NHS payment reformed
Items of service reduced from 500+ to 45, check-up interval extended from six months to a year – and pay increased by six per cent
A major reform of the system of payment for NHS dentistry in Scotland comes into effect on 1 November. Among the changes are a significant reduction in the number of ‘items of service’ – treatments, procedures and undertakings – from more than 500 to 45.
The Scottish Government describes the new system as a “high-trust, low bureaucracy model” which will “empower dentists to use their clinical discretion and knowledge of best practice in delivering care. The revised suite of items should be seen, therefore, as broad outcomes of care as opposed to more granular treatment items as under the previous SDR.”
In an accompanying memo it states: “It reflects the start of a journey where, in each step, we empower dentists in how they provide NHS dental care to patients.
Payment reform is the first step towards a truly modern NHS dental service
“Payment reform is also the first step towards a truly modern NHS dental service which appropriately assesses, responds to and supports the oral health needs of every patient in Scotland. Through the fee structure, there will be increased incentives to ensure dentists focus on prevention as well as disease, reflecting modern dentistry.
“Patients will benefit from treatment items being brought in line with current best practice guidance, particularly around periodontal treatment, helping maintain and improve oral health. The reform also provides greater visibility of NHS care to patients through the reduced range of treatment items, meaning the new system will be much easier for patients to understand.”
Another major change has been made – in the regularity that NHS patients receive routine check-ups.
For patients in good oral health, with low oral health risk factors, a recall of 12 months is “sufficient to determine any changes in lifestyle, risk factors and/or development of new dental disease. For patients assessed as having higher risk, shorter intervals may be determined as appropriate and may therefore continue to be consistent with the intervals as previously prescribed.”
At the same time the Scottish Government announced a six per cent increase in the fees paid for items of service, including orthodontic items, and capitation payments. The pay award has also been applied to the vocational trainee salary, backdated to 1 April.