Primary care trusts (PCTs) are expected to make all reasonable efforts to ensure that resources allocated for primary dental care services are spent on commissioning and/or providing dental services. This can be through general dental services contracts, personal dental services agreements or through PCT dental services. Strategic health authorities have also been asked to maintain, as a minimum, levels of investment in dental services across their area, if necessary by re-deploying resources between PCTs. It is for PCTs locally to decide what levels of dental services to seek to commission for a given level of expenditure and to decide how far services should be monitored through weighted courses of treatment (for example, units of dental activity) or through other measures.
The contracts agreed between primary care trusts (PCT) and providers of national health service dental services specify both an annual contract value and the overall level of services, measured in terms of weighted courses of treatment (or units of dental activity), that are to be carried out over the course of a year. These annual requirements are at least 5 per cent. below the equivalent service levels carried out under the former general dental services arrangements. Where it appears from a mid-year review or subsequently that a provider is unlikely to carry out the agreed annual service level, the PCT may propose a variation to the contract value to reflect the level of services likely to be provided. In the event of disagreement, any proposed variation may be referred to the NHS Litigation Authority.