Job satisfaction of dental practitioners before and after a change in incentives and governance: a longitudinal study

to measure changes in dental practitioners' job satisfaction following a contractual change, and compare differences between those transferring from a fee-per-item system (general dental service, GDS) and those previously working under a block contract with the primary care trust (personal dental service, PDS).

Analysis of postal questionnaires conducted in 2006 and 2007.

Four hundred and forty dental practitioners responding to the 2006 baseline questionnaire.

Although perceived workload was unchanged, global job satisfaction had decreased for 24.7% (31) of GDS dentists and 49.0% (95) of PDS dentists comparing their scores given before and after the contractual change. PDS dentists showed a significant change in attitudes towards feeling restricted in providing quality care (change in factor mean [SD] = -2.88 [0.82]; p < 0.001). They also showed less positive attitudes towards 'respect' (change in factor mean [SD] = -3.70 [0.48]; p < 0.001).

The 2006 contractual change appears to have had a negative impact on dentists' job satisfaction and has not addressed concerns which have led dentists to move into the private sector. The study indicates that the fall in job satisfaction is more a result of a perceived erosion of professional autonomy than a reaction to the change in the system of remuneration.