N
obody likes change but businesses who prepare for and deal effectively with different ways of working often prosper over the long-term – especially when it comes to accelerating quality and boosting performance.
The dental industry here in the UK is a sector where massive change is looming with modernisation driven by Westminster-led dental reforms and a pilot scheme aimed to fine tune contracts between dentists and the NHS. It has been labelled the ‘care pathway’ approach and, love it or hate it, it is likely to be rolled out sometime in 2017.
After sitting down with people across the industry in recent months it is clear that many practice owners and managers have, unintentionally, failed to grasp or understand how their world will change. So what actually is happening? Put simply, NHS dental contracts are being revised with the intention to focus more on the customer by measuring the performance of dentists through a qualitative approach.
It will see dentists being paid for the number of patients they care for and the positive health results they produce – a move which is radically different to the current numbers-based system whereby dentists are paid solely on units of dental activity.
Nearly 70 practices are currently working under the trial pilot contract arrangement. These practices are basically acting as guinea pigs which are helping to fine tune aspects of the new contract and bring a sense of industry realism and evaluation. As part of the proposals, these practices are also currently using the care pathway approach – a term the industry will become more familiar with. Care pathways have historically been used to support quality improvement and measure treatment through standardising clinical processes.
Interestingly for dentists, it’s an approach which will offer guidance and information on treatment for patients depending on their oral health. Whilst some have commented it is a bit ‘big brother’ what it does give is a new information flow which makes sure practices deliver quality and first-class care.
We’ve seen some mid-term reviews on how the trial is being received but many have commented that it would’ve been useful to have seen more evidence on how dental practices, who are part of the pilot, are coping.
A simple straw poll as I’ve travelled around the country over the past few months suggests a good response. Most practices, if not all, recognise the faults with the current contract and that quality and safety must sit at the top of the tree. Some have quite rightly suggested it will rid the UK’s dental industry of poorly performing practices - a stance the majority will side with. It’s also clear dentists who are part of the pilot are focused on preventive care and a handful of sites are also trialling a new self-care plan.
At present the obvious criticisms surround income levels, which in one of the proposed regimes, could drop, alongside turnover. But (and this is a well-considered ‘but’) it’s right to say that only good performing dental practices will survive or prosper. Practices who give consistently poor clinical service to patients – and therefore dip in the commissioning board’s rating model – will struggle. Some will cease to exist. That’s a hard message but it is important that dentists properly grasp what these changes could bring.
A world of pain awaits those practice owners or managers who allow the details of the reforms to bypass them. The message is clear and simple, take expert advice quickly to understand, over and above what the NHS is communicating, what steps you must take now and what stepping stones you have set today for an easier tomorrow. In a little over three years dentistry in this country will be based on quality, not quantity. Practices can’t afford to get caught up in the latter.