Dental Tribune United Kingdom Edition

9OpinionFebruary 25- March 3, 2013United Kingdom Edition I n the uproar following the 2006 dental contract, one of the main criticisms coming from all quarters was that no pilot studies had been carried out before it was rolled out - and that if it there had been, surely it wouldn’t have been implemented in its cur- rent form. By definition a ‘pilot’ is a small scale study designed to test a system for flaws before a full scale launch, in order to avoid costly mistakes. As we all know, trials are currently taking place in prep- aration for the ‘New New Con- tract’; however, as these trials do not test the final version of the contract, is it correct to describe them as ‘pilots’? One might argue that by not field testing the final version of the new contract the current trials are dragged a long way away from the definition of a ‘pi- lot’ and simply do not test the most unpredictable variables of the lot: the human respons- es towards the incentives con- tained within the new con- tract and how this might skew clinical decision making. The current trials aim to explore a range of facets such as a patient pathway, a quality and outcome framework, and methods of remuneration. As I simply don’t understand the first two, I will stick to exam- ining the third aspect, remu- neration, in this article; how- ever, I promise to come back to you if I can manage to get my head around these in the future. The three remunera- tion models being tested are Type one - guaranteed in- come, Type two - a simulation of capitation and Type three- a simulation of capitation for routine treatment and guar- anteed income identified for complex treatment. At present the DoH has not confirmed whether it will or will not ‘pilot’ the final version of the contract prior to imple- mentation but surely there is a good case for this to be pi- loted for a reasonable amount of time before we can judge its merits. Recently the DoH an- nounced that it is to introduce another 25 pilot sites to the existing 70. The DoH claim that the extra sites will help fine tune different parts of the new contract that will see dentists paid for the number of patients they care for, and the health results they pro- duce, rather than the number of courses of treatment they perform. I strongly support piloting the new dental contract, in New Dental Pilots: Practical or Pointless? Will the pilots tell us anything useful? asks Neel Kothari page 10DTà ‘By definition a ‘pi- lot’ is a small scale study designed to test a system for flaws before a full scale launch, in or- der to avoid costly mistakes’