In the prototype arrangements, a practice’s contract value is split between:
- capitation – the practice will be expected to have a number of capitated patients at year end
- activity – the practice will be expected to deliver a minimum level of activity
There are two models of remuneration being tested under prototype arrangements. These are referred to as blend A and blend B. Each practice was allocated a blend type when they started working under prototype arrangements.
This will cover the oral health assessment and preventive care (the Band 1 element of courses of treatment). Urgent courses of treatment and charge exempt courses of treatment delivered to capitated patients will also be covered by the capitation element of the contract.
This will cover all treatment (the Band 2 and Band 3 elements of courses of treatment) delivered to capitated patients. The activity element of the contract will also cover urgent care, treatment on referral and charge-exempt courses of treatment delivered to non-capitated patients.
This will cover the oral health assessment, preventive care and routine treatment (the Band 1 and Band 2 elements of courses of treatment) delivered to capitated patients. Urgent courses of treatment and charge exempt courses of treatment delivered to capitated patients will also be covered by the capitation element of the contract.
This will cover only complex treatment (the Band 3 elements of courses of treatment) delivered to capitated patients. The activity element of the contract will also cover urgent care, treatment on referral and charge-exempt courses of treatment delivered to non-capitated patients.
How the system works
Factsheets are available which summarise each of the financial components of the prototype arrangements.
Listen to recording of a webinar which explains the calculation of prototype delivery requirements (finance schedules).
We've prepared a presentation to help business owners explain how the prototype remuneration system works to the practice team:
- prototype remuneration system - presentation only (PowerPoint: 327KB)
- prototype remuneration system - with speakers notes (PDF: 5MB)
Wave 4 practices ONLY
Listen to a recording of a webinar which describes the handling of year-end 2018/19. The recording will be available to 31 August 2019.
The exchange mechanism
With the emphasis being on prevention, it's expected that the oral health of a practices' patients will improve over time.
This will result in the need for less treatment and in time, may lead to practices being unable to meet the expected minimum activity (EMA) of their contract.
However, the remuneration model looks at achieving capitation and activity measures, allowing practices to compensate for a lower than expected delivery of its activity measure by seeing more patients.
This modelling tool is referred to as the 'exchange mechanism'. We have further guidance for the exchange mechanism available. This guidance can help practices with calculating the number of patients they need to see in exchange for the number of prototype UDAs they will not deliver.
Dental Quality and Outcomes Framework (DQOF)
The Dental Quality and Outcomes Framework (DQOF) is intended to reflect and measure the quality of the service being provided by each practice working within the dental contract reform programme.
It is under consideration whether DQOF should be applied as a financial adjustment or whether measurement only is more appropriate.
In the interim, a decision has been taken by the dental contract reform programme that for the period 2018-2020 there’ll be no financial adjustments associated with DQOF. Prototype practices will still continue to collect data and will still receive information on their achievement against the indicators.
You can find out more about the dental quality and outcomes framework which was last revised in 2016/17.