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Dental Services: Fees and Charges

Volume 461: debated on Thursday 21 June 2007

To ask the Secretary of State for Health what the (a) definition and (b) value is of the units used to calculate NHS dentists' fees. (144606)

Under the new contractual arrangements introduced from April 2006, dentists are no longer paid on the basis of separate fees for individual treatments. Dentists or dental practices instead have an agreed annual contract value, paid in monthly instalments, in return for which they carry out an agreed volume of dental services over the course of the year.

These annual service levels are defined primarily in terms of the courses of treatment provided for national health service patients, but with courses of treatment categorised into three main bands and with different weightings to reflect the relative complexity of these bands. There are separate, though similar, arrangements for defining annual service levels for specialist dental services such as orthodontics. Within the overall contract value, primary care trusts (PCTs) and practices may also arrange for the provision of other services that are not measured through courses of treatment.

A course of treatment which consists of an examination, diagnosis, e.g. x-rays and oral health advice, and a scale and polish if needed, is recorded as a band 1 treatment. This equates to one unit of dental activity.

A course of treatment which includes band 1 items together with additional treatment such as fillings, root canal work or extractions, is recorded as a band 2 treatment. This equates to three units of dental activity.

A course of treatment which includes band 1 and 2 items together with more complex procedures such as crowns, dentures or bridges is recorded as a band 3 treatment. This equates to12 units of dental activity.

There are additional arrangements for urgent courses of treatment and for certain other categories of treatment such as the issue of prescriptions.

The relationship between annual contract values and annual service levels, expressed in terms of units of dental activity, varies between contracts. For dentists or dental practices, who had previously provided services under the old general dental services arrangements, the calculation of annual contract values and annual service levels was based on an assessment of overall NHS earnings and corresponding courses of treatment during a 12-month reference period before the start of the reforms. The resulting variations in contract prices reflect, in turn, historic differences in treatment patterns and patients’ oral health needs. Subject to these transitional protections, the calculation of annual contract values and corresponding service levels is a matter for agreement locally between primary care trusts and dentists or dental practices.