The Dental Practice Board for England

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The Dental Practice Board for England Wales
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GDSInformation for Commissioning
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Contract Value

• Based on the fees and additional payments
  scheduled October 2004 to September
  2005

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Fees Earned

• Capitation
• Commitment Pay
• Continuing Care
• Item of Service (Adult)
• Item of Service (Child)
• (Add them up)
• Total Gross Fees

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Additional Payments

• CPDA
• CPDA Travel
• Clinical Audit Payment
• (Add them up)
• Total Additional Payments

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Contract Value

• Total Gross Fees
• Additional Payments
• Total Gross Fees plus Additional Payments
• (Increase by 2.33 per cent)
• THE CONTRACT VALUE

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Seniority Payment

• This will be paid in addition to the contract
  value

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Example

• Gross fees
• Additional Payments
• GF plus AP
• Uplift
• CONTRACT VALUE

• 100,000
• 1,000
• 101,000
• 2,353
• 103,353

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Dentist issues

• How can we check the figures
• Not a typical period
• My practice has changed since September
• Can I have the profiles for my associates
• I have only been open for 3 months
• I didnt get all my claims in on time
• I should get Seniority Pay next year

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Contract Activity Requirement

• Based on treatment claims scheduled October 2004
  to September 2005

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Contract Activity Requirement

• Activity Requirement for Non-Orthodontic work
• AND
• Activity Requirement for Orthodontic work

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Claims / Courses of Treatment

• Claims including the fitting or repair of an
  orthodontic appliance, or an interim payment for
  this type of work are classed as ORTHODONTIC
  CLAIMS
• All other claims are classed as
  NON-ORTHODONTIC CLAIMS

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Activity Requirement for Non-Orthodontic
Work

• Based on the complexity of the Non-Orthodontic
  treatments carried out October 2004 to September
  2005

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Units of Dental Activity forNon-Orthodontic
Treatment

• Band 1 treatments 1 unit
• Band 2 treatments 3 units
• Band 3 treatments 12 units
• Urgent Treatments 1.2 units

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Units of Dental Activity forNon-Orthodontic
Treatment

• Arrest of Bleeding 1.2 units
• Denture Repairs 1 unit
• Bridge Repairs 1.2 units
• Removal of Sutures 1 units
• Issue of Prescription 0.75 units

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Calculating Non-Orthodontic Activity

• Match each existing course of treatment to the
  band that would apply under the new regulations
• Count how many treatments in each band
• Multiply number of claims by band weighting
• Add up weightings for each band

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Examples

• Course Band Units
• Exam scale and polish 1 1
• Exam filling 2 3
• Exam, filling fit dentures 3 12
• Repair of bridge Free 1.2
• issue prescription

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Example

• Band 1 12 12
• Band 2 5 15
• Band 3 10 120
• Urgent 2 2.4
• Denture Repair 5 5
• Bridge Repair 2 2.4
• Prescriptions 1 0.75
• Sutures 5 5
• Arrest of Bleeding 3 3.6
• Total 45 166.15

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Under existing GDS regulations

• The child registration fee covers the payments
  for some treatments
• The dentist does not need to submit a claim for
  these courses of treatment

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Under the new regulations

• The capitation only courses of treatment will
  be classed as Band 1 and have a weighting of 1
  dental unit
• So, we need to estimate how much of this type of
  activity is currently undertaken by the dentist

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Child Capitation Units

• Estimate number of children registered
• Each child attends twice in twelve month period
• Number of child attendances in 12 months is twice
  the average child registration
• Take off the number of child claims received in
  the 12 months

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Example

• Dec 04 child regs
• March 05 child regs
• June 05 child regs
• Sept 05 child regs
• Average child regs
• Child visits
• Child claims
• Child Capitation Units

• 20
• 25
• 25
• 30
• 25 (20252530 divd by4)
• 50 (2 times 25)
• 35
• 15 (50 less 35)

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Activity Requirement for Non-Orthodontic Treatment

• Treatment Units
• Child Capitation Units
• (Add them up)
• (Reduce by 5 per cent)
• Activity requirement for Non-orthodontic work

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Example

• Child Capitation Units 500
• Treatment Units 6,000
• CCU plus Treatment 6,500
• 5 reduction 325
• Contract Activity Requirement 6,175

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Dentist issues

• How can we check the figures
• Not a typical period
• I have been splitting courses of treatment
• Why is my UDA unit cost less than others
• What is national / local UDA unit cost
• My recall period is not 6 months

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Contract Issues

• Large contract value with little / no activity
• High UDA unit cost
• Low UDA unit cost
• Irregular pattern to registration figures
• Dentists with more than one contract
• Closed contracts with activity
• Practice summaries

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Activity Requirement for Orthodontic Work

• Based on the value of the Orthodontic work
  carried out October 2004 to September 2005

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Activity Requirement for Orthodontic Work

• Value of Orthodontic claims
• divided by 55

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Example

• Value of orthodontic claims 132,000
• Dividing 132,000 by 55 gives 2,400
• Required activity for orthodontic work is 2,400
  units

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Orthodontic Issues

• New practice
• Mixed practice
• Ortho exams counted as non-ortho work
• Very large practices

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Distribution of Prescribing Profiles

• Paper copy to dentist
• A hard copy set to PCTs
• An electronic copy to PCTs

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PDS Information

• Registration figures for 4 quarters
• Translation of non-orthodontic activity to UDAs
• BUT
• No contract values
• No child Capitation Units
• No 5 reduction
• No orthodontic units quoted
• No profile sent to dentists

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Support Teams

• Information Services
• ? 01323 433218
• ? dentaldata_at_dpb.nhs.uk

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Information for monitoring new contract
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Reporting Strategy

• Content of dentist and PCT reports to be brought
  into line
• Set of core reports available for first reporting
  date
• Library of reports to be developed over time
• Report development in consultation with users

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Reporting Strategy

• Report style top level summary with drill down
  for detail
• Secure on-line access to information
• Provision for one-off analyses
• Annual prescribing profile for dentists
• Identification of benchmarks

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