title: The INCENTIVE protocol: an evaluation of the organisation and delivery of NHS dental healthcare to patients-innovation in the commissioning of primary dental care service delivery and organisation in the UK.
abstract: BACKGROUND
  In England, in 2006, new dental contracts devolved commissioning of dental services locally to Primary Care Trusts to meet the needs of their local population. The new national General Dental Services contracts (nGDS) were based on payment for Units of Dental Activity (UDAs) awarded in three treatment bands based on complexity of care. Recently, contract currency in UK dentistry is evolving from UDAs based on volume and case complexity towards 'blended contracts' that include incentives linked with key performance indicators such as quality and improved health outcome. Overall, evidence of the effectiveness of incentive-driven contracting of health providers is still emerging. The INCENTIVE Study aims to evaluate a blended contract model (incentive-driven) compared to traditional nGDS contracts on dental service delivery in practices in West Yorkshire, England.
  
  
  METHODS
  The INCENTIVE model uses a mixed methods approach to comprehensively evaluate a new incentive-driven model of NHS dental service delivery. The study includes 6 dental surgeries located across three newly commissioned dental practices (blended contract) and three existing traditional practices (nGDS contracts). The newly commissioned practices have been matched to traditional practices by deprivation index, age profile, ethnicity, size of practice and taking on new patients. The study consists of three interlinked work packages: a qualitative study to explore stakeholder perspectives of the new service delivery model; an effectiveness study to assess the INCENTIVE model in reducing the risk of and amount of dental disease and enhance oral health-related quality of life in patients; and an economic study to assess cost-effectiveness of the INCENTIVE model in relation to clinical status and oral health-related quality of life.
  
  
  BACKGROUND
  The study has been approved by NRES Committee London, Bromley. The results of this study will be disseminated at national and international conferences and in international journals.
authors.affiliation: Centre for Health Services Research, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
authors.forename: Sue H
authors.initials: SH
authors.lastname: Pavitt
authors.affiliation: Division of Biostatistics, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Baxter
authors.affiliation: School of Dentistry, University of Leeds, Leeds, UK.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Brunton
authors.affiliation: School of Dentistry, University of Leeds, Leeds, UK.
authors.forename: Gail
authors.initials: G
authors.lastname: Douglas
authors.affiliation: School of Population Health, University of Auckland, Auckland, New Zealand.
authors.forename: Richard
authors.initials: R
authors.lastname: Edlin
authors.affiliation: School of Clinical Dentistry, Sheffield, UK.
authors.forename: Barry J
authors.initials: BJ
authors.lastname: Gibson
authors.affiliation: School of Dentistry, University of Leeds, Leeds, UK Public Health England, Regional Office, Leeds, UK.
authors.forename: Jenny
authors.initials: J
authors.lastname: Godson
authors.affiliation: School of Clinical Dentistry, Sheffield, UK.
authors.forename: Melanie
authors.initials: M
authors.lastname: Hall
authors.affiliation: Department of Psychology, Sociology & Politics Collegiate Campus Sheffield Hallam University, Sheffield, UK.
authors.forename: Jenny
authors.initials: J
authors.lastname: Porritt
authors.affiliation: School of Clinical Dentistry, Sheffield, UK.
authors.forename: Peter G
authors.initials: PG
authors.lastname: Robinson
authors.affiliation: Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
authors.forename: Karen
authors.initials: K
authors.lastname: Vinall
authors.affiliation: Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: Hulme
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration*; D006801:Humans; D009042:Motivation; D011320:Primary Health Care / Q000458:organization & administration*; D013222:State Medicine / Q000458:organization & administration*; D006113:United Kingdom
keywords: HEALTH ECONOMICS; ORAL MEDICINE; PUBLIC HEALTH; QUALITATIVE RESEARCH