DTUK1510

T he current buz- zword within NHS dentistry is piloting. Back in 2006, a lack of ad- equate piloting led to a flood of criticism for the turbulent instal- lation of an untried and untested system. Despite reassurances from the Department of Health (DH) that the new system was fine and working, there has been a constant call for change from both within and out- side our profession. It seems that while the previous system had been around for a few decades, this current one looks destined to be around for only a few years. While scavenging through the dental press, I find that many different groups and organisations have praised the DH’s new- found enthusiasm for piloting, but nowhere can I find details of actually what this pi- loting involves and what chang- es the DH is hoping to assess and implement. The Steele review provided a broad range of recommenda- tions based on evidence gath- ered to help implement real change, but with Government coffers in deficit, it’s still not clear just how likely we are to actually implement change. Wider options The first wave of pilots is look- ing individual aspects of the Steele recommendations. The next wave will aim to trial a wider range of options to cover more areas of the Steele review, including increasing access to NHS dentists, introducing patient registration, measur- ing quality as well as quantity of treatment, and encouraging dentists to carry out more pre- ventive work. As yet, we do not know whether the new Govern- ment will pilot just individual facets of a proposed ‘new’ new contract, or is willing to pilot the full working model before tak- ing it nationwide; if so, when they envisage to realistically do so, is also in question. Whenever I have friends round for dinner I always try and buy the very best ingre- dients to cook with, but that doesn’t mean I always get the right result. If it’s a particularly important meal, I try and cook something that’s worked before. Sometimes when you’ve cooked a dish once, you realise what works and what doesn’t, regard- less of how many times you’ve checked to see you have the right ingredients. Look at the conclusions set by the review, I was glad to see recommendations for improv- ing ‘quality’ as well as address- ing issues with access. But the real debate on how we manage to make this work in practice still needs to be addressed. Den- tistry in the teens (2010-2019) is far more than what can be squeezed into three bands and as such there is still a mismatch between what our patients ex- pect and what the NHS can de- livery. The extra mile Rhetoric on improving quality, however, needs more than just piloting; it actually needs to be substantiated finan- cially. In its evidence to the DDRB (Doctors and Dentists Review Body) this year relat- ing to GDPs, the BDA had asked for an award of 3.8 per cent on con- tract values, fee scales and other appropri- ate allowances. This included a retrospec- tive increase for last year’s award, which the BDA considered to be based on flawed as- sumptions. The DDRB did not accept the BDA’s argument that the award should be changed and as such the current uplift in pay remains at 0.9 per cent. Both the Depart- ment of Health in Eng- land and the Scottish Government Health Directorates have cho- sen not to adopt the full DDRB recommenda- tions due to the current public sector spending constraints, given the state of the nation’s fi- nances. Although I am not surprised at this pay freeze, one has to question the efficacy of piloting changes that may never have the finances or political will to see the light of day. In my opinion, I do hope that some good can be learnt from the current batch of pilots, but when it comes to implementa- tion, let us hope that next time, the Government carries the profession along with it and ul- timately treats working profes- sionals as professionals. DT Piloting through uncertainty Neel Kothari questions what piloting actually involves and what changes the Department of Health is hoping to assess and implement About the author Neel Kothari quali- fied as a dentist from Bristol Univer- sity Dental School in 2005, and cur- rently works in Cambridge as an associate within the NHS. He has com- pleted a year-long postgraduate certifi- cate in implantology at UCL’s Eastman Dental Institute, and regularly attends postgraduate courses to keep up-to- date with current best practice. Im- mediately post graduation, he was able to work in the older NHS system and see the changes brought about through the introduction of the new NHS sys- tem. Like many other dentists, he has concerns for what the future holds within the NHS and as an NHS dentist, appreciates some of the difficulties in providing dental healthcare within this widely criticised system. ‘Whenever I have friends round for dinner I always try and buy the very best ingredients to cook with, but that doesn’t mean I always get the right result’ The Steele review covers many aspects of NHS dental provision June 7-13, 2010United Kingdom Edition EverClear™ a triumph in clarity For details of Carl Zeiss and our wide range of other dental products contact: See what you are missing... 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