PCTs Set To Claw Back Millions Of Pounds From Decaying NHS Dental Contracts, UK

Alarming new statistics uncovered by leading private dental plan administrator DPAS reveal that almost half (48 percent) of NHS dentists in the UK face financial penalties which could amount to over ??100 million.


The research was conducted under the Freedom of Information Act by DPAS chairman Quentin Skinner. It is the first of its kind to give such a detailed account of the delivery shortfalls of the widely criticised new General Dental Service Contracts (nGDS) following their first year of operation.


DPAS' findings reveal that 48 percent of NHS dentists have delivered less than 96 percent of their agreed units of dental activity (UDAs) during year one of the new contracts, the threshold at which PCTs may insist on making a financial recovery to 'claw back' funds. A number of PCTs are known to be in the red making financial penalties for dentists all the more likely.


While some dentists may be sufficiently close to the threshold to be able to agree with their PCT that they can catch up this shortfall in year two (2007 / 08), many are in a much worse position.


The research findings show that more than 11 percent of dentists were short by between 15 percent and 25 percent of their UDA commitment, with a further 11 percent falling behind by a staggering 25 percent.


"Without doubt, there are many NHS dentists all over the country who were so behind in the delivery of their UDAs last year that their cash-strapped PCTs now have no option other than to insist on claw back," said Quentin Skinner. "Indeed, we know from anecdotal evidence that some have already started doing so, with amounts being demanded running towards six-figure sums at some practices."


He added: "For those dentists who have under-delivered by four percent, the contract allows this shortfall to be made up by March 31, 2008 at the latest. Such dentists will have to do more work for less money, as their year two revenue is reduced by year one claw back, as well as coping with the pressure of this year's UDA requirements. Many will find that they have no option other than to agree with their PCT to accept a smaller UDA contract for years two and three and beyond. Thus they are in a position where their NHS earnings will be forced downwards in a one-way only direction."


Among the average findings are significant regional variations. One PCT reported that every single one of its NHS dentists was more than four percent behind. However, the statistics were generally fairly evenly spread over the country, albeit with slightly higher shortfalls in the South West and the West Midlands. The notable exception was the London PCTs (excluding the more affluent Westminster, Kensington and Chelsea PCTs), where the performance was consistently better.


The national average was brought down significantly by the outcome in these PCTs, who reported that just 23 percent of their contracted dentists had under delivered on average - over three quarters of their dentist providers passed the 96 percent threshold (and so will avoid clawback).















Commenting on these regional variations, Mr Skinner said: "Who knows what the underlying reasons are for this, but for such a significant variation there must indeed be a reason. Perhaps it could be an act of social engineering, by means of giving easier UDA targets to the inner city areas where access is seen as poor and so to encourage the provision of NHS dentistry there, or perhaps inner city practices have a different way of working?"


Concluding, Mr Skinner added: "It's all a very far cry from former Minister for Health Rosie Winterton's suggestion of 'the same money for five percent less work', and chief dental officer Barry Cockcroft's promises that the new contract would end the NHS treadmill and deliver guaranteed income. For those NHS dentists who fell short of the mark, the future certainly looks bleak.


"The research carried out by DPAS, together with the national statistics published on the overall total of UDAs delivered against those commissioned, would indicate that whatever the swings and roundabouts contained within the total figures, claw back amounting to over a hundred million pounds would appear to be on the cards."


nGDS


The new general dental contract was introduced in April 2006, when PCTs were allocated ring-fenced budgets and responsibility for commissioning primary care dental services. The new contract saw the move from a fee-per-item system to one based on locally-agreed contracts between dentists and their PCTs or other primary care organisations. In announcing the new contract to NHS dentists, the chief dental officer for England Barry Cockcroft promised it would deliver an end to the NHS 'drill and fill' treadmill; a guaranteed income; enhanced clinical discretion; and more time for preventative work.


DPAS


DPAS is a UK leader in providing dental practices nationwide with cost-effective independent, practice-branded payment plans. Operating as a payment collection agent on behalf of dentists, DPAS' services also include the arrangement of dental insurance.


Instrumental in the establishment and growth of private dental plans in the UK, the DPAS team is expert at supporting forward-thinking dental practices in offering a range of dental plans under the practice's own identity and control.


DPAS has unrivalled experience in helping NHS dentists coming under increasing 'catch-up or claw back' pressure from their primary case trusts as a result of under-delivering their contractually agreed units of dental authority (UDAs). DPAS has pioneered a fast-track conversion process helping dentists complete the journey to independence. Similarly, DPAS has a proven track record in helping practices move from other plans to its own, more cost-effective plans.


DPAS' flexible plan options mean a brighter future for dentists, their practices and their patients.

dpas.co.uk