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Securing Excellence in Commissioning NHS Dental Services

The NHS Commissioning Board (NHS CB) has today published Securing Excellence in Commissioning NHS Dental Services.

From April 2013, the NHS CB will take commissioning responsibility from primary care trusts for all NHS dental services: primary, community and secondary, including dental out of hours and urgent care.

This will include commissioning dental services provided in high street dental practices, community dental services, and dental services at general hospitals and dental hospitals.

The NHS CB will commission NHS dental services based on the local oral health needs assessment which will be developed by public health teams in local authorities and will help determine the needs of local populations.

The benefit of the NHS CB becoming a single commissioner for all dental services will be the ability to plan for and deliver more consistent standards, higher quality services and better health outcomes for patients across the whole of England. A more consistent approach to commissioning and contract management will be implemented in order to deliver these improvements.

In addition, by having the oversight and responsibility for commissioning all dental services for the population, the NHS CB will be able to ensure greater coordination between the different areas of dental care. This offers dentistry a unique opportunity to share excellence across England.

A ‘care pathway’ approach is proposed for all dental services in Securing Excellence in Commissioning NHS Dental Services the new national single operating model for dental commissioning. The care pathways will describe consistent national elements, regardless of setting. This will ensure a focus on patient outcomes and greater consistency in delivery of dental services, both in the sequencing, effectiveness and quality of clinical care and the ‘journey’ that patients’ experience.

The NHS CB has published a factsheet and set of frequently asked questions alongside the single operating model document to provide further information.

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13 comments

  1. Fazal Khan says:

    I am a Dental service manager for salaried dental services in Birmingham. What are the challenges to NHS Trusts presented by the recent Department of Health document ‘Securing Excellence in Commissioning NHS Dental Services’. How will this have an impact on the NHS dentistry with reference to provision of salaried dental services.
    Thank you
    Fazal Khan

    • NHS Commissioning Board says:

      Hi Fazal
      Thank you for your comment. Salaried, or as they are now known, Community Dental Services are an integral part of the pathways described in Securing Excellence in Commissioning NHS Dental Services’. Community Dental Services have developed in different ways across the country with variations of service provision across dental specialties. Special Care Dentistry has been specifically highlighted as a crucial pathway to ensure that dentistry provides equitable access to services. The pathways to be described in the forthcoming guides are intended to define levels of care, quality and standards of provision regardless of setting. Securing Excellence is framework not a script. It will be for Local Dental Networks to understand the needs of its Area and provision it wants within the parameters set out in the pathway guides. Birmingham’s emerging Local Dental Network has specific Community Dental representation and is looking at the integration of community, secondary and primary care provision within an integrated service model. There is no reason why this model cannot be compatible with the pathway guides.

      Kind regards
      Simon

      Digital Communications Officer
      NHS Commissioning Board

  2. Leena Bhavsar says:

    I am a general dental practitioner. Could you please clarify if dental practices will have a local area team lead and who this will be ? I work over two practices and had two different dental advisors, one of which was extremely helpful and made a great advisor ( didnt think much of the other one!) …will we have the same input from such clinical advisors?

    • Simon@NHS CB says:

      Hi Leena
      Thank you for your comment. Each NHS Commissioning Board area team has a primary care commissioning team led by a Head of Primary Care. Commissioning managers within these teams are aligned to dentistry, as well as other primary care contractor groups and should be supported by clinical advise. Whether you have more than one advisor will depend on whether the locations of the your practice cover more than one Area Team’s geography.

      Kind regards
      Simon

      Digital Communications Officer
      NHS Commissioning Board

  3. Joanne Birdsall says:

    I am a consultant in orthodontics at Rotherham NHS foundation. Please can you advise me how my service will be commissioned. The British Orthodontic Society is submitting care pathways will these be nationally recognised or modified to suit local provision? I provide a service which includes but is not limited to orthodontics for cleft lip and palate, orthognathic surgery, joint restorative cases for provision of bridges and implants where teeth are missing and impacted teeth as well as routine orthodontic care for medically compromised patients, will part of my service like OMFS be partially commissioned by the CCG as we carry out work jointly?

