Northern Ireland’s take on the IOTN

From the BDA newsdesk:

4.0 IOTN score for orthodontic care in NI proposed
Proposals to introduce a threshold of 4.0 on the Index of Treatment Need (IOTN) for entitlement to orthodontic care for children in Northern Ireland are reported by BBC Online. Parents whose children are not assessed at such a level, but nonetheless wish their offspring to undergo treatment, will have to pay for it privately, incurring a bill of at least £2,000, the report notes. Commentary from the BDA and individual practitioners criticises the proposal to set a different IOTN threshold from that in place in England and warns that children of parents who cannot afford to pay for Health Service care will be at a disadvantage.

When the IOTN was introduced to the NHS in England & Wales I likened it to a valve that would only ever be tightened. Starting, as it did, at the same time as the new contract in 2006 the implications seemed to have been overlooked by many. Setting the “bar” at 3.6 gave a smooth transition without frightening the wire benders too much, but when I recently re-read the the rules in light of the news from Ulster I realised that the guidelines said that,

“Orthodontic treatment would only be provided for:

  • Grade 4 or 5 of the Dental Health Component (DHC) of the IOTN” or
  • Grade 3 of the DHC of that Index with an Aesthetic component of 6 or above”

So it’s easy for those in control of the purse strings to strike out the second statement thus tightening the valves. Of course it could be that in Northern Ireland they have just forgotten to include the second statement and we’re all getting our knickers in a twist over an administrative omission – but somehow I doubt it.


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