We have warned the profession that the administrative, reporting and clinical requirements involved in delivering Complex Care Pathways (CCPs) are disproportionate and risk making the new payment tariffs unattractive.
While we support the principle of providing better recognition and remuneration for the care of high-needs patients through longer-term, prevention-focused pathways, we are concerned that the final model has become significantly more complex than what was consulted upon last year.
The additional documentation, assessment, reporting and contractual requirements create a substantial burden for practices, yet the payment structure has not been amended to reflect the increased workload. As a result, there is a real risk that many practices will conclude that the pathways are neither operationally practical nor financially attractive.
We have argued for the burden in delivering the CCPs to be minimised at all stages to allow dentists to deliver care appropriately, exercising their professional judgement.
These concerns are compounded by an uncertain implementation process. At the point of launch the clinical guidance has not been published, questions remain regarding dento-legal implications, and a number of software systems are not yet fully equipped to support pathway administration and claims submission.
Recent difficulties with unscheduled care reporting and Units of Dental Activity reconciliation have further undermined confidence in the ability of existing systems to support a smooth rollout.
We have raised these issues directly with NHS England and stressed the need for urgency here. Officials have agreed to take these points away for further consideration.
In the meantime, we suggest practices approach the new CCPs cautiously and to ensure they fully understand the clinical, contractual, administrative and financial implications before deciding whether to adopt them.
