Wales Announces Dental Contract Review

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Edwina Hart, Minister for Health and Social Services: "At the end of last year I announced a review of the dental contract and the establishment of a task and finish group to look at a range of issues to improve the way in which the contract works.

"The Review Group completed their work in July and submitted their Report. It concluded that the dental contract is broadly a workable system, and one which, with amendment, can be further improved.

It was very useful for me to see precisely where dentists, Local Health Boards and patients consider improvements can be made to the contract. On the basis of its analysis, the Group made 23 recommendations designed to increase the effectiveness of the contract and deliver improvements in oral health.

I made a statement at the time in which I said that the Group's recommendations deserved the widest possible consideration. As indicated at that time, the Report has been be distributed to every dental practitioner in Wales providing a NHS service, inviting comments on its proposals. Copies of the Review Group's Report were also made available to Assembly Members.

Consultation on the Report's recommendations went on over the summer and closed at the end of September. I am very pleased with the level of response. In total there were 162 replies to the consultation questionnaire from right across Wales, with dental practitioners in every LHB area responding.

Copies of the summary of the consultation responses will be made available to Assembly Members and placed on the Welsh Assembly Government website for more general availability.

There was clear overall agreement with the general findings of the Group's Report and well over sixty per cent of those who responded agreed or strongly agreed with its conclusion that the current contract was workable subject to the recommended changes.

Some of the Group's specific recommendations met with universal support. In particular the wish to allow dental practitioners to introduce a discretionary charge for patients who fail to attend appointments and ensuring annual growth of LHB primary dental care funding allocations.

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There was also strong support for national guidance on termination and transfer of dental contracts and the need for help in the upgrade of dental surgery equipment to meet new statutory requirements.

The current review of Units of Dental Activity as the sole contract currency was also seen as a key area. There is a sub group of the main Review which continues to work on these complex issues and I look forward to seeing their final report and implementation proposals.

I asked Professor Wayne Richards, as Chairman, to reconvene the Task and Finish Group to review the consultation responses and produce a further report for my consideration.

The Review Group met on 4 November and they will shortly be providing additional advice to me on their findings. Taking into account the views of those responding to the consultation, I have asked the Group to consider the need to prioritise the recommendations and to also identify any areas which responders felt were not adequately addressed in the initial Review.

Once I have received the Review Group's report from Professor Richards I will be in a position to consider an official response and to indicate how I wish to take forward the proposed changes.

Linked to the work of the Dental Contract Review Group is a need to lay the ground for consolidating and strengthening the Community Dental Service as part of our One Wales commitment to refocus provision of dental services to provide a new emphasis on public health.

Through the Review process I received a report, during the summer, on the future role and structure of the CDS which made a number of recommendations about the operation of the service. Some of these will need to be looked at in the context of the wider restructuring of the NHS in Wales. However they also recommended revised guidance on the role of the CDS and for the care of the vulnerable in society, including children from deprived areas and those people with special needs. This guidance was published at the end of October and will strengthen provision of dental services for those most in need and support the development of the CDS.

The CDS is also delivering the National Child Oral Health Improvement Programme – Designed to Smile – which is at the centre of the National Oral Health Action Plan for Wales.

I am pleased to be able to say that the first phase of the Designed to Smile programme commenced last month, and is already providing tooth-brushing programmes in well over 100 schools. This will be rolled out steadily across the 2 super pilot areas covering North Wales, Bridgend, Rhondda Cynon Taff, Merthyr Tydfil, Cardiff, and the Vale of Glamorgan areas. A number of schools in Swansea are also participating in the programme.

While the review of the dental contract and the subsequent consultation on its findings clearly shows that the dental profession wants to work with the current system there is still of course much to do. While we have stabilised NHS dentistry in Wales and built foundations for the future, we now need to ensure that the dental contract is working as well as it possibly can and delivering benefits to the public and those working in the dental profession."

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