A number of challenges for local commissioning of dental services must be addressed, according to the results of a survey released yesterday. Alongside the survey is a practical guide to dental commissioning, produced by an independent working group led by Professor Chris Drinkwater of the NHS Alliance, to help primary care organisations to meet those challenges. Both initiatives were undertaken in light of the findings of the Health Select Committee's (HSC's) highly-critical 2008 report on dental services. That report expressed concerns about the national dental contract, saying it lacked the flexibility to meet the needs of patients and that primary care trusts (PCTs) needed to improve their commissioning.

The survey, which quizzed both commissioning leads and Local Dental Committee secretaries, found that 60 per cent of commissioners said that the national contract did not allow sufficient flexibility to meet local oral health needs, with 77 per cent of LDC secretaries agreeing. Less than a third of dental leads (29 per cent) agreed they received contracting assistance or advice from their strategic health authority and 27 per cent said they did not have the resources to develop changes to the national contract.

How long primary care trust and local health board commissioning staff had been in post was also investigated. More than a quarter (26 per cent) of the primary care organisation dental leads questioned had been in their role for less than a full year, with an average tenure of 3.4 years.

But despite concerns about the constraints placed on commissioners by the national contract, the survey found very positive attitudes towards liaison between practitioners and commissioners. Eighty-seven per cent of dental leads and 85 per cent of LDC secretaries felt the regular contact they had with one another was helpful. Consensus about priorities for dentistry was also obvious with access for new patients the most commonly cited for both groups.

Building on these findings, the Local Commissioning Working Group Report maps the commissioning cycle from start to finish, and provides practical guidance, tips and ideas for commissioning general dental services. It also sets each stage of the commissioning cycle in the context of the World Class Commissioning framework, explaining how competencies can be achieved and exceeded. The report is available at: bda.

Launching the report, Professor Drinkwater said:

"The research underpinning this report has presented some excellent examples of innovation on the part of commissioning teams around the country, but it has also demonstrated room for improvement in others. Drawing on examples of best practice and building on the World Class Commissioning competencies framework, this report has a clear focus on quality. We hope that it will be a valuable tool for both new and experienced commissioners, helping to achieve local oral health improvements and reduce inequalities."

Dr Susie Sanderson, Chair of the BDA's Executive Board, welcomed its publication:

"Effective local commissioning is essential to meeting the needs of local populations. This report provides a really good resource for commissioners that encourages excellence in the delivery of primary dental care. Importantly, in developing the work Professor Drinkwater has engaged with Professor Jimmy Steele, author of the review of NHS dental services published in the summer, to ensure that the two pieces of work are complementary. What's important now is that Government, dentists and the commissioners of care, work together constructively to improve the delivery of care to patients."

Notes

1. The Local Commissioning Working Group was established in January 2009. A summary of the research carried out by the BDA for the group is available at: bda.

2. The British Dental Association (BDA) is the professional association for dentists in the UK. It represents more than 23,000 dentists working in general practice, in community and hospital settings, in academia and research, and in the armed forces, and includes dental students.

Source
British Dental Association