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Home » Library » Discussion Papers » DP0807 Initial Estimates of the Impact of the New NHS Dental Contract on England and Wales


Introduction: UK NHS dental services face a number of well documented difficulties and there are concerns that a key reason is the level and structure of the ‘traditional’ fee-for-service General Dental Service (GDS) dental contract. In response to these concerns a new NHS dental contract was introduced in England and Wales on 1 April 2006. In Scotland changes to the structure of the ‘traditional’ GDS dental contract are currently under consideration.

Objective: To examine the impact of the new contract on the number of courses of treatment and the probability of each course of treatment being in a particular Band.

 Methods: A natural experiment using routinely collected, individual level, administrative data to compare pre-contract with post-contract treatment delivery in England and Wales using treatment delivery in Scotland as control.

Results: After analysing 171,224 courses of treatment provided by 98 recently qualified dentists we find that the new contract had a significant impact. In particular, the number of courses of treatment per month changed in England and Wales after the introduction of the new contract: dentists who were previously on a GDS contract provided significantly fewer courses of treatment while dentists who were previously on a Personal Dental Service (PDS) contract provided significantly more courses of treatment. In addition, the new contract significantly changed the probability that each course of treatment was in a particular Band. 

Conclusion: The new dental contract in England and Wales has had a significant impact on treatment delivery. This paper has demonstrated the feasibility and utility of using routinely collected data from different jurisdictions to analyse the impact of policy initiatives concerning the NHS dental contract.

Full paper (pdf): Initial Estimates of the Impact of the New NHS Dental Contract on England and Wales

Linda Young, Colin Tilley, Debbie Bonetti, Martin Chalkley, and Jan Clarkson