Source · Select Committees · Health and Social Care Committee
Recommendation 8
8
Accepted in Part
Paragraph: 51
Urgently implement fundamentally reformed dental contract, moving away from UDA system
Recommendation
We welcome the Government’s recognition of the need for dental contract reform. The Department and NHS England must urgently implement a fundamentally reformed dental contract, characterised by a move away from the current UDA system, in favour of a system with a weighted capitation element, which emphasises prevention and person-centred care. This should be based on the learnings from the Dental Contract Reform Programme and in full consultation with the dental profession.
Government Response Summary
The government partially accepts the recommendation for urgent reform, stating they will build on existing contractual changes and work on further reforms to the 2006 contract, but reject moving to a weighted capitation model based on previous pilot evaluations.
Paragraph Reference:
51
Government Response
Accepted in Part
HM Government
Accepted in Part
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.