Introduction to dental contract reform

1. Training pack for practices
Introduction to dental contract
reform

2. Objective of the dental contract reform
programme – Prototypes
The objective of the dental contract reform
programme is:
• To maintain or improve access
• Improve oral health
• Within the current financial envelope
• In a way that is financially sustainable for dental
practices, patients, and commissioners.

3. Support for change
• The reform of the current dental contract is a
well-established aim of this and successive
governments.
• It was repeated as a 2017 manifesto commitment
“We will support NHS dentistry to improve
coverage and reform contracts so that we pay for
better outcomes, particularly for
deprived children.”

4. Why are we doing this?
This is the
direction of
travel for NHS
services as put
forward in
Securing
Excellence in
Dentistry and
the Five Year
Forward View.
We need to
check
reformed
contract will
achieve its
goals of
improving
access and
oral health
whilst being
affordable.
We need to test
out practical
issues prior to
any national
roll-out.

5. • Running since early 2016
• Preventive pathway approach is at the heart of the
programme
• The prototypes are based on a blended remuneration
system where the contract value is split between
capitation and activity
• Are measured (not paid) against clinical and patient
indicators in the Dental Quality and Outcomes
Framework (DQOF)
• There are two blends, blend A and blend B
• Both blends are majority capitation
Introduction to prototyping

6. • Blend A – the capitation element covers band 1
care and the activity covers band 2 and band 3
care
• Blend B – the capitation element covers band 1
and band 2 care and the activity covers band 3
care
Practices will be expected to deliver all necessary
care to each patient on their list within their overall
contract value
The two prototype blends
– a summary

7. • Both blends use the same clinical pathway approach
• Contract values remain the same as UDA contract
value and practices are paid 1/12th each month
• Up to 10% of the contract value is at risk if capitation
and activity levels are not met
• Up to 2% of the contract value will be recognised
where capitation and activity levels are exceeded
• The regulations that underpin the prototype
programme currently run until 31 March 2020
Introduction to prototyping

8. • Proposals for
prototyping
published
• Call for
expressions
of interest
• Prototypes
selected – two
stage process
Spring 2015
• Prototypes
start to go live
Early 2016
Start
Prototyping
• Prototypes running
for necessary
amount of time to
extract learning
2017-2018
Scaling up/stress
testing
• Wave 4 go
live
commences
October
2018
2018-2020
Further testing
& potential
start of roll out
High level prototype timeline