UK - NHS Dentists to Be Paid According to Number of Patients

There will be a shift in NHS dentistry to focus on preventative care, following an independent review into NHS dental services in England, published in June 2009. The review, led by Professor Jimmy Steele, made recommendations that dentists be paid according to the number of patients on their books and the quality of care they provide, rather than the amount of treatment carried out.

The review recommends that a “significant chunk” of dentists’ income should be linked to the number of patients registered with them, and this could amount to as much as 50%. The report also recommends that dentists have greater accountability, and should be penalised for faulty work and required to carry out necessary procedures to correct it at no extra cost to the NHS. Dentists should also focus on ensuring patients understand the importance of oral health and diet, as dentistry has become too preoccupied with treatment rather than prevention, according to the review.

The proposed changes see a return to patient registration, which was scrapped in the widely-criticised dental reforms of 2006. It is estimated that a million fewer patients have access to an NHS dentist in England than before the reform came into force three years ago.

The review also proposes a new system of patient charges, replacing the current three-band system with one of between five and 12 bands. This will relate payments more closely to the amount of work being done, as currently it costs the same amount to have one filling, as it does to have ten.

Health Secretary Andy Burnham has accepted all of the recommendations “in principle” and pilot trials of the new system will begin in the autumn.

Further reading - An in-depth review of the UK pharmaceutical market, including some background information on dentistry, is available from Espicom: The Pharmaceutical Market: United Kingdom (published March 2009)