Source · Select Committees · Health and Social Care Committee
Recommendation 5
5
Acknowledged
Paragraph: 38
Permanently apply ringfence to prevent diversion of NHS dental funding by ICBs
Recommendation
We welcome the fact that to try and address the underspend, NHS England is applying a ringfence for 2023/24, to ensure that no ICB can divert funding away from NHS dentistry. We recommend that this ringfence applies permanently, and NHS England puts in place transparent scrutiny to ensure compliance.
Government Response Summary
The government partially accepts the recommendation, stating they need to build on existing contractual changes but do not commit to making the dental funding ringfence permanent. They are working on further reforms to the 2006 contract in discussion with the profession.
Paragraph Reference:
38
Government Response
Acknowledged
HM Government
Acknowledged
Partially accept The Department partially accepts this recommendation. We accept the Committee’s recommendation that we need to build further on the contractual changes we announced in July 2022, to further support and incentivise Dental Practices to deliver more care and improve access for patients. However, there is no one perfect payment model. From 2011 to 2022 the Department, with NHS England, piloted alternative models to test a new form of contract remuneration for NHS work based on a capitation approach. Assessment of the programme suggested that if implemented as tested and evaluated, the proposed contract model would not maintain dental access for patients, reduce oral health inequalities, or offer overall sustainability within available resources for the NHS. The evaluation also did not provide any evidence that capitation improved personalised care. The proposed model could not therefore be supported for further rollout and the programme closed at the end of March 2022. Nevertheless, these pilots and prototypes provided good insight and learning, and will continue to inform future contract reform. We have already made changes to tackle some of the problems identified with the current contract, including band 2 changes, rebasing, and ring-fencing ICB allocations but we need to go further. We are working on further reforms to the 2006 contract, in discussion with the profession, and will continue to engage on the best way to remunerate dentists for care for patients with complex needs and support more preventative care such as chairside prevention activity, fluoride varnish and oral health education.