Dental Tribune United Kingdom Edition

associates all too frequently are placed in a very difficult position, whereby in order to get a job they have to accept UDA targets not really designed for them, levels of remuneration based on the reali- ties of supply and demand rather than clinical need and the full li- ability of clinical decision making should something go wrong. This cocktail of ingredients may work for the architects of the nGDS contract, but surely there must be a trade off in front line services and the professional integrity of those dentists who are often placed in this position. Whilst many within the in- dustry may complain of how they have been affected, I per- sonally feel that the worst af- fected are dental associates, es- pecially those just entering into the profession. The complexity of providing quality NHS dental services seems to be traded off in a system designed to make pro- fessionals meet targets and score points based on formulas de- signed by a series of accountants rather than focusing on quality dental care. Over the past few years I have had many conversations with colleagues on the basis of ‘what do you provide on the NHS?’ The availability of NHS provision is not really a postcode lottery but probably more a case of how the dentist interprets the 2006 con- tract and what funding they have in place. Whilst the vast major- ity of dentists are most likely in agreement over what constitutes standard treatment, we come back to the age old question of ‘what exactly should be avail- able on the NHS.’ The standard DH answer to this question is whatever is clinically necessary. In some cases ‘clinically neces- sary’ ranges from a full acrylic denture to an all on four implant supported bridge! Now corporate organisations may not like this next bit, but oh well. The ability to use the young- est members of our profession in an attempt to meet a ridiculous number of points for a fee scale designed to encourage a swing away from best practice is unfair, untried and untested. It deliber- ately abuses the self employed nature of an associate and their ability to retain control, whilst at the same time heavily promot- ing business agendas which are not always in the patient’s best interest. This dilutes profession- al integrity in a worse way than when Mercedes Benz released their A class (original design not the latest version which starts on the road from £18,945). DT About the author Neel Kothari qualified as a dentist from Bristol Uni- versity Dental School in 2005, and currently works in Saw- ston, Cam- bridge as a principal dentist at High Street Dental Practice. He has completed a year-long post- graduate certificate in implantol- ogy and is currently undertaking the Diploma in Implantology at UCL Eastman Dental Institute. “The ability to use the youngest members of our profession in an attempt to meet a ridiculous number of points for a fee scale designed to encourage a swing away from best practice is unfair, untried and un- tested.” 9November 12-18, 2012United Kingdom Edition Comment