Reform of dental care proposed


The review has looked at complex treatments

An independent review has recommended significant changes to the way NHS dentistry is organised in England. They include a return to linking a significant part of a dentist's income to the number of NHS patients registered on their books.
Another proposal is to make dentists "more explicitly accountable" for providing high quality, long-lasting treatments.
Ministers say they will pilot some of the recommendations in the autumn.

This review is a vision of a better deal for both patients and dentists


Professor Jimmy Steele, review author



Q&A: NHS dentistry

Health Secretary Andy Burnham said: "I recognise that more needs to be done to bring NHS dentistry up to the standards that patients should expect.
"We and the NHS are committed to ensuring that anyone can access high quality dental services."
Professor Jimmy Steele, who led the independent review, said: "This review is a vision of a better deal for both patients and dentists.
"It is about making sure that patients can see an NHS dentist who will take long-term responsibility for their care."
New contract
A new dental contract for dentists was introduced in April 2006 in an attempt to widen access for NHS patients.
It aimed to reform the so-called "drill and fill" culture by effectively paying dentists the same amount to see slightly fewer patients.
In theory this allowed them to spend more time with their patients so they could also give them advice about oral health, rather than trying to maximise throughput to maximise their income.
But it has proved highly unpopular with the profession - and with the public.

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Opposition parties have also been highly critical of the effect of the contract, with the Conservatives in particular calling for a return to patient registration.
Figures show 1.2 million fewer patients visited a dentist in England in the two years to June last year than in the period before the reforms were introduced.
Under the contract, patients paid fixed charges for particular types of procedure and local primary care trusts were given the power to commission and pay for dental services.
There has also been criticism that because dentists now receive a flat salary, they no longer have any financial incentive to carry out difficult work such as crowns and bridges.
In the first year of the contract, the number of complex treatments - including bridges and crowns - which involve laboratory work was halved, and the number of root canal treatments fell by 45%.
In Scotland and Northern Ireland, not covered by the changes, the number of complex treatments rose.
The contract also covers Wales, although the review only deals with services in England.


http://news.bbc.co.uk/1/hi/health/8109679.stm