The current NHS dental contract was implemented in England in 2006. The contracts involve working towards activity targets known as units of dental activity (UDAs). The current contract has a focus on rewarding dentists for meeting government targets for treatments. This reflects the issues faced by the UK when the contracts were drawn up as many patients were struggling to see an NHS dentist.
Dentists would like patients to be at the centre of their contracts rather than government targets. They also feel that they are rushed with appointments so would like the flexibility to spend longer with patients when it is necessary. Additionally, the contracts currently make it difficult for dentists to treat patients with complex needs. This means that these patients are often subject to long specialist waiting lists or struggle to access the care that they need.
The British Dental Association are lobbying for a contract that puts patients and prevention at the centre. They believe that UDAs aren’t benefiting dentists or patients and if activity targets are a requirement, they should be related to preventative dentistry where possible. Having a contract that rewards dentists for improvements in oral health rather than UDA is hoped to improve oral health in England.
Currently, two prototypes are being trialled through participating dental practices in England. The new contract prototypes reward dentists both for treatment and continuing care. It is thought that the existing contract will be replaced around 2018/19 although the next contract is not finalised.
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