title: Changes to financial incentives in English dentistry 2006-2009: a qualitative study.
abstract: OBJECTIVE
  To explore the views of NHS dentists in England regarding reforms, which changed their incentive and payment structure.
  
  
  METHODS
  Semi-structured interviews with 35 dentists, digitally recorded, transcribed verbatim and analysed using a constant comparative method.
  
  
  RESULTS
  Dentists reported changing their behaviour in response to incentives in ways that were likely to have adverse impacts on patients. There was also a loss of trust in NHS paymasters, as well as a loss of faith in the ability to provide high quality care in NHS dentistry.
  
  
  CONCLUSIONS
  Responses suggest that many dentists were quick to change behaviour following the introduction of a revised contractual structure in 2006. The coalition government in the UK has stated its intention to introduce a new NHS dental contract. Our data suggest that part of the process of changing behaviours, norms and attitudes will require the rebuilding of trust in the NHS amongst NHS dentists, as opposed to merely redesigning incentive structures, though the two are related.
authors.affiliation: University of Nottingham, Nottingham, UK. ruth.mcdonald@nottingham.ac.uk
authors.forename: Ruth
authors.initials: R
authors.lastname: McDonald
authors.forename: Sudeh
authors.initials: S
authors.lastname: Cheraghi-Sohi
authors.forename: Caroline
authors.initials: C
authors.lastname: Sanders
authors.forename: Martin
authors.initials: M
authors.lastname: Tickle
mesh_terms: D000328:Adult; D003657:Decision Making; D004739:England; D055094:Evidence-Based Dentistry; D005260:Female; D018166:Health Care Reform; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010816:Physician Incentive Plans / Q000191:economics*; D019239:Practice Patterns, Dentists' / Q000706:statistics & numerical data; D011640:Public Policy; D036301:Qualitative Research; D012052:Reimbursement, Incentive / Q000191:economics*; D013218:State Dentistry / Q000191:economics*