Introducing care pathway commissioning to primary dental care: the concept

Key Points Puts care pathways in dental care into a wider healthcare context. Describes a new commissioning model for general dental practice based on a needs and risk assessment linked to care pathways for preventive care. Outlines potential benefits and drawbacks of a care pathway approach. Care pathways are defined as 'a methodology for the mutual decision making and organisation of care for a well-defined group of patients during a well-defined period'. Although most often used in Europe as a tool to improve the quality of care and to aid the continuity of care between disciplines and settings, care pathways also have an application in underpinning the commissioning process. This paper describes the development of a new model of commissioning for general dental practice services based on a need and risk assessment linked to specified care pathways for preventive care. In this system dentists are monitored on adherence to care protocols based on nationally accepted guidelines for preventive care interventions as well as recommended recall intervals for routine dental examinations. A traffic light system to distinguish between patients with different levels of need and risk of disease is being used.