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Lookup NU author(s): Dr Richard HolmesORCiD, Emeritus Professor Jimmy Steele CBE, Professor Cam Donaldson, Professor Catherine Exley
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).
The aim of this research was to explore and synthesise learning from stakeholders (NHS dentists, commissioners and patients) approximately five years on from the introduction of a new NHS dental contract in England. The case study involved a purposive sample of stakeholders associated with a former NHS Primary Care Trust (PCT) in the north of England. Semi-structured interviews were conducted with 8 commissioners of NHS dental services and 5 NHS general dental practitioners. Three focus group meetings were held with 14 NHS dental patients. All focus groups and interviews were audio recorded and transcribed verbatim. The data were analysed using a framework approach. Four themes were identified: 'commissioners' views of managing local NHS dental services'; 'the risks of commissioning for patient access'; 'costs, contract currency and commissioning constraints'; and 'local decision-making and future priorities'. Commissioners reported that much of their time was spent managing existing contracts rather than commissioning services. Patients were unclear about the NHS dental charge bands and dentists strongly criticised the contract's target-driven approach which was centred upon them generating 'units of dental activity'. NHS commissioners remained relatively constrained in their abilities to reallocate dental resources amongst contracts. The national focus upon practitioners achieving their units of dental activity appeared to outweigh interest in the quality of dental care provided.
Author(s): Holmes RD, Steele JG, Donaldson C, Exley C
Publication type: Article
Publication status: Published
Journal: Health Policy
Year: 2015
Volume: 119
Issue: 9
Pages: 1218-1225
Print publication date: 01/09/2015
Online publication date: 25/02/2015
Acceptance date: 17/02/2015
Date deposited: 17/02/2015
ISSN (print): 0168-8510
ISSN (electronic): 1872-6054
Publisher: Elsevier
URL: http://dx.doi.org/10.1016/j.healthpol.2015.02.012
DOI: 10.1016/j.healthpol.2015.02.012
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