Background: Commissioning of state-funded (NHS) dental care in Wales underwent a fundamental reform in April 2006. A major concern was the degree to which the reforms would impact on dentists' commitment to the NHS. Objectives: to investigate how the introduction of the New Contract affected the immediate work patterns of dentists and to assess whether dentists' stated intentions with regards to NHS service provision pre-contract, served as an accurate predictor of their work patterns post-implementation. Methods: Data were collected via two postal questionnaires mailed to all 1092 Welsh general dental practitioners in January 2006 (pre-contract) and a follow-up survey mailed to 608 respondents in November 2007 (post-contract). Results: 457 (75%) responded to the second questionnaire. 426 provided usable data and fulfilled the criteria of having been providing NHS dental care in January 2006 and responding to both questionnaires. Of these 38 (8.9%) stopped offering NHS dental services. Ceasing to provide NHS services was significantly (p<0.01) related to time since qualification and previous NHS commitment. Overall the average number of days worked per week for the NHS fell from 3.1 to 2.7, commitment again being significantly related to time since qualification (p<0.01), more recent graduates being more heavily committed to the NHS. No significant gender related differences in commitment were observable. Of the 299 dentists who pre-contract confirmed their intention to continue providing NHS services, 289 did so. 39 expressed their intention to quit, although 18 were continuing to provide NHS services at the time of the second survey. While 84 were initially undecided, 74 continued in the NHS. Conclusion: These data confirm relatively few dentists ceased providing NHS dental services. Leavers were older, and more likely to be already devoting significantly less time to the NHS.
This work was funded by a grant from the Local Health Boards in Wales.