The Dental Practice Board for England

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The Dental Practice Board for England Wales
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The DPB

• Set up under 1946 NHS Act
• Arms length body
• Majority of Board have to be dentists
• Funded by Dept of Health and National Assembly
  for Wales
• Accountable through Service Level Agreements and
  Annual Reviews

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Principle Functions

• Approval of payment applications
• Calculating and transferring payments
• Preventing and detecting fraud and abuse
• Providing dental health information.

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Three Departments

• Finance and Operations
• Information and Probity
• Dental Reference Service.

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The business of the DPB is paying dentists.

• Which leads to
• An accumulation of data
• Which in turn facilitates
• Reporting, monitoring and research

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Reporting Monitoring Dental Activity
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General Dental Services

• Contract based
• Closely linked to the SDR
• Some patient demographics
• Some dentist demographics
• A lot about treatment
• Information collected relates to a course of
  treatment

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GDS (England and Wales) Year ending March 2004

• 19,539 dentists
• 25,681 contracts
• 9,351 surgery addresses
• 1.7 billion gross fees
• 24.9 million registrations
• 34.44 million claims

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GDS course of treatment

• Who carried it out
• When it was done
• How long it lasted
• Where it was done
• Who the patient was
• What treatments were carried out

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Information collected used to calculate

• How much the dentist should be paid
• How much should be collected from the patient

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Derived Information

• Types of patient treated
• Types of treatment carried out
• Cost of a course of treatment
• Length of a course of treatment
• List size
• Demographics of dentists carrying out particular
  treatments
• Local and national benchmarks

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Reporting levels

• Contract
• Postcode
• Postal district
• Local Ward (parliamentary constituency)
• PCT
• SHA
• England Wales

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Reporting formats

• Prescribing profile (to dentist)
• Quarterly annual EXCEL summary reports
  (to PCTs)
• DPB publications
• DPB website (dpb.nhs.uk)

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Prescribing profile
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2004 GDS Prescribing Profile

• Financial details
• Patient Profile
• Registrations
• Treatments

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Financial details

• Gross fees
• Capitation
• Continuing Care
• Item of service
• Commitment pay
• Transitional pay
• Total fees earned

• Other items
• Deprived area payments
• Additional payments
• Contract value
• Average claim cost
• Proportion of exempt claims

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Additional Payments

• Maternity / Paternity
• Long term sick pay
• Seniority pay
• CPDA
• CPDA travel
• Business rates

• Training grant
• Clinical audit
• Clinical audit secretarial support
• VDP salary and NI contributions

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Contract value

• In the 2003 / 04 profile the contract value was
  defined as the total of the gross fees and
  additional payments (except VDP salary)
• An uprating factor of 1.038 used to provide the
  contract value at 2004 / 05 prices

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Patient demographics

• Patient profile shows the proportion of males,
  females, children and local residents on the
  registration list

• Registration list shows the distribution by age
  of registered patients as in March 04

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Treatments

• Treatment categories defined by SDR codes
• Number of claims (or teeth treated) provided
• Treatment rate provided
• Children and adults counted separately

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Treatment rate

• Total number of claims (N)
• Number of claims with treatment (T)
• Treatment rate 100 T / N
• Treatment rates away the norm may indicate
  unusual activity

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Benchmarking
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Comparison of treatment rates
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Information for commissioning

• Summary from annual prescribing profile
• Monthly earnings any period
• Historic registration figures
• Historic patient charge income
• Patients seen in a given period
• Fees for specific treatments

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2005 prescribing profile

• A profile will be distributed to dentists in July
  / August (same format and content as in 2004)
• A profile summary will be sent to PCTs in May /
  June (to include postcode and contract summaries
  as well as contract detail)

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What is PDS?

• Launched in 1998
• Different types of schemes
• Funded through DoH
• Managed through local contracts
• Commissioners, Providers and Performers

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PDS

• Contract based
• SDR required for patient charge calculation
• Information collected for a course of treatment
• Potential for more patient demographics
• Potential for recording treatment experience
• More emphasis on practice level reports

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PDS activity March 2005

• 4,606 PDS dentists
• 1,643 PDS surgery addresses
• 663,376 PDS claims processed
• Year end 3,800,352 PDS claims processed

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December 2004
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Information collected used to calculate

• How much should be collected from the patient

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Derived Information

• Types of patient treated
• Types of treatment carried out
• Length of a course of treatment
• Practice size
• Demographics of dentists carrying out particular
  treatments
• (Benchmarks)

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Reporting levels

• Contract
• Postcode
• Postal district
• Scheme
• PCT
• National

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PDS Reports

• Monthly Activity Report
• Monthly Registration Report
• 9000 Code Reports
• Baseline Payment Report
• Prescribing details all patients
• Time to treatment
• Duration of treatment
• Registration profile

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Monthly Activity Report
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Monthly Activity Report

• Different patients treated by age
• Number of claims by age
• Number of exempt and non-exempt adult claims
• Patient charge recovered from dentist

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Baseline finance report
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M A 9000 code data

• Number of dental contacts
• Number of hygienist contacts
• Number of therapist contacts
• Number of DHE contacts
• Number of dental specialist contacts
• Number of contacts with dental professionals

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M A 9000 code data

• Patient type (emergency, routine ..)
• New patient
• Postcode unknown
• Method of entry into field site
• Restorative, Preventative, Informative treatment
• Type of referral out of practice

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GDS / PDS comparison

• Registration list
• Gross fees / Add pay
• Patient charges
• Courses of treatment
• Number of patients
• Patient type
• Types of treatment

• Registration list
• Salary
• Patient charges
• Courses of treatment
• Number of patients
• Patient type
• Types of treatment

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Other information sources

• Patient surveys
• DRS practice visits
• Practice appointment books

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High level Indicators

• Patient charge income
• Number of courses of treatment
• Number of patients seen
• Number of exempt patients
• (Size of registration list)

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Possible developments

• Move from SDR to treatment categories
• Reporting levels to include commissioner,
  provider, practice and performer
• More reporting of patient demographics
• Practice size measured by patients treated rather
  than registered
• Internet access to information
• Re-evaluation of 9000 code data

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Patient flow in / out a PCT
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Internet Access to Information

• PCT password protected access to reports
• Requires internet link
• Reports downloaded as pdf or EXCEL file
• Report level SHA/PCT/postcode/contract
• Report can be manipulated before download
• Prototype being used in 20 PCTs
• Further roll out likely to start June
• All PCTs to have facility by April 2006?

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Patient Charges

• Report suggests various options

NO DECISION HAS YET BEEN MADE
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Future Developments
ABOLISHED
Dental Practice Board
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Future developments

• Arms Length Body Review the DPB will become part
  of the new NHS Business Services Authority
• Modernising Dentistry working in partnership
  with DoH to lead modernisation process and
  provide support to PCTs and
  dentists

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Support Teams

• PCT Liaison Team
• ? 01323 433550
• ? pctliaisonteam_at_dpb.nhs.uk
• PDS Support Team
• ? 01323 433550
• ? pds_at_dpb.nhs.uk

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Support Teams

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