I Think Removal of the Activity Base is a Good Thing:
A GDP experience @ a pilot practice.

Sabrena Kara, Associate dentist at Oasis Health Care
Based on presentation @Westminster Health Forum, Keynote Seminar 2nd July, 2014.
 
I have been working at a type 3 pilot for the past two and a half years. Initially, the practice had one dental therapist. Currently, we have two dental therapists and an oral hygiene educator. At the start of the pilot, the practice allocated 15 minutes for dental check‐ups on UDAs. Now, we allocate 20 minutes for our check‐up and oral health assessment, discuss the RAG scoring with the patient and carefully explain the risks and needs.
This is the dentistry I was taught, and can genuinely say, I enjoy working on a prevention based model.
 
The pilot meant a massive diary backlog, and took almost two years to clear. We achieved this, by using our therapists.
Most patients don’t know what therapists do or their scope of practice. The practice put a great deal of emphasis on patient awareness of the therapist’s work, and increasing the trust in accessing therapists, who are able to deliver restorative and periodontal treatment. Our therapists also started to take interim care appointments. In effect, we are pushing patients away from the traditional six month check‐up model, using the NICE guidelines.
One of our aims has been to ensure that patients understand that their appointments are based on the risks in their mouth. A nine month appointment or one year appointment, can be more appropriate for their needs, and the patient will not see me for two years. This is an important approach; it means my time is allocated fairly. I am able to provide oral hygiene assessment and oral health assessment and the complex care, without creating a backlog.  The use of RAG scoring to emphasise prevention and preventative health, has been very important for the way we deliver dental care.
Patients have genuinely taken on board the dental care we delivering. We tend to have two different types of patient in our practice. The under 35/40 year olds, who are minimally restored, don’t want to have any work done, and tend to listen to what we’re saying. The 40s and 45 plus, who are very heavily restored, they too are buying into prevention. They see prevention as better than cure and don’t want any more drilling and filling for themselves or for future generations, they are seriously buying into the preventative care model.
 
From my experience, the skills mix of the work force is a critical issue, which needs to be discussed and explored further.