Pitts N B
Dental Health Services Research Unit, University of Dundee.
Br Dent J. 2003 Dec 6;195(11):631-5. doi: 10.1038/sj.bdj.4810779.
The aims of this paper are to provide an impartial overview of the proposals and agenda for the future brought together in the NHS Dentistry: Options for Change document in the context of previous dental service delivery in primary care, and to start to explore what Options for Change could mean for the future of NHS dental services. Options has been described as perhaps the most radical and ground breaking opportunity for NHS dentistry to finally move forward after prolonged periods of stagnation and disharmony. The Options agenda has the potential to bring in a new style of NHS practice for dentistry, providing a way to finally get off the current 'treadmill' and to develop new NHS dental services where prevention is a priority and providing high quality dental treatment, tailored to the long term needs of the 21st century patient, is the driving aim. However, the difficulties on all sides of leaving behind decades of disputes and overcoming real access, workforce and funding issues must not be underestimated or dismissed. The report was prepared by a working group comprising representatives from the profession, of patient groups and various sections of the Department of Health in England which was brought together by the then Chief Dental Officer. The key themes and priorities for action identified in Options include: local commissioning and funding, methods of remuneration for general dental practitioners, prevention and an oral health assessment for patients, clinical pathways, information and communication technology, practice structure, development of the dental team and the patient experience. The document also contains comprehensive reports of the three Options for Change task groups making recommendations for: 1) a new deal for patients - national standards, 2) systems of delivery of dental care and 3) education, training and development of the dental team. Ways forward for delivering improved, modern, effective, preventive, patient-centred dental care have been identified. This potential can, however, only be realised if viable and sustainable agreements can be achieved to operationalise the best choices.
本文旨在结合初级医疗中以往的牙科服务提供情况，对《国民保健制度牙科：变革选择》文件中提出的未来提议和议程进行公正概述，并开始探讨“变革选择”对国民保健制度牙科服务未来可能意味着什么。“变革选择”被描述为国民保健制度牙科在长期停滞与不和谐之后最终向前发展的或许最激进、最具开创性的机遇。“变革选择”议程有可能带来一种新的国民保健制度牙科执业模式，提供一种最终摆脱当前“跑步机”状态的方法，并发展新的国民保健制度牙科服务，将预防作为优先事项，提供高质量牙科治疗，根据21世纪患者的长期需求进行量身定制是其主要目标。然而，绝不能低估或忽视摆脱数十年争端以及克服实际可及性、劳动力和资金问题等各方面临的困难。该报告由一个工作组编写，该工作组由来自专业人士、患者群体以及英格兰卫生部各部门的代表组成，由当时的首席牙科官召集。“变革选择”中确定的关键主题和行动优先事项包括：地方委托和资金、普通牙科从业者的薪酬方法、患者的预防和口腔健康评估、临床路径、信息和通信技术、执业结构、牙科团队的发展以及患者体验。该文件还包含三个“变革选择”任务组的全面报告，这些报告就以下方面提出了建议：1）患者新政——国家标准；2）牙科护理提供系统；3）牙科团队的教育、培训和发展。已经确定了提供改进的、现代的、有效的、预防性的、以患者为中心的牙科护理的前进方向。然而，只有达成可行且可持续的协议以实施最佳选择，这种潜力才能实现。
