The INCENTIVE protocol: an evaluation of the organisation and delivery of NHS dental healthcare to patients—innovation in the commissioning of primary dental care service delivery and organisation in the UK

• Published in: BMJ open 2014-09, Vol.4 (9), p.e005931-e005931
• Main Authors: Pavitt, Sue H, Baxter, Paul D, Brunton, Paul A, Douglas, Gail, Edlin, Richard, Gibson, Barry J, Godson, Jenny, Hall, Melanie, Porritt, Jenny, Robinson, Peter G, Vinall, Karen, Hulme, Claire
• Format: Article
• Language: English
• Subjects: Cost analysis; Delivery of Health Care - organization & administration; Dentistry; Dentistry and Oral Medicine; Dentists; Humans; Incentives; Innovations; Motivation; Performance evaluation; Primary Health Care - organization & administration; Qualitative research; Quality of life; Stakeholders; State Medicine - organization & administration; Studies; United Kingdom
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2014-005931

Introduction In England, in 2006, new dental contracts devolved commissioning of dental services locally to Primary Care Trusts to meet the needs of their local population. The new national General Dental Services contracts (nGDS) were based on payment for Units of Dental Activity (UDAs) awarded in three treatment bands based on complexity of care. Recently, contract currency in UK dentistry is evolving from UDAs based on volume and case complexity towards ‘blended contracts’ that include incentives linked with key performance indicators such as quality and improved health outcome. Overall, evidence of the effectiveness of incentive-driven contracting of health providers is still emerging. The INCENTIVE Study aims to evaluate a blended contract model (incentive-driven) compared to traditional nGDS contracts on dental service delivery in practices in West Yorkshire, England. Methods and analysis The INCENTIVE model uses a mixed methods approach to comprehensively evaluate a new incentive-driven model of NHS dental service delivery. The study includes 6 dental surgeries located across three newly commissioned dental practices (blended contract) and three existing traditional practices (nGDS contracts). The newly commissioned practices have been matched to traditional practices by deprivation index, age profile, ethnicity, size of practice and taking on new patients. The study consists of three interlinked work packages: a qualitative study to explore stakeholder perspectives of the new service delivery model; an effectiveness study to assess the INCENTIVE model in reducing the risk of and amount of dental disease and enhance oral health-related quality of life in patients; and an economic study to assess cost-effectiveness of the INCENTIVE model in relation to clinical status and oral health-related quality of life. Ethics and dissemination The study has been approved by NRES Committee London, Bromley. The results of this study will be disseminated at national and international conferences and in international journals.