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If you have ever tried running with, or been involved in training exercise with a bungee cord, you know how difficult it can be. For those of you who haven't have the (dis)pleasure, it involves some lump of 300 pounds standing at one end, yelling at you to run to the other end of the hall with this giant harness wrapped around your waste and a bungee rope behind you, while simultaneously trying to stop that from happening by yanking on said bungee rope. Sounds a hoot, I know.

People who offer training in this fashion tell me it increases core strength, an absolute must for any exercise fanatic keen to become the 300-pound behemoth one day yelling at other unsuspecting souls to get a wriggle on. Get your core right, and you can build everything around that, is the principle.

It makes you wonder whether this is NHS dentistry in a nutshell. I have been in situ as editor of BDJ In Practice for approaching six and a half years, and even in the first publication I sent to press, 'contract reform' featured heavily. Has dentistry been a part of the world's longest workout, trying to move towards contract reform, with ministers pulling vigorously at the resistance band?

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© Marco VDM / E+ / Getty Images Plus

If so, then the core work done by those demanding contract reform saw something finally happen last month. On Tuesday 19 July, NHS England sent out a letter headed 'Outcome of 2022/23 Dental Contract Negotiations' and contained a rather triumphant-sounding paragraph that read 'These reforms represent the first significant change to the contract since its introduction in 2006. They follow 12 months of engagement with stakeholders and the profession, and in recent months a set of more focused conversations with the British Dental Association, after NHS England was asked by the government to lead on the next stage of dental system reform in March 2021'.1

The announcement was welcomed by the College of General Dentistry (CGDent), the Oral Health Foundation and the British Society of Paediatric Dentistry. The British Dental Association - named checked in the announcement from NHS England and very much to the fore in contract reform negotiations - were rather more circumspect, announcing they would be taking a 'neutral position' on the new package of changes, neither endorsing nor rejecting what it characterised as modest and marginal fixes to the widely discredited NHS dental contract.

The million dollar question is will these changes make a material impact on the day-to-day lives and working environment of the dental profession? Are they significant enough to see a visible change in course? Are you, the membership and those at the coal face, pleased with these changes? What do they represent - the carrot of real change coming, or failure of bringing about meaningful reforms? Will they bring about a better working environment? The BDA is sceptical, to put it mildly, and who can blame them.

As any good trainer will know, training does not stop - once you commit to change, you're on that metaphorical (and literal) treadmill to maintain and build upon your gains for life. Change does not happen overnight, and it is not immediate. You have to start somewhere, and this announcement from NHS England could be that starting point. Could it be that the significant groundwork and core building that precedes this announcement will now allow for faster, more significant reforms? We all hope so. By taking a 'neutral position' on the changes while simultaneously appearing to be critical of them in the same release, I wonder whether the BDA has training fatigue. Demanding reform for so long and being given something so 'modest and marginal', in their words, highlights just how fed up the BDA is of waiting for meaningful progress.

I wonder, is this is our bungee cord training moment, a small breakthrough that precedes a larger change? I have my doubts, but it would be churlish not to acknowledge progress, however small. And, like in a training environment, perseverance when you expect immediate change is key. If this is the precursor to wider reforms, great. If this is where change terminates, so will NHS dentistry.