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. 2018 Jun 22;18(1):487.
doi: 10.1186/s12913-018-3302-8.

Resource allocation in NHS dentistry: recognition of societal preferences (RAINDROP): study protocol

Christopher R Vernazza  1 , Katherine Carr  2 , John Wildman  3 , Joanne Gray  4 , Richard D Holmes  2 , Catherine Exley  5 , Robert A Smith  6 , Cam Donaldson  7
Affiliations

Resource allocation in NHS dentistry: recognition of societal preferences (RAINDROP): study protocol

Christopher R Vernazza et al. BMC Health Serv Res. .

Abstract

Background: Resources in any healthcare systems are scarce relative to need and therefore choices need to be made which often involve difficult decisions about the best allocation of these resources. One pragmatic and robust tool to aid resource allocation is Programme Budgeting and Marginal Analysis (PBMA), but there is mixed evidence on its uptake and effectiveness. Furthermore, there is also no evidence on the incorporation of the preferences of a large and representative sample of the general public into such a process. The study therefore aims to undertake, evaluate and refine a PBMA process within the exemplar of NHS dentistry in England whilst also using an established methodology (Willingness to Pay (WTP)) to systematically gather views from a representative sample of the public.

Methods: Stakeholders including service buyers (commissioners), dentists, dental public health representatives and patient representatives will be recruited to participate in a PBMA process involving defining current spend, agreeing criteria to judge services/interventions, defining areas for investment and disinvestment, rating these areas against the criteria and making final recommendations. The process will be refined based on participatory action research principles and evaluated through semi-structured interviews, focus groups and observation of the process by the research team. In parallel a representative sample of English adults will be recruited to complete a series of four surveys including WTP valuations of programmes being considered by the PBMA panel. In addition a methodological experiment comparing two ways of eliciting WTP will be undertaken.

Discussion: The project will allow the PBMA process and particularly the use of WTP within it to be investigated and developed. There will be challenges around engagement with the task by the panel undertaking it and with the outputs by stakeholders but careful relationship building will help to mitigate this. The large volume of data will be managed through careful segmenting of the analysis and the use of the well-established Framework approach to qualitative data analysis. WTP has various potential biases but the elicitation will be carefully designed to minimise these and some methodological investigation will take place.

Keywords: Health economics; Oral health; Preference elicitation; Priority setting.

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Conflict of interest statement

Ethics approval and consent to participate

Ethical approval has been granted for the study by Newcastle University Ethics Committee (Ref Nos. 00873/2015 and 7065/2016). For all phases and groups, a written participant information sheet will be provided and informed written consent will be taken.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Overview of workstreams and Participatory Action Research
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