A major review of the provision of dental care should improve NHS-provided care, but there will be an increasing need for private funding solutions, it has been claimed.
Professor Jimmy Steele’s review includes a number of measures which could improve the way people access NHS care. In it, he says that local NHS authorities across England and Wales will have to communicate more clearly how people might find a dentist and what to expect from a dentist. Patients should also have an “absolute right” to return to the practice where they have a relationship with a dentist for both routine and urgent care.
The report, which was commissioned by the government, also says that dental contracts should include incentives for improving health, improving access and improving quality. They should include an annual per person registration payment to dentists and should explicitly link reward to the quality of a service and the outcomes it achieves.
However, insurers remain unconvinced that the measures will lead to an exodus from private solutions back towards NHS care. Even if more people do access NHS care, they will still need help to meet some of the charges that will bring, since NHS dentistry is very rarely “free”.
“I don’t think the review will make much difference,” said Kirsty Jagielko, head of product management at CIGNA HealthCare, which offers both indemnity and co-insurance dental plans. “The proposals will slow the decline of NHS dentistry but not reverse it. People have been exposed to the benefits of private dentistry so they are unlikely to go back to the NHS. It will take two to four years to really show whether the proposed changes are working or not.”
While Professor Steele’s review acknowledges that there are access problems in certain parts of the country it concentrates on the consequences of the public’s perception that NHS dentists are unavailable.
Jill Davies, chief executive of cash plan provider Westfield Health, said that the limited availability of NHS dentists means that many people will continue to have “little alternative” other than to seek private dental treatment.
“This, and the fear of losing existing NHS access, has undoubtedly increased the appeal of the cash plan dental benefit as it covers both NHS and private treatment,” she said.
Providers of capitation plans also forecast a bright future in light of the report’s findings, since they reflect the sort of long-term relationships Professor Steele would like to see NHS dentists cultivate.
Roger Matthews, chief dental officer of Denplan, said the plans are designed for people who want to have a “routine, ongoing” relationship with a practice.
“It is more than just a payment, it’s a relationship that they think twice about lapsing with,” he said.
Professor Steele’s report suggests that the common motivation for dentists providing private care is “often less about income and more about lifestyle” with more time spent with patients being “a major incentive” for them.
“The phrase I most often hear from our dentists is that they want the opportunity to practice the dentistry they were trained for,” Matthews said. “Denplan offers dentists the opportunity to provide as unbiased advice as possible, unbiased by elements of remuneration.”
The creation of such as bias is the chief failing of dental contracts introduced in 2006, according to the review, which identifies limited incentives for dentists to see patients or take on new ones and no measure or reward of quality.