England abandons new model of care prototype

14 January, 2022 / infocus
 Will Peakin  

The testing of new ways of providing NHS dental care – with an increased emphasis on preventing dental disease – has been abandoned by NHS England.

Around 100 practices that were taking part in the Dental Prototype Agreement Scheme have been told that from 31 March they will revert to the historic, target-based, model of care.

Under the prototype scheme dentists were allocated greater time to assess the oral health needs of patients and provide necessary care. This reduced the volume of patients that these practices could treat, and their patient base.

In a letter to practices involved, NHS England said it would contact patients directly to explain the change and that it would offer support to practices to restore their patient base. But the British Dental Association (BDA) said these steps fell short of what is required.

“Reverting to existing models of care has taken up to four years for practices that have left the programme in the past,” said Shawn Charlwood, Chair of the BDA’s General Dental Practice Committee.

“Practices are anticipated to face severe staffing problems, aggravated by already acute recruitment problems across the service. Many practices are already facing real issues with their longterm sustainability.

“The support offered to these pioneering practices is too little, too late. Colleagues who volunteered to find a new and better way of delivering NHS dentistry have been thrown under a bus. After committing years of effort their reward amounts to a helpline, a few leaflets, and the uncertainty of starting again, effectively from scratch.

“These NHS practices were given the time to care that all dentists require. Going back to chasing targets could take years, and there will inevitably be casualties. Patients will once again pay the price for the reckless decisions taken by [the] Government.”

In Scotland, the design of a new model of care was begun after publication by the Scottish Government of its Oral Health Improvement Plan in 2018. The last formal update was published in January 2020.

At a Conference of Scottish Local Dental Committees webinar last summer, Tom Ferris, Scotland’s Chief Dental Officer, indicated that it would be introduced in the lifetime of the current Parliament.

Speaking about the SNP’s pledge to scrap the patient charge, he said: “In my mind that’s tied up with the new model of care that we were hoping to do.

“There’s probably no point in having two major policy changes over the course of the parliament – ‘let’s make dentistry free and then let’s completely change the system of how we deliver dentistry’.

“Our view is part of that system reform will bring in a new, preventatively focused, patient-centred dental system that is free at the point of care, and we’ll do both things together.

“That’s a big piece of work which will involve a lot of discussion with a lot of groups, including DCP [dental care professional] groups whose skill mix might be more important as we go forward.”

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