Dentist access in Buckinghamshire worse since reforms (From Bucks Free Press)

Dentist access in Buckinghamshire worse since reforms

3:27pm Friday 12th February 2010 in

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FEWER Buckinghamshire patients have access to an NHS dentist than when much heralded reforms were introduced almost four years ago, bosses said today.

In December 41 per cent of people had access – down from 43 per cent when a new contract was introduced in April 2006.

Many dentists stopped providing NHS care when the contract, which scrapped registration and set an annual ‘target’ of procedures, was introduced.

The move comes despite Bucks health bosses opening extra practices and buying more work from dentists.

The Department of Health’s website says the contract was ‘designed to help provide better access’.

Now bosses have been given targets to improve access, 45 per cent of residents by March 31 and 58 per cent 12 months later.

This needs extra funding, said dental boss Michelle Campbell, who warned: “We have some way to go to reach these targets.”

The NHS Buckinghamshire authority is buying in £4.3m of extra work in 13 of the county’s most deprived areas, she said, to begin in September and serving 65,000 people.

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Yet she said access is being hampered in part by the way the new contract works, where dentists have to meet a yearly number of ‘units of dental activity’.

If a dentist does six fillings in a session then that is one UDA, councillors heard – but they could tell the patients to come for six visits, giving them six UDAs.

The system created ‘perverse incentives’ said NHSB consultant Paul Batchelor.

“It is a ridiculous system, absolutely ridiculous,” he told a Buckinghamshire County Council NHS watchdog committee today.

Miss Campbell said: “It is not a fail safe process, unless you have somebody within the practice looking at every single patient. We can only work with the data we have got.”

Yet she said more appointments are available – even though some people think they are not.

She said: “They haven’t actually tried to find one. It is getting the message out there.”

A county survey found 64 per cent had visited a dentist in the last year and this was broadly split between NHS and private care.

About half thought they could see an NHS dentist and half said costs did not put them off.

About 40 per cent said getting an appointment is easy – but the same amount disagreed.

Under the reforms people no longer register at practices and only register for a course of treatment.

They pay one of three charges, £16.50, £45.60 and £198 instead of a choice of hundreds.

Miss Campbell and Mr Batchelor were speaking to the council’s overview and scrutiny committee for public health services.

It also heard dental access for OAPs in homes has ‘fallen dramatically’ and efforts are being made to tackle it.

Care for vulnerable people and those with learning disabilities is being reviewed and could be changed, Miss Campbell said.

Click the links below for the NHS’s full report and other dentist stories.