Power to patients in dental payments revolution

Patient ratings will be a factor in how much dentists earn under trials of new contracts which will pay according to how many patients are seen and how good the care is, rather than how many treatments are carried out, as under the current system, which is widely deemed to have failed.

After a trip to the practice, patients could be given a survey or asked by text message to rate their dentist on issues like how long it took to get an appointment, cleanliness, the treatment received and whether they would recommend them to a friend. If practices score badly, they would lose part of their payment in a move towards patient power.

The plan to rip up contracts introduced by Labour in 2006 is a major success for the Yorkshire Post Stop the Rot campaign, which has called for better access to dentists in the region after the failed reforms left thousands struggling to get treatment.

Health Minister Lord Howe said: "We want to give dentists the freedom to deliver high quality care and reward them for the outcomes they achieve for their patients, not just for the volume of treatment delivered, as is the case now.

"This is about prioritising prevention. People need a dental service that helps them maintain good oral health and prevents decay, rather than one that is based solely on treatment."

Plans for between 50 and 60 dentists to pilot the new contracts from next April marks progress towards a coalition pledge to change the current deals which were intended to improve access to treatment but proved so unpopular that about one in ten dentists opted out and went private.

Currently dentists are paid according to how many treatments they carry out each year – with no distinction between a single filling and more complex work - rather than the number of patients they see or quality of care they provide, leaving no incentive for preventive work or carrying out complex work.

Also, patients are not registered with an individual practice, and figures showed that at one point 50,000 fewer patients in Yorkshire were seeing an NHS dentist than in 2006.

But the new contracts will pay dentists according to the number of patients they see and the quality of their care, while also restoring the right to register with a particular dentist.

Ministers hope this will incentivise dentists to provide the care actually needed and will encourage more preventive work – in turn freeing up time so dentists can take on more patients –rather than "drilling and filling" as quickly as they can.

It is believed that charges patients pay for NHS treatment – currently split into three bands – will be looked at separately by the Government.

Because previous reforms have failed, Ministers want dentists to come forward so three forms of the contract can be piloted in different areas from next April, and reviewed a year later. If successful, new contracts would be rolled out from 2014.

Wakefield dentist Dr John Milne, spokesman for the British Dental Association, said: "The current arrangements, which were implemented in 2006, have failed to promote preventive care for patients and have been deeply unpopular with dentists.

"We are pleased that two principles that we believe are particularly important – quality of care and a continuing care relationship between practitioner and patient – are central to what is being piloted. Getting the detail of these changes right will be crucial to their success."

A report commissioned by Labour last year had recommended similar changes to the contracts, and recommended creating ten payment bands for patients rather than the current three.

Figures released in August showed more than 400 dentists in England and Wales earn over 300,000 a year, while 5,540 earned more than 100,000 a year.