An evaluation of capital grants to promote access to GDS

Objective: To evaluate the success of capital grants offered to general dental practitioners in return for agreements to increase adult list sizes at 17 practices across four PCTs in the West Midlands. The grants were offered under national Investing In Dentistry (IID) and Dental Care Development Fund (DCDF) initiatives and complied with guidance issued in respect of these. Methods: Content analysis of contracts, analysis of registration and finance data supplied by the Dental Practice Board (DPB), interviews with PCT staff and questionnaires completed by practices. Main outcome measure: increase in adult list size. Results: A total of GBP243660 was offered in grants {range GBP3000-GBP35960, mean(+/-SD) GBP14333(+/-9095)} in return for undertakings to register an additional 18070 adults {range 300-2000, mean(+/-SD) 1063(+/-516)}. The grants represented an average of 49% of overall costs of the capital developments and GBP1348 per 100 additional adults to be registered. After three years the practices had collectively registered an additional 19559 adults over the initial base {mean(+/-SD) 1151(+/-1531)} at an overall cost of GBP1,246 per 100 additional adult registrations. Eight practices (47%) failed to achieve their targets and one reduced its adult list size during the three years. A greater proportion of the successful schemes involved recruiting additional dentists, therapists or hygienists compared with the unsuccessful schemes. Practitioners raised concerns over recruitment and retention difficulties which were seen as a major barrier to expansion. PCT staff identified capacity issues preventing close scrutiny of progress. Conclusion: Collectively the schemes were successful but would have benefited from a greater degree of performance management. Future schemes should, where possible, be linked to recruiting initiatives.