Under the new contractual arrangements, providers of national health service primary dental care services undertake to provide an agreed level of services over the course of the year, measured in terms of courses of treatment but with a weighting to reflect relative complexity. Units of dental activity are the measure of these weighted courses of treatment. Dentists previously working under the old general dental services contract were entitled to contracts based on the courses of treatment paid for during the 12-month reference period (October 2004 to September 2005), converted into units of dental activity and then reduced by 5 per cent.
During the period leading up to the implementation of the contract, the Department worked closely with the then Dental Practice Board to make sure that this calculation of units of dental activity represented as fair a reflection as possible of the activity paid for during the reference period. The Department remains confident that these calculations provided a fair basis for calculating the new service requirements, taking into account the 5 per cent. reduction and the opportunity given to dentists to carry out simpler courses of treatment with fewer individual interventions.
The General Dental Services and Personal Dental Services Transitional Provisions Order 2005 (SI No. 2005/3435) required primary care trusts (PCTs) to calculate the units of dental activity to be provided by the contractor under a general dental services (CDS) contract by analysing the data held in respect of care and treatment provided by the contractor during the year 1 October 2004 to 30 September 2005, categorising that care and treatment in accordance with Schedules 1 to 4 of the National Health Service Dental Charges Regulations and converting into units of dental activity by reference to the criteria specified in Part 1 of Schedule 2 to the GDS Contracts Regulations. The primary care trust (PCT) was then required to reduce the number of units of dental activity so calculated by 5 per cent. The Department arranged for the then Dental Practice Board to undertake these functions on behalf of PCTs.
Similar provisions applied in the case of contractors providing services under a personal dental services (PDS) agreement, but with provision for PCTs and contractors to agree the appropriate number of units of dental activity where data did not exist for the reference period or where it was appropriate to adjust the data.
Under the new contractual arrangements, providers of national health service primary dental care services receive an agreed annual contract value in return for undertaking to provide an agreed level of services over the course of the year, measured in terms of the courses of treatment they provide, with a weighting to reflect the relative complexity of different types of courses of treatment. The Department has not made an assessment of the proportion of dental providers who are likely to fulfil their annual service commitments. It is for primary care trusts, working with dental providers, to monitor and manage contract performance locally.
For dentists previously working under the old general dental services contract, the new annual service level is based on the weighted courses of treatment paid for during a 12-month reference period (October 2004 to September 2005), but with a reduction of five per cent. By removing the old fee-per-item system of payment, the new arrangements have also been designed to support dentists in carrying out simpler courses of treatment. Dentists should, therefore, generally have the opportunity to carry out fewer and simpler courses of treatment compared with the reference period, enabling them to devote more time to preventative care and to manage their workload more effectively over the course of the year.
The Department has established an implementation review group, comprising representatives of patients, dentists, national health service organisations and other stakeholders to keep under review the impact of the dental reforms introduced on 1 April 2006.