Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Feature
  • Published:

Flexible Commissioning - a new approach

BDJ In Practice volume 35, pages 18–21 (2022)Cite this article

Access through your institution
Buy or subscribe

Dental contract reform has been on-going for over a decade. Recently Flexible Commissioning (FC) has been implemented by some areas to meet oral health needs and commissioning challenges. This approach uses the existing contractual framework, substituting a percentage of a practice's contract value to deliver additional services instead of units of dental activity (UDAs)1 or alternatively funding programmes with additional financial resource.

This has always been possible within the existing NHS General Dental Services (GDS) and Personal Dental Services (PDS) contracts via the two main components: mandatory services (UDAs) and additional services (which may include dental public health, orthodontic, sedation or other services).2,3 An interesting outcome of the substitution method of flexible commissioning is that where UDA values are lower the UDA target reduction is greater. This has the effect of reducing UDA value inequality. The March 2021 dental contract reform and arrangements letter (NHS England) describes a flexible commissioning toolkit that is intended to make it easier to target local oral health priorities, using the flexibility that exists in the current contractual arrangements.4

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Access through your institution
Figure 1

References

  1. Mustufvi Z, Barraclough O, Hearnshaw S, et al. Flexible Commissioning: A prevention and access focused approach in Yorkshire and the Humber. BDJ In Pract 2020; 33: 20-22.

  2. NHS England. Standard General Dental Services Contract. 2018. Available online at: www.england.nhs.uk/wp-content/uploads/2018/08/general-dental-services-contract-2018.pdf (accessed July 2022).

  3. NHS England. Standard Clauses for a Personal Dental Services Agreement. 2018. Available online at: www.england.nhs.uk/wp-content/uploads/2018/08/standard-clauses-for-a-personal-dental-services-agreement-2018.pdf (accessed July 2022).

  4. NHS England. NHS dental contract reform and arrangements letter. 2021. Available online at: www.england.nhs.uk/coronavirus/documents/nhs-dental-contract-reform-and-arrangements-letter/ (accessed July 2022).

  5. Health Education England. Making Every Contact Count (MECC). Available online at: www.makingeverycontactcount.co.uk/ (accessed July 2022).

  6. Public Health England. Inequalities in oral health in England. 2021. Available online at: www.gov.uk/government/publications/inequalities-in-oral-health-in-england (accessed July 2022).

  7. Office for Health Improvement and Disparities. Delivering better oral health: an evidence-based toolkit for prevention. 2021. Available online at: www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention (accessed July 2022).

  8. Daley A J. Time to get our teeth into reducing obesity: should dentists screen and deliver interventions to reduce obesity in the population? Br Dent J 2022; 232: 78-79.

  9. Hurley S. Why re-invent the wheel if you've run out of road? Br Dent J 2020; 228: 755-756.

  10. Westgarth D. Improving dental care and access for this group is essential. BDJ In Pract 2022; 35: 10-11.

  11. NHS England. Outcome of 2022/23 Dental Contract Negotiations letter. 2022. Available online at: www.england.nhs.uk/wp-content/uploads/2022/07/B1802_First-stage-of-dental-reform-letter_190722.pdf (accessed November 2022).

Download references

Author information

Authors and Affiliations

  1. Health Education England, Yorkshire, United Kingdom

    Simon Hearnshaw

Authors
  1. Simon Hearnshaw
    View author publications

    Search author on:PubMed Google Scholar

Corresponding author

Correspondence to Simon Hearnshaw.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hearnshaw, S. Flexible Commissioning - a new approach. BDJ In Pract 35, 18–21 (2022). https://doi.org/10.1038/s41404-022-1817-5

Download citation

  • Published:

  • Issue date:

  • DOI: https://doi.org/10.1038/s41404-022-1817-5

This article is cited by

Search

Advanced search

Quick links