Indicators for Dental Services

From 2011/12, a series of new dental contract models will be piloted, which have been designed to help shape a fundamental reform of the NHS dental contract. The pilots have been designed in consultation with a national steering group made up of representatives of the profession and patients, together with NHS Managers.

Quality and outcomes are a central part of the future dental contracts, and it will take time to develop a quality system that is solely outcome based. Quality is defined as covering three domains:

  • Clinical effectiveness
  • Patient experience
  • Safety

Dental Quality and Outcomes Framework

A Dental Clinical Effectiveness and Outcomes Group has developed a wide range of potential quality indicators. These have contributed to the initial Dental Quality and Outcomes Framework (DQOF), which will be tested in the contract pilots, and continue to be developed over the coming years.

The DQOF includes a list of 13 potential indicators grouped under the domains of quality above. They will be developed further through piloting to improve their fitness for purpose. In addition, there is a further set of indicators which will be used to monitor pilot practices but will not form part of the pilot DQOF.

The clinical effectiveness outcome indicators included in the DQOF are based on the standardised Primary Dental Care Patient Assessment and the associated risk screening process. The aim of the DQOF is to measure the maintenance or improvement of oral health with respect to caries and periodontal health. The risk screening process incorporates both clinical and patient modifying factors. For the purposes of the outcome measures, only the clinical factors are measured and evaluated. This is because clinical factors are objective and can be measured, recorded and improved by good care. Patient modifying factors can be subjective and some cannot be improved or changed by the dental team.

Patient experience indicators are a fundamental part of performance frameworks in healthcare and are important for delivery of a patient-centred service. The indicators are needed to help ensure that the service delivered is in line with patient expectations and that the outcomes are in line with what patients want and need.