With no fixed timeline for the introduction of any new NHS contract, and some suggesting it could be rolled out from 2018/19, while others predicting a post-Brexit 2021 start – the lack of a set deadline is causing uncertainty in the profession. In light of this we asked Eddie Crouch for his take on the situation and when he thinks the contract will come into effect.
‘I think this is a question that a lot of people would like a definitive answer to, including myself! I remember that at the last BDIA Showcase, during a live debate session, I remarked that the current prototypes had been going for six months, and the evaluations had started. At that time, my personal feeling was that it was far too early to reach any conclusions. Some people were saying that a revised contract was likely to be issued before the next general election. Indeed, the original plan for the reform programme, which was to carry out prototypes in 2016/17 and then upscale, or increase the size or the prototypes, in 2017/18, with roll out in 2018/19.
‘Well, we are now several months on and I am still waiting to see any evaluation of the prototypes and there is no sign of upscaling from April that I am aware of. Indeed, there may be downscaling as I am hearing some involved in the prototypes consider the risk of clawback sufficient to consider leaving on March 31 2017; others may be removed for falling too far behind in patient numbers.
‘We are being told the pilots tested the care pathways and clinician aspects (deemed to be a success); and that the prototypes are testing the business models. Clearly access is still the major marker for success for the Department of Health/NHS England and practices need to work harder and invest more to maintain all that goes with the prototyping.
‘However, politically, the Minister [Rt Hon Alistair Burt MP] states he remains committed to contract reform, but one wonders if civil servants behind the scenes are less enthused by change in a system of UDAs that appears to be holding the access levels up while recouping great chunks of budget in ever-increasing clawback.
‘Many practices have been hoping for change for nearly eight years now, since the Steele Review, and they must be wondering when that change will happen or, indeed, if it will happen. Failure to deliver in this Parliament may make many consider their futures outside of NHS dentistry.’
So, whilst we can’t mark a definite date in the calendar just yet and there may be several more years of uncertainty, the other side of the coin is that this does give time for practices to research the options and prepare for the change so they are in the best position for when it does happen.