Reforming NHS dentistry : ensuring effective management of risks, Department of Health

There is a strong rationale for modernising NHS dentistry, but significant risks will have to be managed if the new arrangements announced by the Department of Health are to be effective and provide value for money, according to the National Audit Office.

In particular, given the scepticism of some dentists compounded by a lack of detail on how the new system will operate, there is a risk that dentists will reduce their NHS commitments.

Today's report to Parliament by head of the NAO Sir John Bourn points out that modern dental practice emphasises prevention rather than intervention; but that the current piecework remuneration system - whereby NHS dentists are paid a fee for each NHS item of treatment they carry out - does not provide sufficient incentives for such an approach.

Given the overall shortages of dentists and the difficulties some patients are experiencing in accessing NHS dental treatment, NHS dentistry needs to provide a more responsive service.