Improved payment system to expand services – but BDA says the reforms will not repair a ‘broken system’
NHS dental teams will receive increased fees under a new payment structure which will help them to provide enhanced NHS care and treatment.
Developed in partnership with the dental sector and as part of the Oral Health Improvement Plan, the reforms also include an additional £10 million from the Scottish Government to support the delivery of laboratory-based treatment items, such as dentures.
The updated system will drive greater consideration of patients’ specific oral health needs, with more focus on patient-centred care such as preventative periodontal – gum disease – treatment.
For dentists it will streamline Item of Service payments by reducing the numbers of fees from over 700 to 45, cutting bureaucracy and giving them greater authority over the treatments offered.
While patients that are required to pay a NHS charge are likely to see an increase in costs, this will be dependent on overall treatment plan. Around 40% of patients will continue to receive free NHS care and treatment, as they did under the previous arrangements.
Public Health Minister Jenni Minto said: “This new NHS offer improves the system for both dental teams and patients and is the first step in the process to make the services available on the NHS reflect the changing oral health needs of the population. It also reaffirms our commitment to the sector and to all NHS patients in Scotland.
“We are confident that the modernised system, with increased clinical freedom for dentists, will provide longer-term sustainability to the sector and encourage dentists to continue to provide NHS care.
“All patients will continue to receive free NHS dental examinations and I want to reassure those who are exempt from NHS dental charges – including children and young people under 26, and those on certain benefits – they will continue to receive free care and treatment. People on a low income are also eligible for support, details of which can be found on NHS Inform.
“I’d like to take this opportunity to thank all NHS dental teams for their continued engagement and commitment to NHS dentistry. Increased costs for energy and the cost of living crisis still pose challenges for them but we will continue to work together to ensure the best quality of care is available.”
The British Dental Association has said Scottish Government reforms to NHS dentistry announced today fall short of the root and branch change required to make the service fit for the 2020s.
Following tense negotiations, a reformed payment system will be rolled out from 1 November 2023. This includes changes to the fees provided for many treatments and will see the number of items on the ‘menu’ at dental practices slimmed down – purportedly meant to make it less burdensome – to 45 codes down from around 400. The BDA had stressed that surging costs had left practices delivering some NHS care at a financial loss, particularly for items like dentures that require laboratory work. These items have seen significant increases in fee levels.
However, the professional body has stressed reforms offer no fundamental changes to the current model of care. The service is still predicated on a low margin/high volume system, without the appropriate targeting of resources for those in highest need. The BDA had been seeking a clean break towards a new patient-centred and prevention-focused model and say the package as it stands will do little to tackle deep oral health inequality across Scotland.
Dentist leaders have warned ministers not to view the current package as a ‘final destination’. There is uncertainty over whether these changes will be sufficient to halt the exodus of dentists from NHS services and restore access to millions.
The Scottish Parliament COVID Recovery Committee recently concluded its inquiry into the recovery of NHS dentistry, including a recommendation that the Scottish Government provide costings for – and consults on – different service model options, including those that it does not prefer, in partnership with the sector so that the opportunity is not missed to consider a full range of options for the future of service delivery.
David McColl, Chair of the British Dental Association’s Scottish Dental Practice Committee said: “We’ve secured some improvements, but the fundamentals of a broken system remain unchanged.
“The Scottish Government have stuck with a drill and fill model designed in the 20th century. They were unwilling to even start a conversation on making this service fit for the 21st.
“Ministers cannot pretend this is a final destination for NHS dentistry in Scotland. We struggle to see how these changes alone will close the oral health gap, end the access crisis or halt the exodus from the NHS.”
Anyone struggling to pay for their dental care is urged to visit NHS Inform to view the support available. Patients can check if they are exempt from NHS dental charges by visiting NHS Inform.
For those not eligible for exemption but on a low income, financial support is available via the NHS low income scheme. Patients can apply for this support by completing a HC1 form. Paper copies can be picked up at community pharmacies, GP practices, Citizens Advice Scotland offices and Jobcentre Plus offices.
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