Key Features of recent House of Commons Health Committee report
A Health Select Committee (HSC) Review looking at Dental Services took place in March 2008 at the House of Commons. The committee announced its intention to undertake an inquiry into NHS dental and orthodontic services late in 2007 and has chiefly been examining the principles underlying the recent reforms and the extent to which the changes brought about have been consistent with these principles. The committee published its findings and recommendations in July 2007. The full report can be found at:
www.parliament.uk/healthcom
The British Orthodontic Society was able to present both written and oral evidence to the inquiry. We are pleased that much of our evidence has been reflected in the published report and encouragingly a number of recommendations have been made on some of the issues raised by BOS. The key features and recommendations of the report with respect to orthodontic provision are summarised below.
Key Issues highlighted:
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The lack of orthodontic provision in the UK and the uneven provision across the country.
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The flawed needs assessment methodology suggested in previous Department of Health (DoH) guidance, which is likely to dramatically underestimate treatment need.
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The benefits of Primary Care Trusts (PCT’s) and Local Health Boards (LHB’s) working with Local Orthodontic Clinical Networks to develop a greater understanding of the orthodontic needs of the area.
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That funding based on historic earnings alone has not addressed areas of under-provision.
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The inappropriate nature of using historic earnings as an indicator of historic activity and the problems caused for newly established and growing practices by the use of historic earnings as a baseline for contract values. These did not accurately reflect activity resulting in inappropriately low contract values for such practices.
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That commissioning skills are very variable with many PCT’s not doing a good job because of lack of appropriate training and insufficient use of Specialists or Consultants in Dental Public Health when assessing local need and commissioning services.
Key recommendations of the report:
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The DoH must base local funding on appropriate needs assessment and not just historic spending.
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That an appropriate needs assessment is carried out according to best available evidence and that the DoH clarify the evidence it has previously suggested as a basis for this.
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PCT’s/LHB’s should employ appropriately trained staff and make proper use of Consultants and Specialists in Dental Public Health. In addition the DoH must clarify how it intends to improve the performance of PCT/LHB’s who have failed to introduce the new contract with sufficient flexibility.
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More widespread establishment of Local Orthodontic Clinical Networks.
In general, the BOS welcomes the findings of the inquiry and sees the findings and recommendations as a step in the right direction that hopefully will go some way to resolving some of the problems that have arisen during the transition to the new dental and orthodontic contract. The DoH will now formally respond to the report although this response is not expected before the new session of parliament in the Autumn. On the back of this report and the anticipated DoH response, the BOS is keen to work constructively with the Chief Dental Officer and his team at the DoH to try and resolve some of the issues raised by the inquiry.
Richard Jones,
Chairman, Orthodontic Practice Committee of the British Orthodontic Society,
August 18th 2008