    Best wishes
    Jo

    • NHS Commissioning Board says:

      Hi Jo
      Thank you for your comment. All secondary care dentistry specialties including Orthodontics, Restorative and OMFS will be commissioned by the NHS Commissioning Board in the first instance. Cleft Lip and palate work is within the remit of specialised commissioning which will also be commissioned by the NHS CB through ten area teams nationally. The other areas you have mentioned like Orthognathic surgery, because it comes under OMFS will be commissioned by the Board initially, but is not clear yet if it will be part of what transfers back to CCGs as a medical speciality. Ideally we would have been ready to separate out the medical elements of OMFS for the 1st April, but at this stage issues such as the one you have presented will need to be resolved before we do.

      Kind regards
      Simon

      Digital Communications Officer
      NHS Commissioning Board

  4. john alexander says:

    When is the orthodontics pathway likely to be published?

    • Simon@NHS CB says:

      Hi John
      Thank you for your comment. We do not have a date yet for the Orthodontic pathway guide. However any pathway guide will look to consult with relevant stakeholders. It is not possible at this stage to say if the BOS care pathway will be recognised nationally in its entirety, but they are of course a relevant stakeholder and will therefore be a resource to feed in to the production of the Orthodontic pathway guide.

      Kind regards
      Simon

      Digital Communications Officer
      NHS Commissioning Board

  5. IAN MARKER says:

    Can you tell me what the policy will be on under /overachievement on UDA delivery year 2012/2013 and the following years
    Our current agreement is a 4% tolerance either way with our PCT

  6. Peter Howard says:

    Collateral to responsibility for local GDPs it is my understanding that the NHS CB also carries responsibility for tresponding to those Primary Care complaints about these services that patients choose to direct to you.
    How, where and by whom do you intend that these complaints be investigated?

    • Simon@NHS CB says:

      Hi Peter
      Thank you for your question. NHS Commissioning Board area teams will have complaints arrangements in place for the services they commission in the same way that PCTs do now, for patients who don’t want to complain to the practice or provider. These arrangements will complement CCGs’ plans for complaints management.

      Kind regards
      Simon

      Digital Communications Officer
      NHS Commissioning Board

  7. Richard Langford says:

    I am a Consultant in Oral & Maxillofacial Surgery at JCUH, Middlesbrough. Can you tell me who will be commissioning hospital OMFS services – we take referrals from General Dental and General Medical practitioners, other hospital specialties and see and treat a wide range of emergency and acute conditions.There follows a brief list of conditions which are referred to us:
    H&N cancer
    Dento facial deformity
    Facial/jaw pain
    Oral medicine/soft tissue mouth problems
    Dentoalveolar pathology/unerupted & impacted teeth
    Salivary gland disease

    I should be grateful for your guidance regarding whom we should liaise with over commissioning our services.
    Kind regards,
    Richard Langford

    • Simon@NHS CB says:

      Hi Richard
      Thank you for your comment. The NHS Commissioning Board will be commissioning Oral and Maxillofacial Surgery services from the 1st April 2013. It was not possible without defining clear pathways to robustly separate the delivery of oral surgery and many elements of oral and maxillofacial (OMFS) surgery procedures and therefore to define the resources that flow with them. However, by working collaboratively with clinical commissioning groups (CCGs) during a transition period, the eventual aim is to transfer maxillofacial surgery, as a medical specialty to CCGs as part of their remit to commission all medical services.

      For information, this issue is explained within the main Securing Excellence in Commissioning NHS Dental Services, paragraph 4.9 and 4.10, page 16.

      Kind regards
      Simon

      Digital Communications Officer
      NHS Commissioning Board