Dental Tribune United Kingdom Edition

7News & OpinionsJune 6-12, 2011United Kingdom EditionUnited Kingdom Edition T he welcome: As you all know we are in the mid- dle of a listening exer- cise, so we can ensure that the reforms and the modernisation of the NHS, to take the views of the clinicians, patients and the public, so we can abso- lutely make sure that we have a legislative framework and a structure of modernisation that supports the objectives that we all subscribed to. When we talk about putting the patients at the heart of what we do or focus- ing on outcomes and evolving the responsibility to those clini- cians who have care of patients – that is the basis of the agree- ment. I have been Shadow/Sec- retary of State for seven years, and this experience has giv- en me the view that there is a very chequered history of dental reforms. With regards to the listening exercise on the Health and Social Care Bill – whilst the Bill itself does not directly affect what we’re doing in relation to den- tal contracts we will of course in the future introduce legisla- tion to reform the contract and the charging system for den- tistry. So we do have to make sure that the reformed dental contract is a good fit with the NHS structures that are being developed through the health and social care bill and in par- ticular the new commissioning arrangements. NHS Commissioning Board: We intend that the new NHS commissioning board will com- mission all dental services, and I think I’m right in saying that this is very broadly welcomed. Some primary care trusts have worked innovatively and con- structively to commission bet- ter services. But I also know that the different approaches taken by different PCTs has been frustrating for everybody, especially dental professionals. So by taking responsibility for all dental services in one place, with the NHS commissioning board we have a greater oppor- tunity to integrate primary and secondary care dental services and to bring a far greater de- gree of consistency to dental commissioning. Under our proposals, lo- cal authorities, through their health and well-being boards, will need to produce joint strategic lead assessments. So the commissioning board will then develop services that do respond to locally identified leads, at the same time bringing consistency across the country in for the profession. And that core consistency offers real op- portunities to the patients, to exercise real choice in relation to dental services. Sir David Nicholson will be the Chief Executive of the new NHS Commissioning Board was recently here in the North West meeting dentists to dis- cuss how they thought commis- sioning could be developed to the best effect. I understand it was a frank and construc- tive meeting, and I hope this constructive relationship both with the BDA and other dental groups continues. The contract: We’re currently laying the foundations for a new dental contract, which learning the lessons of the past, we are go- ing to highlight and I am ab- solutely aware both in relation to the dental contract brought in under the last government and the dental contract brought in under the last conserva- tive government it did not go through the process that we are now determined to get right. We are going to lay the foun- dations through these pilots, which will go live in the next month or so, and we’ll learn through the evaluation of these pilots as we move towards leg- islation and implement a new national contract. The new contract will be based on three elements: registration, capitation and quality. Registration – to reassure patients that they have guar- anteed continuity of care and to clearly divide the respon- sibilities of dentists and their patients. Capitation – to take the per- verted incentives of an activity based system out of the NHS, to focus on good oral health and preventative work and to really for the first time get dentists off the treadmill. Quality – providing high quality services to patients is a key aim of all our NHS reforms. Measuring quality can be diffi- cult but it is an essential ele- ment of the pilots. Finding out if we can really identify how quality indicators to help us ensure that we can improve the outcomes of all the patients. The constructive engage- ment we had with the dental profession and indeed with the BDA, for which I and my col- leagues are very grateful, has contrasted sharply with the atmosphere of hostility and an- ger that had developed at the previous dental reform pro- gramme. I think there are im- portant lessons of dentistry that we can learn from a whole NHS modernisation programme. We are working with clinicians on dental reform whereas previ- ously reform was imposed on the profession. More than anyone else, you the clinician, know what is right for your patients and I want to engage with you as it’s how we take forward the re- forms of dentistry and it is how we are taking forward wider reforms across the National Health Service. The changes we are making are essential, but it’s vital that we take the clinicians with us for the long term benefit of pa- tients. We have to develop a sys- tem be it in dentistry or wider healthcare, that will measure success by outcomes and tells us to what extent we are im- proving the health of individu- als and the wider population, not just how process indicators have been achieved. Dental public health: At either end of the age spec- trum, the overall oral health in this country is amongst the best in the world. The recent Adult Dental Health Survey and Child Dental Epidemiol- ogy programme results shows that around 70 per cent of adults were free of active tooth decay and that nearly 70 per cent of children had no expe- rience of dental caries. That’s great news, and it tells us we’re right to be seeking to use dental contract reforms to move clini- cal practice in the direction of continuing care and preven- tion. But it also shows that the 30 per cent of children who suf- fer from tooth decay, do suffer very significantly. And given that this is a completely pre- ventable disease, this is not ac- ceptable. Lansley at the BDA Not at the BDA this year? Couldn’t get to Secretary of State for Health Andrew Lansley’s speech on dentistry? Don’t worry, Dental Tribune has the highlights... Andrew Lansley speaking at the BDA Conference in Manchester page 8DTà ‘I have been Shadow/Secretary of State for seven years, and this experience has given me the view that there is a very chequered history of dental reforms’