PhD Studentship: ‘Choosing Wisely in Dentistry: To Dis-invest or Re-invest?’

The NHS has limited resources, with fixed budgets, and must prioritise the treatments delivered, with difficult decisions having to be made about the most efficient allocation of resources. The Choosing Wisely programme was developed to encourage communication between patients and healthcare professionals to prevent unnecessary treatment. In dentistry, Covid-19 has resulted in prolonged treatment restrictions, highlighting the importance of prioritising. Recent studies have identified areas of dental activity which provide minimal clinical benefit, yet patients value these services highly. It is important that decisions regarding the potential re-distribution of these costs are approached in a way which is mindful of benefits, such as the effectiveness, efficiency and equity of the dental care system as well as potential risks, such as reducing patient engagement with dental services.

One tool which can aid this process of resource allocation is Programme Budgeting and Marginal Analysis (PBMA). PBMA is a priority-setting framework used to assist decision-makers in identifying the most efficient use of resources. It involves collaborative and meaningful engagement with all stakeholders (patients, healthcare professionals, policy makers) to identify areas for disinvestment, and then prioritises areas for future re-investment of the identified funds.

The aim of this PhD is to utilise and advance PBMA methodology as a tool to improve the efficiency of resource allocation decisions (de-implementation and re-investment) in the context of primary dental care in Scotland.

Objectives:

1. To review the literature on resource allocation/priority setting tools, including an in-depth review of the use of Programme Budgeting and Marginal Analysis (PBMA) to aide in healthcare resource allocation decisions. This step will identify advantages and disadvantages of the method and help shape the thesis methodological research questions.
2. To evaluate the impact of presenting evidence in different formats to inform disinvestment decisions.
3. To identify the determinants of disinvestment decisions from different stakeholder perspectives.
4. Based on objectives 1-3, to design, run and evaluate a PBMA in the context of dental primary care in Scotland.
5. Make recommendations on best practice methods for resource allocation in dental primary care in Scotland.

The study can be tailored to the student’s specific skills and interests; however, an interest in health economics and public health would be beneficial.

To apply please send a CV and covering letter to Dr Heather Cassie; [Email Address Removed]

Closing date: Friday 10th June 2022, 5pm.