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
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...
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description | 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. |
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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.</description><identifier>ISSN: 2044-6055</identifier><identifier>EISSN: 2044-6055</identifier><identifier>DOI: 10.1136/bmjopen-2014-005931</identifier><identifier>PMID: 25231492</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>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</subject><ispartof>BMJ open, 2014-09, Vol.4 (9), p.e005931-e005931</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions 2014 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://bmjopen.bmj.com/content/4/9/e005931.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttp://bmjopen.bmj.com/content/4/9/e005931.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27526,27527,27901,27902,53766,53768,77343,77374</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25231492$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pavitt, Sue H</creatorcontrib><creatorcontrib>Baxter, Paul D</creatorcontrib><creatorcontrib>Brunton, Paul A</creatorcontrib><creatorcontrib>Douglas, Gail</creatorcontrib><creatorcontrib>Edlin, Richard</creatorcontrib><creatorcontrib>Gibson, Barry J</creatorcontrib><creatorcontrib>Godson, Jenny</creatorcontrib><creatorcontrib>Hall, Melanie</creatorcontrib><creatorcontrib>Porritt, Jenny</creatorcontrib><creatorcontrib>Robinson, Peter G</creatorcontrib><creatorcontrib>Vinall, Karen</creatorcontrib><creatorcontrib>Hulme, Claire</creatorcontrib><title>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</title><title>BMJ open</title><addtitle>BMJ Open</addtitle><description>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.</description><subject>Cost analysis</subject><subject>Delivery of Health Care - organization & administration</subject><subject>Dentistry</subject><subject>Dentistry and Oral Medicine</subject><subject>Dentists</subject><subject>Humans</subject><subject>Incentives</subject><subject>Innovations</subject><subject>Motivation</subject><subject>Performance evaluation</subject><subject>Primary Health Care - organization & administration</subject><subject>Qualitative research</subject><subject>Quality of life</subject><subject>Stakeholders</subject><subject>State Medicine - organization & administration</subject><subject>Studies</subject><subject>United Kingdom</subject><issn>2044-6055</issn><issn>2044-6055</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpdkstu3CAYhVHVqommeYJKFVI33Tjl6ksXlarRNBklmiw66RZhjGcY2eAa21J2fYg-WJ8hT1I8dm5lA_wcPg5wAHiP0TnGNP6c1wfXaBsRhFmEEM8ofgVOCWIsihHnr5-NT8CZ9wcUGuMZ5-QtOCGcUMwycgr-bvcarjfL1Wa7_rmCTes6p1z1BUoL9SCrXnbGWehK2AWha3fSGj_VpC1goSsz6PZuFGwuf4S57WQF91pW3V7JVsPOwSboQ93f__5jrHXDtN3YI1K5ujbeh4qxuxHTtKaWgTijjhCv28Eo_XTcePYLMzPt9uodeFPKyuuzuV-A2--r7fIyur65WC-_XUc5pbSLWMpyHpdckrhEEqUZwpIlFCekIBplmJY6ZZQQTbnKcyYpjhNMpVKq0AprQhfg68Rt-rzWhQpuW1mJ2b1w0oiXK9bsxc4NguE4JiwOgE8zoHW_eu07Ed5B6aqSVrveC8xjmqXHr12Aj_9JD65vbbiewEnKScYzkgTVh-eOHq08fHYQnE-CEJ7HVYzEGCgxB0qMgRJToOg_DDzCYg</recordid><startdate>20140917</startdate><enddate>20140917</enddate><creator>Pavitt, Sue H</creator><creator>Baxter, Paul D</creator><creator>Brunton, Paul A</creator><creator>Douglas, Gail</creator><creator>Edlin, Richard</creator><creator>Gibson, Barry J</creator><creator>Godson, Jenny</creator><creator>Hall, Melanie</creator><creator>Porritt, Jenny</creator><creator>Robinson, Peter G</creator><creator>Vinall, Karen</creator><creator>Hulme, Claire</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>9YT</scope><scope>ACMMV</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20140917</creationdate><title>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</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b333t-484b56f5a26f0a08901a473172d2e0913fe84322e35cbb4a316713acccdec1e23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Cost analysis</topic><topic>Delivery of Health Care - organization & administration</topic><topic>Dentistry</topic><topic>Dentistry and Oral Medicine</topic><topic>Dentists</topic><topic>Humans</topic><topic>Incentives</topic><topic>Innovations</topic><topic>Motivation</topic><topic>Performance evaluation</topic><topic>Primary Health Care - organization & administration</topic><topic>Qualitative research</topic><topic>Quality of life</topic><topic>Stakeholders</topic><topic>State Medicine - organization & administration</topic><topic>Studies</topic><topic>United Kingdom</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pavitt, Sue H</creatorcontrib><creatorcontrib>Baxter, Paul D</creatorcontrib><creatorcontrib>Brunton, Paul A</creatorcontrib><creatorcontrib>Douglas, Gail</creatorcontrib><creatorcontrib>Edlin, Richard</creatorcontrib><creatorcontrib>Gibson, Barry J</creatorcontrib><creatorcontrib>Godson, Jenny</creatorcontrib><creatorcontrib>Hall, Melanie</creatorcontrib><creatorcontrib>Porritt, Jenny</creatorcontrib><creatorcontrib>Robinson, Peter G</creatorcontrib><creatorcontrib>Vinall, Karen</creatorcontrib><creatorcontrib>Hulme, Claire</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pavitt, Sue H</au><au>Baxter, Paul D</au><au>Brunton, Paul A</au><au>Douglas, Gail</au><au>Edlin, Richard</au><au>Gibson, Barry J</au><au>Godson, Jenny</au><au>Hall, Melanie</au><au>Porritt, Jenny</au><au>Robinson, Peter G</au><au>Vinall, Karen</au><au>Hulme, Claire</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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</atitle><jtitle>BMJ open</jtitle><addtitle>BMJ Open</addtitle><date>2014-09-17</date><risdate>2014</risdate><volume>4</volume><issue>9</issue><spage>e005931</spage><epage>e005931</epage><pages>e005931-e005931</pages><issn>2044-6055</issn><eissn>2044-6055</eissn><abstract>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.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>25231492</pmid><doi>10.1136/bmjopen-2014-005931</doi><oa>free_for_read</oa></addata></record> |
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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 |
title | 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 |
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