The use of conversation mapping to frame key perceptual issues facing the general dental practice system in England

To demonstrate the use of a novel qualitative methodology namely conversation mapping, which can be used to capture differences in stakeholder perspectives and give a root definition of the problem in a complex policy area. The methodology is used in the context of the changes introduced in the English general dental practice system in April 2006, to investigate the key issues facing the system, as perceived by general dental practitioners (GDPs).

From a broad trigger statement, three transformational statements were produced. Each participant recorded their contribution on a hard diagrammatic form as a 'map', with others responding with their own written comment, thus generating three conversation maps. Thematic analysis resulted in the generation of a preliminary model summarising key perceptual issues.

The five emergent themes identified were: financing, dentists' wants/needs, the role of the public and patients, system goals and policy level decision making. Financing was identified as the core category to which all other categories were related.

Conversation mapping, a methodology arising from a systems approach, can be used to develop a 'rich picture' of an oral health care system in order to define the core problem within this policy area. Findings suggest that GDPs identify the financing of the system as a fundamental source of problems within the general dental practice system. This appears to be at variance with the perception of policy makers, who report a more limited view, identifying the system of remuneration as the 'heart of the problem'.