Source · Select Committees · Public Accounts Committee
Recommendation 4
4
Accepted
Articulate improved central-local coordination and support for ICBs in future NHS dentistry plans.
Conclusion
The dental recovery plan relied on centrally planned and imposed initiatives that ultimately failed to positively influence the amount of care delivered by dental practices. The dental recovery plan set out national initiatives that relied on take–up and delivery at a local level, hoping to influence the behaviour of individual dental practices. This approach ultimately failed, with the example of mobile dental vans particularly illustrative of a nationally–planned idea failing to address issues on the ground. Going beyond this national plan, it is imperative that regional disparities in access to NHS dentistry are resolved–access to NHS dentistry ranged from 382 courses of treatment delivered per 1,000 people in Somerset ICB to 800 delivered per 1,000 people in South Yorkshire ICB in 2023–24. NHSE and DHSC must support ICBs to use what flexibilities they have in their commissioning powers to deliver improvements that will work for their particular areas, and where necessary there should be clear lines of accountability for how ICBs manage NHS dental services under their responsibility. Commitments like the new government’s proposed 700,000 urgent appointments will rely on NHSE and DHSC’s ability to work with the people who deliver the service to translate that national priority into a local reality. recommendation NHSE and DHSC must in their future plans for NHS dentistry: a. clearly articulate how they will improve on previous efforts to co–ordinate between central and local initiatives. b. explain how they intend to support ICBs to innovate within their commissioning powers, while holding them to account for improving dentistry in their areas. 5 c. explain how they intend to support ICBs where, contrary to Government initiatives to expand access to dental treatment, practises may be experiencing a reduction in funding for 2025–26.
Government Response Summary
The government is extending the dental ringfence into 2026-27, increasing its value to £4,104 million in 2025-26, and uplifting contract values. They are also supporting ICBs through continued Golden Hello payments and the inclusion of an additional 700,000 urgent appointments in planning guidance, with regular monitoring.
Government Response
Accepted
HM Government
Accepted
The government agrees with the Committee’s recommendation. also note that there has been no reduction in dental funding in 2025-26 and that the dental ringfence is being extended into 2026-27 to provide further support to ICBs. The value of the dental ringfence has increased from £3,974 million in 2024-25 to £4,104 million in 2025-26- an increase of 3.29%. Dental contract values for 2025-26 will be uplifted (backdated to April 2025) once ministerial decisions have been taken in response to DDRB recommendations. Where there have been changes to individual practice funding levels this will have been because of either: • practices asking to reduce their NHS commitment, or • ICBs taking steps to release monies from persistently under-delivering contractors to enable these monies to be used to buy care from providers who can deliver. Cash reductions could also be possible where ICBs are recovering funding paid for activity which was not delivered in the previous year. All these scenarios support access to dental treatment and best value for public money. Immediate actions to support ICBs to expand dental access in 2025-26 include the continuation of the dental ringfence to signal the importance of maximising the dental budget to secure care, inclusion of the manifesto commitment for an additional 700,000 urgent care appointments in Planning Guidance and ongoing support for Golden Hello payments to new dentists. Delivery of the 700,000 additional urgent care appointments will be monitored regularly and remedial action taken with regions and ICBs where necessary.