In December 2025, the Government published its response to the NHS dentistry quality and payment reforms consultation that had been held over the summer. Following this consultation they have confirmed that all the changes will be implemented. However, following this feedback there some changes to the proposals. The new arrangements are outlined below, some will commence from 1 April 2026 with others to follow.
Wendy Crew
Urgent and unscheduled care
Contractors will be expected to deliver 8.2% of their contract activity as urgent/unscheduled care. This can be for existing patients at the practice but also those not known to them. The funding for an urgent course of treatment will be changed from the current banded course of treatment (1.2 units of dental activity (UDA)) to a financial payment of £60 per course of treatment completed and a £15 payment for each mandated urgent care appointment, regardless of the attendance of a patient.
Complex care
Three new care pathways were consulted on for how care for patients with complex need should be remunerated. This was taking it from a banded course of treatment to a financial payment value based on the individual pathway. These will be implemented in April. It was confirmed that these pathways will only be offered to patients aged 16 or over at this stage.
Additional recognition of clinical treatment and skill mix
It was recognised that under the current system some clinical treatments were in the wrong band of treatment or were not fairly remunerated for. The proposed additional allocation of two units of dental activity for denture modifications will proceed alongside the rebanding of denture repairs and fissure sealants. Prevention is key in improving oral health especially for children and going forward dental nurses will be able to provide fluoride varnish outside of a standard check up based on clinical need and it will be recognised with an allocation of 0.5 UDAs.
Setting of recall intervals
The National Institute for Health and Care Excellence (NICE) have set the appropriate recall intervals for seeing patients. The setting of these will remain the responsibility of the treating clinicians. It was identified through the consultation that patients need to have better education in relation to these recall intervals but that support should also be made available for providers and performers. Therefore, this will be the first topic of the new quality improvement programme that is proceeding from the consultation.
Quality programme
The first topic for the structured audit and peer reviews will be on NICE recalls and following feedback from the consultation the proposed remuneration is currently being reviewed. The second part of the quality programme was the introduction an annual appraisal programme this will be introduced and remunerated by a payment of £213 per participating clinician rather than six UDAs. It was confirmed that the appraisal funding is not available to staff members who are directly employed by the contractor.
Supporting the workforce to feel part of the NHS
The three proposals are being taken forward with the change to the entitlement for discretionary support payments will be implemented in April 2026 with the model contract and handbook to follow.
Impact on commissioners
The changes will require changes to legislation and commissioners need to be prepared to issue the relevant contract variations when they are released. In 2026/27 contract management processes will need to be reviewed to ensure that the relevant quality and monitoring requirements are being implemented by practices and that the reforms are bringing the required results. Commissioners are being supported by nationally provided workshops and new or updated guidance will be issued in the coming months.
PCC can support commissioners in creating their variation notices, working to develop, review or support implementation of new processes. If you would like to discuss any support requirements please contact wendy.crew@pcc.nhs.uk.
