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Dental care changes report due Reform of dental care proposed
(about 4 hours later)
The findings of a review into how dental services in England should change are to be published later. An independent review has recommended significant changes to the way NHS dentistry is organised in England.
The independent review, ordered by ministers, will consider the continuing problems in access to NHS dentists. They include a return to linking a significant part of a dentist's income to the number of NHS patients registered on their books.
It will also look at how dentists are funded, and how to ensure high-quality NHS dental care. Another proposal is to make dentists "more explicitly accountable" for providing high quality, long-lasting treatments.
A spokeswoman for the British Dental Association said it was "vital" to address the problems which existed for doctors and patients. Ministers say they will pilot some of the recommendations in the autumn.
Complex treatments concern This review is a vision of a better deal for both patients and dentists Professor Jimmy Steele, review author class="" href="/2/hi/health/8112538.stm">Q&A: NHS dentistry
Health Secretary Andy Burnham said: "I recognise that more needs to be done to bring NHS dentistry up to the standards that patients should expect.
"We and the NHS are committed to ensuring that anyone can access high quality dental services."
Professor Jimmy Steele, who led the independent review, said: "This review is a vision of a better deal for both patients and dentists.
"It is about making sure that patients can see an NHS dentist who will take long-term responsibility for their care."
New contract
A new dental contract for dentists was introduced in April 2006 in an attempt to widen access for NHS patients.A new dental contract for dentists was introduced in April 2006 in an attempt to widen access for NHS patients.
It aimed to reform the so-called "drill and fill" culture by effectively paying dentists the same amount to see slightly fewer patients.It aimed to reform the so-called "drill and fill" culture by effectively paying dentists the same amount to see slightly fewer patients.
In theory this allowed them to spend more time with their patients so they could also give them advice about oral health, rather than trying to maximise throughput to maximise their income.In theory this allowed them to spend more time with their patients so they could also give them advice about oral health, rather than trying to maximise throughput to maximise their income.
But it has proved highly unpopular with the profession - and with the public.But it has proved highly unpopular with the profession - and with the public.
We shall make the recommendations we feel we need to make, and will do so in the spirit of trying to move forward to a better service Professor Jimmy Steele, review author class="lp" href="http://news.bbc.co.uk/1/hi/talking_point/default.stm">HAVE YOUR SAY Perhaps one day there will be a review where the public will be asked for their opinion Rob Allsopp, Oldham class="" href="http://newsforums.bbc.co.uk/nol/thread.jspa?forumID=6626">Send us your comments
Opposition parties have also been highly critical of the effect of the contract, with the Conservatives in particular calling for a return to patient registration.
Figures show 1.2 million fewer patients visited a dentist in England in the two years to June last year than in the period before the reforms were introduced.Figures show 1.2 million fewer patients visited a dentist in England in the two years to June last year than in the period before the reforms were introduced.
Under the contract, patients paid fixed charges for particular types of procedure and local primary care trusts were given the power to commission and pay for dental services.Under the contract, patients paid fixed charges for particular types of procedure and local primary care trusts were given the power to commission and pay for dental services.
There has also been criticism that because dentists now receive a flat salary, they no longer have any financial incentive to carry out difficult work such as crowns and bridges.There has also been criticism that because dentists now receive a flat salary, they no longer have any financial incentive to carry out difficult work such as crowns and bridges.
In the first year of the contract, the number of complex treatments - including bridges and crowns - which involve laboratory work was halved, and the number of root canal treatments fell by 45%.In the first year of the contract, the number of complex treatments - including bridges and crowns - which involve laboratory work was halved, and the number of root canal treatments fell by 45%.
In Scotland and Northern Ireland, not covered by the changes, the number of complex treatments rose.In Scotland and Northern Ireland, not covered by the changes, the number of complex treatments rose.
The contract also covers Wales, although the review only deals with services in England.The contract also covers Wales, although the review only deals with services in England.
'Notable difficulties'
It has been led by Professor Jimmy Steele of Newcastle's School of Dental Sciences.
In a blog on the Department of Health website, which he wrote while the review was being carried out, he said: "This is an independent review and I am an independent chair.
"We (the team and I) shall make the recommendations we feel we need to make, and will do so in the spirit of trying to move forward to a better service and not looking backwards to apportion blame or responsibility for any previous decisions."
Susie Sanderson, chair of the British Dental Association's executive board, said: "The 2006 reforms caused significant problems for patients and dentists; notably difficulties in accessing dental care and a system that does not encourage the provision of preventive care.
"This is an opportunity to address those problems and it is vital that it is taken."
But she said Professor Steele's review had been "notable for its openness".
Ms Sanderson said the BDA looked forward to a "constructive dialogue" with the Department of Health about its recommendations.