Measuring oral health: Does your treatment really make a difference

An understanding of a broader concept of health is increasingly important for all health professionals, including dentists, and has recently been incorporated as a key principle in the Government White Paper, The New NHS¹. This aims to deliver a dependable, high quality, egalitarian health service. In the past, performance measurements in the UK have often relied simply on those areas which are most easily quantified. For example, within the hospital service, performance was measured in terms of the cost and the number of finished consultant episodes, from which the 'purchaser efficiency index' was calculated. This tended to produce a driving force rewarding those doing more rather than those doing more better. It is analogous to the system which has been the backbone of NHS dental practice for many years, 'fee per item of service', where throughput is rewarded rather than outcome. However, the White Paper has signalled a move away from simply counting activity. From April 1999 within the hospital service the purchaser efficiency index has been replaced with more rounded measures, reflecting the changing concepts of health, in a new broader performance framework to determine what really counts for patients. It will focus on measuring health improvement, fairer access, better quality and outcome, including the views of patients.