Pull the other one

DENTISTS in the North-East face having their funding pulled by health bosses as fears rise that many have failed to meet controversial targets.

DENTISTS in the North-East face having their funding pulled by health bosses as fears rise that many have failed to meet controversial targets.

Shiv Pabary

Practitioners have previously warned there will be no NHS dentists left in the region in two years time as the new contract is driving them away.

They believe the reforms brought in on April 1 last year, have not improved patient access to dentists, removed dentists from “the treadmill” of the old system or encouraged a more preventative approach to dental care.

Many surgeries have been forced to switch to private care leaving thousands of patients without an NHS dentist.

Now there are growing concerns that if funding from the region’s primary care trusts is clawed back because of missed targets many more will leave the NHS.

MPs last night called for the contract to be reviewed.

North-East British Dental Association spokesman Shiv Pabary said dentists had received figures on their performance against the targets in recent weeks although they had not yet been made public.

He said in the NHS North of Tyne, which covers Newcastle and North Tyneside Primary Care Trusts and Northumberland Care Trust, a quarter of the 200 dental contracts hadn’t hit their targets.

North of Tyne disputed this figure but would not provide an accurate statistic as it said bosses were still analysing the information and talking to individual dentists.

“The feeling is that dentists haven’t hit the targets for different reasons,” said Mr Pabary. “The funding has been given up front so if a dentist hasn’t made a target it is classed as a breach of contract. The PCTs may take the funding back for the work that hasn’t been done.”

If the reduction in funding is continued for the coming year the surgeries would no longer be viable and may close.

Mr Pabary, based at Lesbury Dental Clinic in Heaton, Newcastle, said: “Practices would have to downsize and they wouldn’t be able to treat the same number of patients. If they do that then more dentists will leave the NHS and more people will end up without an NHS dentist.”

The figures are expected to be released soon by the Department of Health. Less than 96% Units of Dental Activity achieved is classed as a breach of contract.

Durham City Labour MP Roberta Blackman-Woods and North Durham’s Kevan Jones have raised concerns directly with the Government over a shortage of NHS dentists in the county.

Ms Blackman-Woods said: “If we have got dentists not fulfilling it and pulling out then we have got to look at that contract.”

A spokesperson for NHS North of Tyne said: “Due to the hard work and dedication of dental practices in Newcastle, North Tyneside and Northumberland – a 95% average was achieved for contracted UDA work – with some practices doing more than their contract value and some doing less.”

Mr Jones said that other trusts could learn from Durham PCT, which has used money it would have spent on NHS patients to part-fund a brand new practice in Pelton, which has slashed waiting lists.

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Targets have led to huge queues

THE new contracts for dentists were introduced on April 1 last year and have been criticised by the profession ever since.

The British Dental Association points to NHS dentists going private and other practices have been inundated with patients – with queues lining the streets to sign up where places are available.

Richard Fretwell, of Guide Post Dental Practice, near Ashington, left the NHS in November 2005 ahead of the new contract.

The practice shed 3,500 NHS patients and instead opted to treat just 2,500 people privately, with Mr Fretwell saying the effect of the changes has been “unprecedented” as local practitioners have been forced to chase “untried and untested” targets.

Other practices that have closed include Anne Davidson’s in Durham Road in Gateshead, which looked after more than 2,000 patients and had spent over 40 years with the NHS.

And Tyne Valley dentist Richard Parker took his Hexham practice out of the NHS in December 2005.

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The points system is ‘impossible’

BEFORE the reforms patients were charged for each treatment and dentists were paid accordingly.

Now there are only four set charges for patients and dentists must notch up a set amount of points – Units of Dental Activity – to get paid.

Dentists have said the UDA system is impossible because the points awarded do not reflect the time taken.

For example they get three points for fillings, whether a patient needs one or 12 at any one time.

Consequently if they treat high need patients they will struggle to meet the targets. If they do not hit their targets their funding will be cut.

The following banding prices are subject to inflation.

BAND ONE: Patients are charged £15.90 for a check-up or scale and polish. Dentists receive one point.

BAND TWO: £43.60 for fillings, whether they need one or 12 fillings at any one time. This also includes root canal work which can take two to three hours. Three points.

BAND THREE: £194 for complex treatment like crowns or dentures.
12 points.

BAND FOUR: £15.90 for initial work, like a temporary filling, needed as an emergency. 1.2 points.

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