Time to think again?

It is nearly three-and-a-half years since the NHS pilots began, and nearly five years since Jimmy Steele published his proposals in 2009. Just to remind you, that was in response to the Health Select Committee’s critical review of the UDA contract (now nearly six years ago).

A second report on ‘learning and outcomes’ from the pilots to date, published in early February, makes for mixed reading. There is overall enthusiasm from dentists and their teams, but what is not to like about a system which is financially protected from the real world, and most of all, free of the dreaded UDA and all its attendant woes? Patients are also reported to be welcoming of the reformed world of preventive care, but there is no update of the figure, reported in 2012, which showed that 60 per cent failed to return for their ‘preventive’ appointments.

It is disconcerting, to say the least, that accurate and valid data is only available for patient appointments up until March 2013 – over a year ago. Moreover, the same cannot be said for clinical data even up to that point. The report is, in part, a minority report, since access data for 46 of the original 70 pilot practices (the so-called ‘block payment’ group) is not analysed in detail. Why? Could it be that the decline in registrations in this larger group was even worse than that in the capitation groups (where 19 of the 24 practices who were actually analysed showed a reduction in patients attending)?