Fewer dental referrals to NCAS sparks concern

A drop in the number of dentists being referred to the National Clinical Assessment Service (NCAS) has prompted fears that performance concerns within the profession may be going unnoticed by local managers.

NCAS reports a third reduction in the number of dentists referred during the 12-month period to March 2011. This comes after a steady year-on-year growth in dentist referrals to NCAS.

Professor Alastair Scotland, Director of NCAS, said there is no obvious reason for this drop but admitted it gives cause for concern. He said: "Our experience at NCAS is that the great majority of our referrals are among the most senior grades of practice – essentially those practitioners, in whichever profession, who have a high degree of autonomy in their work.

"We know that most dentists work extremely hard to give an excellent service to their patients, but we also know that – just as with the other professions we work with – there is a small but consistent group who get into difficulty. These latest statistics buck the trend for previous years where we saw a steady increase in referrals of dentists. There is no obvious reason why this should be so, but I would add that it echoes a similar drop five years ago, when considerable organisational change was occurring in primary care. We saw fewer organisations making referrals and it took two years for use of services to recover in the GP sector. This posed questions at the time about whether poor practice was being identified and managed in a timely way. We need to work hard with our colleagues across the NHS to ensure that this is not repeated."

NCAS is calling on the NHS to ensure that performance concerns amongst dentists are picked up and acted on as soon as possible to ensure patient care is not compromised.

The 2010/11 Casework Activity Report also found that most of the practitioners referred to NCAS remain in the clinical workforce but with increased work restrictions. There was also an association between performance concerns and social deprivation. The rate of referral to NCAS is more than a third higher than average in the most deprived quarter of primary care trusts in England and well below average in the least deprived quarter.