Department publishes evaluation of prototypes
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- Published: Wednesday, 23 May 2018 07:32
- Written by News Editor
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The Department has published: Dental Contract Reform, Evaluation of the first year of prototyping 2016-2017. It shows some progress, with the clinical model well accepted by the profession. However further work needs to be done and adjustments made to the business model to improve the sustainability for practices. More practices should be recruited.
Conclusions
Given the analysis of the data collected and the feedback and views of the prototype practices at the engagement events, it is the ERG's view that:-
- Progress has been made in the first year of prototyping on the key issues of improving oral health, providing appropriate care and quality, and maintaining or increasing access to merit continuation of the programme.
- The clinical model is well accepted by the profession, however further work needs to be done and adjustments made to the business model and in a range of areas to improve the sustainability for practices.
- To improve the robustness of evaluation, and of any adjustments made, further practices should be recruited to the programme.
It is important to consider that it is possible to continue to develop and test an approach, looking to get the best contract for all parties, but to recognise that at some point a decision has to be taken that the approach is “good enough” for scaling up. It is a balance of risk for all parties and this point has not been reached yet.
Recommendations
Based on the findings in this report, 17 recommendations have been made:
- Consideration is given to extending the period over which patients are transitioned from the 2006 contract system to the new clinical pathway approach.
- Consideration is given to managing any future transition in areas where supply is greater than demand.
- The length of the capitation period used in the prototypes is explored more fully.
- The DQOF sub group continues to develop the DQOF and its use.
- A patient survey is carried out to determine the impact of the prevention advice on patients’ oral health behaviour.
- A detailed piece of work is undertaken to understand the reasons and rationale from patient and professional perspectives for the approach to implementing the longest recall periods recommended by NICE.
- The outcomes of the PREFER trial should feed into the review and development of the risk communication aspects of the clinical pathway.
- The programme continues to monitor oral health at the practice, population and individual level, and that specific work to quantify the preventive activity takes place.
- That further practices are recruited to the programme and randomly allocated to the Blends so as to provide a more robust evaluation of the Blends.
- The exchange mechanism is more widely promoted and consideration is given to renaming the Expected Minimum Activity (EMA) measure.
- When reform of contracts takes place, public facing communication is developed and delivered by the local health system to support scaling up.
- A well designed comparison in terms of the National Health Service (NHS) commitment in matched practices is carried out.
- The programme looks into how a robust and independent view of the impact of the prototypes on practice profitability may be established and reported.
- A form of weighting, that supports the objectives of ensuring equitable access for patients, fairly reflects the resource required to meet the needs of patients and will be capable of working as part of the new models of care should be explored and tested through the remuneration workstream of the programme.
- The contract design and the supporting infrastructure, software and NHS BSA data should support transparency of information for providers and performers to improve the sustainability of dental practices and the practice workforce.
- Robust economic analysis is undertaken to establish a more sophisticated understanding of the value for money being delivered by the prototype practices.
- Work with practices and software companies is undertaken to improve the quality and completeness of the information on private treatment delivered by the prototypes.
See this GDPUK news story: BDA responds critically to prototype evaluation https://www.gdpuk.com/news/latest-news/2957-bda-responds-critically-to-prototype-evaluation
Link to report: https://www.gov.uk/government/publications/dental-contract-reform-evaluation-report-2016-to-2017
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