Self-declaration and Self-reflection
NHS commissioning pathways
I, Nuwan Kumara Rajapaksha Rajapaksha Pathiranlage, hereby confirm that I have
read the following guidance on the topic of “NHS commissioning pathways” which is
readily available on the www.england.nhs.uk web site.
https://www.england.nhs.uk/commissioning/what-is-commissioning/
https://www.england.nhs.uk/primary-care/dentistry/dental-commissioning/
After reviewing this web article, I now understand that commissioning is an ongoing
process involving planning, agreement, and monitoring of healthcare services. As it
describes, commissioning spans various levels, from local needs assessments and
patient pathway design to national-level service specification and procurement. The
geographical scope of commissioning varies depending on the service, with some
services best delivered locally, while others require a national approach, especially for
rare conditions. Furthermore, the article describes some authorities called Integrated
Care Boards (ICBs) that are responsible for commissioning healthcare services on a
regional and national level. ICBs replaced Clinical Commissioning Groups (CCGs)
which were established in 2013 to manage primary care services but were dissolved
in 2022 as part of the transition to Integrated Care Systems (ICSs).
As a dental care professional to be in the United Kingdom, I specifically have read on
dental commissioning segment in the web article. According to that, NHS England
plays a crucial role in dental commissioning, aiming to improve the quality and
accessibility of dental care across England. As I have understood, NHS England
focuses on reducing oral health inequalities, particularly among children under 5, and
promoting flexible commissioning models. Additionally, they work to address areas
with weak dental provision, ensure fair contract performance management, and reform
dental contracts to enhance service delivery and value for money.
I further noticed that the UK government has initiated a multi-phase reform of the
dental contract to address challenges faced by dental professionals and patients. The
first phase was launched in 2021, and it involved extensive engagement with
stakeholders to identify issues and develop solutions. Key changes introduced include
enhanced units of dental activity (UDA) to support higher-needs patients, increased
focus on prevention and self-care, and steps to maximize access to NHS dental care.
Additionally, the government is supporting the use of skill mix in NHS general dental
practice to improve efficiency and patient care. Now, I am aware that there was a
prototype program which was led by the office of chief dental officer, running from
2010 to 2022, tested new clinical and remuneration models, prioritizing prevention,
and self-care. I understand that the government is committed to ongoing reform and
further engagement with dental teams, patients, and the public.
As I have understood after reading this article, the NHS England clinical and
commissioning standards aim to standardize the commissioning of NHS dental care
in England. They provide a framework for commissioners to improve access to dental
care, based on patient needs and high-value health outcomes. The standards
encourage collaboration between primary dental care and hospital specialists,
removing the roadblocks to deliver better patient care. They have emphasized the
importance of patient choice and the flexibility to deliver specialist care in various
settings. According to the article, the standards outline mandatory clinical
competencies, best practices, contract design, and performance metrics. Moreover,
they have encouraged commissioners to work closely with clinical networks, regional
dental public health consultants, and dental local professional networks to deliver high-
quality care.
As far as I understood, these standards had aimed to remove barriers between primary
and secondary dental care, allowing for a more integrated approach to patient care.
As per discussed in the article, the key aspects of the standards include:
• Standardized framework: Providing a standardized framework for
commissioning dental specialties to ensure consistency across England.
• Patient-centered care: Focusing on patient needs and delivering high-quality,
value-based care.
• Collaborative approach: Encouraging collaboration between commissioners,
clinicians, and patients to improve service delivery.
• Clinical competency: Setting clear standards for the clinical competencies
required to deliver specialist dental care.
• Flexible service delivery: Allowing for flexible service delivery models to meet
the diverse needs of patients.
• Performance measurement: Establishing performance metrics to monitor the
quality and efficiency of dental services.
• Implementation support: Providing support and guidance to commissioners
during the implementation process.
NHS England aims to improve access to dental care, reduce inequalities, and enhance
patient outcomes by following these standards.
As described in the article, the implementation of the standards will be gradual, with a
focus on identifying capability gaps and measuring the impact of changes.
Commissioners will work with local stakeholders to set local priorities and benchmarks
for quality, value, and sustainability. NHS England will provide support and guidance
throughout the implementation process.
Going forward with challenges with commissioning, the article emphasizes the fact
that commissioning in the NHS is evolving to meet the challenges of improving
population health, enhancing care quality, and controlling costs. This involves greater
collaboration between commissioners, providers, and local government. The authors
have identified ICSs and devolution are key strategies to maximize the value of
healthcare spending. The Health and Care Act 2022 enables new collaborative
working arrangements between NHS organizations and local government. NHS
England has delegated some commissioning functions to ICSs, including those related
to pharmaceuticals, ophthalmology, and dentistry.
As a dental hygienist, I found this website as a quick reference to NHS commissioning
with separate section on dental commissioning allowing me to keep myself up to date.
Name- Nuwan Kumara Rajapaksha Rajapaksha Pathiranalage
Date- 30/11/2024
