We acknowledge that this ambitious programme of work will require both new investment and the realignment of certain existing funding streams. Our intention is to proceed in a progressive manner in order for practices that provide GDS to have the opportunity to plan accordingly whilst maintaining their financial stability.
Payments to General Dental Practitioners/Dental Practices
The strength of the existing payments regime for GDS is that there is a mixed economy of item of service, capitation and continuing care payments, and individual and practice allowances. We will continue to retain a mix of payments going forward, but the balance of payments will change accordingly.
In summary there will be:
- a new system of capitation payments to support preventive care and treatment in children and young adults, supported by monitoring;
- a new system of enhanced continuing care payments to support the introduction of Oral Health Risk Assessments for adult patients;
- a simplified set of item of service payments for restorative care and treatment;
- changes to the General Dental Practice Allowance to incentivise general dental practices with patients from more deprived communities;
- changes to the reimbursement of rental costs to ensure that payments are based on an appropriate size of practice and taking into consideration its location;
- a new NHS commitment criteria; and
- a single quality-based practice allowance which reflects the unique circumstances faced in both remote and rural areas and deprived communities.
Payment Verification ( PV)
Practitioner Services make all payments under the Statement of Dental Remuneration ( SDR), on behalf of all NHS Boards. We need to encourage a stronger partnership model between NHS Boards and NSS to ensure that payment verification is carried out thoroughly.
Action 36: The Scottish Government will work with NHS Boards and NSS to ensure that any PV issues are dealt with.
Enhanced Services/The Health and Social Care Partnerships ( HSCPs)
As we develop our plans for enhanced service provision we need to take into account the role of HSCPs in planning and delivering services. Legislation to implement health and social care integration came into force on 1 April 2016, bringing together NHS and local council care services under one partnership arrangement for each area.
We are mindful that the consultation process highlighted concern over the security of the devolved funding and whether HSCPs have a level of experience and understanding of managing the GDS budget. Going forward we need to consider how we can build effective working relationships with each of these partnerships.
Action 37: The Scottish Government will actively consider how we can increase the engagement and participation of the dental profession in HSCPs through our programme of stakeholder engagement.
We appreciate this may take time as we undertake this journey and our stakeholder engagement activities prior to implementation of the plan will be a key component in achieving this. Further information on our stakeholder engagement plans can be found in the ‘ Next Steps’ section of this document.
As we take forward actions to simplify the number of treatments dentists can provide under GDS this will result in the charges for patients becoming more straightforward.
At present, adult patients, unless exempt from NHS dental charges, contribute towards their NHS dental treatment. Arrangements are in place to ensure that vulnerable groups and those on low incomes are protected. These arrangements will remain in place as we move forward. Further information on patient charges and exemptions can be found at: http://www.gov.scot/Resource/0052/00525866.pdf.