8 Jul 2019  •  Blog, NHS  •  5min read

The questions you should be asking in the run up to contract reform…

There are just months to go until contract reform begins being rolled out in April 2020. That means that any practice in England with some commitment to the NHS, needs to begin considering what it could mean for them.  

It’s not yet known whether practices will be given a choice to stay on their existing contract or choose either prototype A or prototype B. If you are able to choose, you need to know which one suits your business the most. And, if not and you are assigned one – with some forethought and planning you will better know where you stand and be able to make well-informed decisions from there.

To help you prepare for the changes as best as you can, we have created a quick list about the kinds of questions it’s worth thinking about now…

What is my practice’s current profile?

Take some time to think in ways you wouldn’t ordinarily do day-to-day about your practice. For clarity it can be helpful to write down or create a document with a synopsis of your business; especially if you may decide to work with consultants or third parties later down the line.

Having an up-to-date view of what your patient base looks like, in terms of numbers, demographics, whether your list is growing or shrinking, and whether they’re high or low needs, is key.

It’s also worth looking at your team, in terms of what roles you currently have – and whether there’s any opportunity for more mixing – and also their attitude to embracing the changes that are coming.

What is happening locally?

Regardless of exactly what happens with contract reform, there is likely to be targets related to access and patient numbers. According to the BDA ‘a substantial number of prototypes are having difficulties in hitting their capitation targets’ and in the prototypes activity targets were reduced by 20% for band two treatments and 30% for band three treatments.

Consider what is happening with other practices in your area – are new ones springing up or have some closed down? Do you expect demand to increase, stay the same or reduce?

How are the different contracts remunerated?

For several years, prototype practices have been testing two different ‘blends’ of remuneration based on differing levels of capitation and activity.

Prototype A – capitation accounts for approximately 60% of the contract and is used as the basis for band one treatments. Activity accounts for around 40% and is used as the basis for band two and three treatments.

Prototype B – capitation accounts for approximately 85% of the contract and is used as the basis for band one and two treatments. Activity accounts for around 15% of the contract and is used as the basis for band three treatments.

Is there a preferred option?

The BDA and ADG have said that their preferred option is blend B. This is due to more weighting being given to capitation. Prototype B practices have also generally fared better than A when it comes to clawback; around 25% of all prototypes have had clawback.

Evaluation reports have shown that 21% of blend B practices aren’t meeting their targets, compared to 32% of blend A and 38% of UDA practices. The analysis shows that both A and B practices required additional surgery time and more recruitment to meet the targets.

A total of 200 NHS dentists gathered at events held in Durham and Solihull to hear from and ask questions to a panel of experts, including those involved with the BDA and prototype practices, about the future of NHS dentistry.

More free ‘What Next for NHS Dentistry?’ events will be held throughout the country. The next two are in June 2019 in Gatwick and Manchester. Find out more and book your place here.

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