Public Perspectives on using Societal Values in Oral Healthcare Decisions

Objectives: Making decisions regarding resource allocation in dentistry should involve the public, who often pay for care through patient charges, health insurance and/or taxation. The RAINDROP (Resource Allocation In NHS Dentistry: Recognition of Societal Preferences) study undertook a evaluation of 15 dental services to examine which procedures should be provided by NHS dentists in England. This study was the first to use methodology directly incorporating public values into the decision making process using a questionnaire issued to a representative sample of the general public, asking for societal values for 15 dental services. After the evaluation took place resource allocation decisions were made by a panel, including public health representatives, dentists, academics, resource managers and public representatives.

This paper evaluates the new methodology using the perspective of the participants who took part in the questionnaire; how they felt their views were incorporated into the decision making process and their opinions on the decisions made by the panel.
Methods: Members of the public who answered the questionnaire regarding dental services were approached to take part in focus groups. Three focus groups took place in two major cities, one in the North and two in the South. The sessions used an evolving topic guide, were audio recorded and transcribed. Analysis was undertaken using the Framework approach.
Results: The results indicate those who participated in the focus groups were satisfied with their representation and the way societal values were used in decision making. Participants felt those who have experience in commissioning dental care would fully understand the treatments/implications and were in a better position to make decisions. Participants understood the questionnaire and found the process convenient.
Conclusions: The initial results offer validity to the overall methodology proposed for NHS resource allocation for dentistry, and further encourage the use of a societal values.