orthodontic treatment criteria michael matheson reply2011!12!21
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8/3/2019 Orthodontic Treatment Criteria Michael Matheson Reply2011!12!21
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Ministear airson Siainte Poblach
Minister for Public Health
Micheal Matheson BPA
Michael Matheson MSP
F IT : 0845 7741741
Kezia Dugdale MSPThe Scottish ParliamentEDINBURGH
EH991SP
Ur faidhlelYour ref: GC-04/11/11Ar faidhle/Our ref: 2011/1024256I~December 2011
The ScottishGovernmentRiaghaltas na h-Alba
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::::?DELIVERINGA GA ME S LE GA C Y F OR S C OT IA N D
I refer to your letter of 4 November to Nicola Sturgeon, Cabinet Secretary for Health,
Wellbeing and Cities Strategy, about the introduction of the Index of Orthodontic Treatment
Need (IOTN). Your letter has been passed to me for reply as I have portfolio responsibilityfor dental policy in Scotland.
It may be helpful if I explain that the Scottish Government is focussing orthodontic treatment
in the NHS on those children who have a clinical need for treatment. In addition, we are
making the system simpler to allow dentists to treat children with the greatest need more
quickly.
The purpose of NHS general dental service (GDS) provision is to secure and maintain the
oral health of the patient. The Scottish Government is introducing the Index otlOTN into the
GDS as this assessment method will ensure that orthodontic resources are focussed clearly
on those children who have a clinical need for treatment and who will have an oral healthbenefit at its completion. If the problem is purely cosmetic, the patient will still be treated if
the misalignment is significant.
I should point out that the use of IOTN was proposed by the Labour/ Liberal Democrat
partnership administration in the Dental Action Plan (DAP) in 2005. Prior to publication ofthe DAP a wide-ranging consultation was undertaken on "Modernising NHS Dental Services"
which considered orthodontics and the place of IOTN. The DAP was subsequently debated
in Parliament in November 2005.
IOTN gives an evidence based framework to the decision making, and has come into forceonly after negotiation with the profession, dentists in general and orthodontists specifically,
Taigh Naomh Anndrais. Rathad Regent, Dun Eideann EH1 3DG
St Andrew's House. Regent Road. Edinburgh EH1 3DG
www.scotland.gov.uk
mailto:[email protected]://www.scotland.gov.uk/http://www.scotland.gov.uk/mailto:[email protected] -
8/3/2019 Orthodontic Treatment Criteria Michael Matheson Reply2011!12!21
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and after systems have been put in place to record the IOTN. In essence it brings clarity to
the system. The IOTN now being introduced in Scotland does not differ from the IOTN
proposed by the Labour/ Liberal Democrat partnership administration in 2005. IOTN is also
in place in the rest of the UK. Northern Ireland, like ourselves, has introduced IOTN this
year, and it has been in place in England and Wales since 2006.
In accordance with the regulations and policies which dictate the provision of NHS
orthodontic treatment, any NHS dental treatment, including orthodontic treatment, the cost of
which is likely to exceed a set limit, currently 350, requires the prior approval of the Scottish
Dental Practice Board (SDPB) before treatment commences. Practitioners seeking
orthodontic prior approval are required to submit treatment plans, radiographs and models to
Practitioner Services Division (PSD) of NHS National Services Scotland, who consider such
cases on behalf of the SDPB. In all cases where prior approval is refused the dentist orpatient (or their representative) has the right to appeal to their NHS Board.
I would like to make it quite clear that decisions not to approve treatment are made entirely
on clinical grounds in accordance with the requirements of the regulations. There i~no cashlimit on the provision of oiiRooontic-treatmen( .~mdTundingmScotland under the NHS is
available for all cases where the treatment is necessary to secure and maintain oral health.
In your letter you also mention the General Dental Services (GDS) budget. The GDS budgethas been protected in cash terms across the three years of the Scottish Spending Review
2011. We continue to take every opportunity to maximise the value for money derived fromour investment in dental services.
I hope this reply will help reassure you and your constituents that the Scottish Government is
continuing to fund orthodontic treatment on the NHS for children who need it. I should like to
reassure you also of the Scottish Government's commitment to improving oral health in
Scotland. We have made a considerable investment in NHS dentistry since 2007 and all
current indicators show the great progress that has been made. Since 2007 there has beenan increase of 1.36 million patients registered with a dentist under NHS arrangements, anincrease that has been reflected across all age groups, and the number of dentists working
in General Dental Services has increased by nearly 500 since 2007.
Michael Matheson
Taigh Naomh Anndrais, Rathad Regent, Dun Eideann EHl 3DG
St Andrew's House, Regent Road, Edinburgh EHl 3DG
www.scotland.gov.ukIS\'K'iTOR IS 1'f.(lP1.E
http://www.scotland.gov.uk/http://www.scotland.gov.uk/