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Flexible Commissioning: A prevention and access focused approach in Yorkshire and the Humber

BDJ In Practice volume 33, pages 20–22 (2020)Cite this article

The current dental contract was introduced in April 2006, and resulted in significant changes for the commissioning arrangements of dental care services in England and Wales.3 Scotland and Northern Ireland continue to operate under predecessor systems where patients are registered under a capitation or continuing care arrangements with the dentist and fee per item of service respectively, as set out in the Statement of Dental Remuneration.4

The introduction of the new General Dental Services (GDS) and Personal Dental Services (PDS) contracts, based on Units of Dental Activity (UDA), in England and Wales has been met with some criticism for focusing on target delivery over the quality of care or prevention.5 In areas of deprivation and poorer oral health, the risk of failing to reach targets is higher. Recruitment of dentists is more challenging in these areas combined with high needs patients requiring more clinical time. Practices are disincentivised from treating patients with high oral health needs due to increased care time required. This can lead to missing targets, clawback, contract hand back or contract reduction.6

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References

  1. Wenzel L, Robertson R. What is commissioning and how is it changing? 2019. Available from: https://www.kingsfund.org.uk/publications/what-commissioning-and-how-it-changing (Accessed January 2020).

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  9. Public Health England. Delivering Better Oral Health: an evidence-based toolkit for prevention Summary guidance tables. Available from: https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention (Accessed January 2020).

  10. NHS England. Standard Clauses for a Personal Dental Services Agreement - July 2018. Available online at: https://www.england.nhs.uk/wp-content/uploads/2018/08/standard-clauses-for-a-personal-dental-services-agreement-2018.pdf (Accessed January 2020).

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Author information

Authors and Affiliations

  1. School of Dentistry, University of Leeds, Worsley Building, Clarendon Way, LS2 9LU, Leeds, UK

    Zhain Mustufvi, Olivia Barraclough, Stefan Serban & Gail Douglas

  2. Local Dental Network, North Yorkshire, North Yorkshire, UK

    Simon Hearnshaw

  3. Yorkshire and the Humber Centre, Public Health England, Leeds, UK

    Sandra Whiston & Siobhan Grant

Authors
  1. Zhain Mustufvi
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  2. Olivia Barraclough
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  3. Simon Hearnshaw
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  4. Sandra Whiston
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  6. Stefan Serban
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  7. Gail Douglas
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Correspondence to Zhain Mustufvi.

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Mustufvi, Z., Barraclough, O., Hearnshaw, S. et al. Flexible Commissioning: A prevention and access focused approach in Yorkshire and the Humber. BDJ In Pract 33, 20–22 (2020). https://doi.org/10.1038/s41404-020-0296-9

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