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John Milne & Dr Stuart Allan: NHS Contract Reform #WHFevents

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John Milne & Dr Stuart Allan eye the stalled NHS Dental Contract reform

Senior National Dental Advisor, Surgery, for the CQC, John Milne, is staggered that NHS Dental Contract reform is still on the agenda at the Westminster Health Forum. Since Professor Jimmy Steele put his prevention-based pilot proposals together in 2006 contract reform has groaned to a halt and NHS dentists remain caught in the UDA hamster wheel (The latter are Dental Review’s words not John’s).

John was there to talk about the ongoing evolution of the Care Quality Commission, which sees the regulator becoming simple and safe while concentrating on having the greatest impact on people’s experience of care. Smarter, more flexible regulation should be targeting practice resources to make them more effective.

CQC aims to be less burdensome for the people it regulates, providing support to help health service improve their quality of care. This means improving alliances with service providers such as dental practices. CQC’s transitional regulatory approach will see the regulator contacting practices for an hour-long telephone call to gather any concerns and build a model of the best ways to guide dentistry for the future.

There will only be a need to CQC visit when real problems are indicated.

John then returned to the subject of the reformed NHS contract, under which he believed care must be safe, effective, caring responsive and well-led. Access must be addressed. He then responded to the question of what the NHS can afford, which he dismissed as: “The wrong question.”

He posited that the right question is to ask what the NHS wants? Currently NHS dentistry costs around £3 billion per annum, which isn’t very much. The NHS could afford more. The true question is to ask how important dental health is to the government and the NHS. The fact is that oral health is hugely important and has a massive effect on people’s lives.

Dr Stuart Allan, Professional Advisor – Dentistry, Greater Manchester Health and Social Care Partnership

Dr Stuart Allan took up the thread by observing that contract reform was really hard and that there was no silver bullet that could trigger change. However, statistics demonstrate that the only system that has improved access to NHS dentistry to date has been a capitation scheme.

He advised that we should try not to waste a good crisis. There was an opportunity to rebuild dentistry as we come out of the COVID pandemic. The thing is that rotten teeth and gums are preventable. Think about improving the nation’s diet and do something about sugar – then address the toxic system of UDAs that act as a barrier to dental treatment for those most in need.

The delivery of prevention can’t be based on outcomes in the UK’s most deprived areas when the patient’s daily routine is chaotic. There’s no point in talking about teaching children to brush their teeth for two minutes morning and evening when their parents can’t follow any regular regimes. It is a waste of time and breath.

He added that there needs to be an alignment between contract and commissioning, and there is a desperate need for NHS contract reform, because at the moment the NHS measures what it wants – but it only wants what it can measure.