The NHS Dental Services Contract came into force in 2006 in Wales and pays an annual amount for dental work which is split into Units of Dental Activity (UDA).
Because the payment is the same whether a dentist undertakes one or more similar procedures, the Committee was told there was no incentive for dentists to take on high-needs patients, as they would be paid the same amount for doing more work.
The Committee is concerned that the current UDA system may discourage some dentists from taking on high-needs patients, particularly in areas of deprivation where poorer access to dental services already exists.
Dai Lloyd AM, chair of the Health, Social Care and Sport Committee, said, “What is clear to this committee is that the current NHS contract arrangements for dentists simply aren’t working.
“Paying someone the same amount to deliver a course of treatment on a patient regardless of the amount of work involved makes little sense.
“Therefore, this committee believes it is time to end the current arrangements and find a new way of making sure everyone in Wales has access to quality dental services regardless of where they are.”
The committee also looked at waiting times for orthodontic treatment and ways of improving these.
Progress with the Welsh Government’s Designed to Smile programme was welcomed, but the committee would like to see the oral health programme extended to older children.
The Committee makes six recommendations in its report, including:
- That the Welsh Government replaces the current UDA targets with a new, more appropriate and more flexible system for monitoring outcomes to include a focus on prevention and quality of treatment
- That the Welsh Government ensures and monitors the consistent reinvestment of clawback money recovered by health boards back into dentistry services until a new system for monitoring outcomes is in place
- That the Welsh Government undertakes an evaluation to determine if the UK wide recruitment system effectively supports a strategy to increase the recruitment of those who are Welsh domiciled and the levels of retention of students generally following training.
The report will now be considered by the Welsh Government.