of patients to register with their dentist - something that was cancelled by the 2006 contract. Currently, no formal registration process exists and patients do not have a right to return to their dentist, no matter how long they have been treated there.

Ministers want to return to a system of formal registration, as is the case with GPs. They say it will help foster a good relationship between dentist and patient and help promote better oral health.

Measuring success

The Government is also committed to introducing a system to monitor the quality of NHS dentistry by using a framework that measures quality and outcomes, the results of which will determine a proportion of a dentist’s pay.

Three different systems will be piloted this summer in order to test various aspects of the new contract.

Professor Jimmy Steele, who was a member of the National Steering Group which developed the proposals, said in a statement: "The Adult Dental Health Survey, published last month, showed further improvements in oral health in England. We now need an NHS dental service to match; one that maintains good oral health as well as providing appropriate treatment.

“The dental contract pilots will explore how best to make this a reality but it is important to get it right, so time spent setting this up properly is time well spent."

Reviewed on April 11, 2011

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