Leading Dental Experts Welcome Scottish Payment System Reform

Leading Dental Experts Welcome Scottish Payment System Reform

Published: 1 November 2023 | Dental, FDS, faculty of dental surgery

The Royal College of Surgeons of Edinburgh’s Faculty of Dental Surgery has welcomed a major reform of the payment system for NHS dentistry in Scotland which comes into force as of 1st November 2023.

The former ‘item of service’ funding model, which disproportionately emphasised treatment over prevention, is now being replaced with a more streamlined approach.

This will mean general dental practitioners (GDPs) in Scotland will be renumerated for aiding in the prevention of oral health issues as well as treatment, in a bid to tackle soaring waiting list backlogs within the NHS.

The system has been designed in line with current best practice guidance, including the regularity with which patients receive routine checkups, helping maintain and improve oral health across the board.

Professor Grant McIntyre, Dean of the Faculty of Dental Surgery at the Royal College of Surgeons of Edinburgh, which represents dentists across the UK and internationally, said:

This change heralds the introduction of a new payment system for general dental practitioners in Scotland which focuses on prevention rather than cure. This is the first major reform for dentistry in Scotland in decades and is welcomed.

At present, a lot of patients presenting for dental appointments require repair work rather than prevention, which is not only costly for patients but also damaging to their oral and sometimes overall health.

The historical item of service funding model for dentistry in Scotland placed inadequate value on disease prevention and focused almost exclusively on treatment. Now, rather than being paid solely for the treatment of dental diseases, GDPs will be renumerated for the prevention aspect, which will hugely benefit patients.

Under the new system being introduced by the Scottish Government, the number of items of service payments for general dental practitioners in Scotland will be reduced from over 500 to 45, and the recall interval for checkups will be extended from six months to 12 months.

The Faculty is calling for other parts of the UK to follow suit in the changes to contract fees – named Determination 1 - supporting dentists to work in a system based on high trust and low bureaucracy, allowing dentists use their clinical discretion in delivering an overall oral health promotion-based package of care.

Extension of the examination recall interval from six months to a year will allow scope for dentists to provide care for a greater proportion of the population.

Professor McIntyre continued: 

Patient safety and health promotion is key to easing the huge pressure NHS dentistry is facing, and helping the patients who are suffering because of that.

However, with only 50% of the adult population regularly attending their general dental practitioner, the Faculty would encourage the Scottish Government to work with the profession to educate the public on the need for regular examinations of the oral cavity by a dentist in order to identify the early signs of cancer in and around the mouth in addition to the other diseases that affect the oral cavity.

The Faculty of Dental Surgery will be launching a new suite of Dental Diploma Examinations in 2024 which will provide recognition of expertise in seven key specific areas of dentistry for general dental practitioners.

We would hope with further revisions to Determination 1, that the Scottish Government will recognise such additional clinical skills through further financial enhancements.

Find out more about the Royal College of Surgeons of Edinburgh’s Faculty of Dental Surgery here.

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  • RCSEd was first incorporated as the Barber Surgeons of Edinburgh in 1505 and is based in Edinburgh and Birmingham. 
  • It is one of the oldest surgical corporations in the world with a global membership of more than 32,000, including 15,000 members in the UK. 
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  • The College promotes the highest standards of surgical and dental practice through education, training and examinations, its liaison with external medical bodies and representation of the modern surgical and dental workforce. 
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