NHS makes major change after dentist fined £150K for keeping teeth too healthy
NHS changes have been announced to pay dentists more to treat those most in need.
The Government has outlined a series of changes while it rips up and redesigns NHS dentistry. The interim fixes are published a day after the Mirror 's Dentists for All campaign exposed the perverse incentives at the heart of the NHS crisis. Rob Mew told how he is currently being fined £150,000 by the NHS effectively for keeping his patients too healthy with regular check-ups and preventative work. Emergency measures announced on Tuesday will tackle a situation where dentists are disincentivised from treating the patients who need care most.
Writing for the Mirror, health minister Stephen Kinnock said: 'Once again it falls to a Labour government to give all people the healthcare they deserve, not just those who can afford it. The Mirror's Dentists for All campaign has exposed the shocking state of NHS dentistry after 14 years of Conservative mismanagement.'
The Mirror came to Devon - one of Britain's worst dental deserts - for the first of a series of special reports on the crisis. We visited Fairfield House Dental Surgery in Exmouth which is one of the few in the county still seeing NHS patients.
Units of Dental Activity (UDAs) are the metric used by the NHS dental contract - which has been deemed 'not fit for purpose' by Parliament's Health and Social Care Committee. It requires practices to agree to perform a set number of UDAs - and they are penalised if they come in below this. A check-up is worth one UDA while giving a patient a filling racks up three UDAs.
Fairfield owner Rob Mew told the Mirror: 'We are being penalised for preventing patients requiring more UDAs. We have £150,000 'claw back' this year but we have 19,000 NHS patients which is more than the practice has ever had. The clawback is for not doing enough UDAs but when patients are being looked after better they don't have as much need for dental work.'
The NHS contract currently means dentists get paid the same for a patient having three fillings as 20. However interim measures confirmed today include a new time-limited 'care pathway' for higher needs patients so dentists get paid more for clinically complex cases.
Other proposals going out to consultation include paying dentists extra for a special course of treatment for patients with severe gum disease or with at least five teeth with tooth decay. There will also be more money for denture modifications.
Stephen Kinnock, the Minister of State for Care
While he was Health Secretary, Nye Bevan received a letter from an elderly woman in Lancashire. She was overwhelmed with gratitude to have received dentures, free of charge, on the new National Health Service. She wrote: 'Now I can go out in any company.'
The shame of the state of her teeth had trapped her in her home. The NHS liberated her.
Once again, it falls to a Labour government to give all people the healthcare they deserve, not just those who can afford it.
The Mirror's Dentists for All campaign has exposed the shocking state of NHS dentistry after 14 years of Conservative mismanagement.
We've started the work on fixing, with an extra 700,000 urgent and emergency appointments this year through our Plan for Change. But with problems in dentistry that run this deep, we need to drill down and extract the problem at its roots.
That means completely reforming the dental contract, which right now is making it unattractive to offer NHS dental care, especially for those who need it most. That's why we're opening up a major consultation into our proposed first changes to the dental contract today.
It isn't right that it's less cost effective for dentists to take on patients who need more complex and extensive treatments such as crowns, bridges and dentures. Our plans will rip up nonsensical processes like these – and we want to know from dentists what other changes like these we need to make.
Our plans will bring in urgent care for those most in need: with new, special treatments for patients with severe gum disease or terrible teeth decay, and a requirement for dentists to deliver a set amount of urgent and unscheduled appointments each year.
And we'll make sure children's teeth are better protected. On top of our supervised tooth brushing programme already rolled out across schools in England, we'll bring in preventative measures for children's teeth, including better use of tooth resin sealants for children with a history of dental decay and applying fluoride varnish on children's without a full dental check-up.
Importantly, we'll bring in those measures dental staff have told us they need to feel rewarded, incentivised and a bigger part of the NHS.
Along with our changes last week to ensure that newly qualified dentists practise in the NHS for a minimum period, intended to be three years, we are rebuilding NHS dentistry.
It will take time, but it's only with this government that patients will have a repaired dental service, and an NHS that is truly fit for the future.
The changes Government announced will also require practices to provide a number of additional emergency appointments, on top of their regular patients, at an improved rate.
Tuesday marks the start of a six week public consultation on major reform of the dental contract - but, crucially, the Government has given no timeline for it to be implemented.
The Government unveiled its Ten Year Health Plan last week which sparked fears that proper contract reform will be kicked into the long grass until after the next General Election. It only said that by 2035 a new dental contract would be at the heart of a "transformed" NHS system. And there is uncertainty as to what extent the Treasury will fund radical reform.
The new interim measures being announced today are 'cost neutral' and will redistribute the existing NHS dentistry budget - which is only enough to treat half the population in England.
The share of government health spending allocated to dentistry halved under previous Conservative administrations, from 3.3% of the overall budget in 2010/11 to just 1.5% in 2023/24. The British Dental Association (BDA) says dentistry has been subject to real-terms cuts not seen anywhere else in the NHS.
Shiv Pabary, chair of the BDA's General Dental Practice Committee, said: 'These small, positive improvements are about as far as we can fix NHS dentistry while a broken system remains in place. We can steady the ship, but this is not the final destination for a service still at risk of going under.'
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