Electronic versions

  • Fiona Sandom
  • Simon Hearnshaw
    NHS England, North Yorkshire and the Humber Area, UK.
  • Siobhan Grant
    Public Health England, North Yorkshire and the Humber Area, UK.
  • Lynne Williams
  • Paul Brocklehurst
Introduction An In-Practice Prevention (IPP) programme was developed by the Local Dental Network in the North Yorkshire and the Humber area in England in response to an oral health needs assessment. The underpinning logic model drew on a flexible commissioning approach and aimed to incentivise dental teams with NHS contracts to promote the delivery of prevention. This used care pathways that involved the whole dental team and was cost-neutral.Aim The programme was evaluated using realist methodology to identify 'what works, in which circumstances, how and for who?'.Design Realist evaluations are explanatory in nature and attempt to understand the factors that appear to influence the success (or not) of an intervention, rather than demonstrating causality.Methods and results Following a review of the pertinent literature, semi-structured interviews and focus groups, five theory areas were considered to be critical to the delivery of IPP. In order of stated priority, these were: 1) clinical leadership; 2) 'skill mix'; 3) financial incentives; 4) institutional logic/practice culture; and 5) behaviour change.Conclusion The results appear to show that clinically-led programmes could offer value to dental commissioners within a flexible commissioning model, although this would need to be further tested using an experiment design. [Abstract copyright: © 2022. The Author(s), under exclusive licence to the British Dental Association.]
Original languageEnglish
JournalBritish Dental Journal
Early online date5 Apr 2022
DOIs
Publication statusE-pub ahead of print - 5 Apr 2022
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