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Health Minister Lord Howe warns out-dated dental contracts need replacing

12 December 2012

Out-dated dental contracts need replacing to provide a better service for patients, warns Health Minister Lord Howe and Deputy Chief Dental Officer, Sue Gregory.

Preventing dental disease rather than waiting for it to occur and tackling it afterwards will save the taxpayer money and improve patient care, says Health Minister Lord Howe, in an exclusive article for the latest Royal College of Surgeons, Faculty Dental Journal (FDJ).

In the authoritative paper the Health Minister, who took over responsibility for oral health and dental policy in 2010, provides insight into progress and shares his hopes for the long-term future of dentistry.

In a separate article in the January edition of the FDJ Deputy Dental Chief, Sue Gregory, reinforces many of the recommendations made by the Health Minister and stresses that the current dental contracts are now out-dated. Dental Contract Reform: Opportunities and Challenges, outlines the piloting test results for a potential new contract system. The findings reveal that 79% of respondents agreed that the advice provided gave them a better understanding of how to look after their oral health. Seventy-two per cent of patients who took part also had a better understanding of their (or their children’s) teeth and gums following experiencing the new dental care approach.

Both authors maintain that any new contracts will need to be based on improving patients’ oral health over the long-term rather than simply treating disease.

Lord Howe states that oral health in this country compares favourably with any other country in the world: levels of decay have dropped significantly and there is a real commitment to driving up standards of care within the profession.
However, he warns that a contract where dentists are paid per treatment is no longer appropriate and that the old contracts should be replaced with a system based on outcomes.

“In the last two years I have visited dental practices and clinics and talked to dental students and one thing is clear: there is broad consensus towards focusing on preventing disease - rather than waiting for disease to occur then treating it. We want to tackle the cause of poor oral health at its root and work in a more preventative way,” says the health minister.

Sue Gregory’s paper goes further: “The National Health contracts for dental services have been in place since the inception of the NHS in 1948. During that time a payment system which predominantly rewards procedures was an effective way of maximising productivity and getting disease treated.  Since then the oral health of children and adults has transformed making the old contracts inappropriate.”

The Deputy Dental Chief explains that dental care reform is complex and that piloting tests are crucial to addressing the challenges inherent with designing new contracts. The paper summarises the details of piloting that started in July 2011 with 70 Dental practices moving to the new approach.  Clinical data is being collected across four key areas: caries, periodontal disease, non-carious tooth surface loss and soft-tissue. The pilot also uses a new software package, which stores a much wider range of clinical information.

The paper concludes by highlighting that the oral health assessment, pathway and software are far from the finished product and that further development is needed to hone them, to ensure they are efficient and deliverable.

Kathy Harley, Dean of the Faculty of Dental Surgery, said: “As a profession it is vital to patients that we keep pace with the process of change, therefore it is right that we look at redesigning the way we deliver dental care in the 21st century. New oral healthcare contracts, which are fit for modern day use, will ultimately ensure an optimal patient experience during and after treatment. Crucially they will arm patients with the knowledge they need to take care of their oral health in between check-ups.”


Notes to Editor:
1. The Royal College of Surgeons of England is committed to enabling surgeons to achieve and maintain the highest standards of surgical practice and patient care. Registered charity number: 212808.
2. To arrange an interview with Lord Howe or Sue Gregory contact - Lisa Ettridge on 0207 210 5197
3. To arrange an interview with the Faculty of Dental Surgery call the RCS press office.
For more information and a copy of the FDJ articles, please contact the RCS press office on:
• 020 7869 6047/6052
• Out-of hours: 07966 486 832