Source · Select Committees · Public Accounts Committee
Recommendation 10
10
Deferred
Previous NHS dental contract reform efforts largely unsuccessful despite recent changes.
Conclusion
DHSC told us that issues with NHS dentistry pre–date the 2006 contract, and that with any change since the 1990s, “things have got worse”.18 DHSC began attempts at contract reform in 2010, testing changes through a prototype programme which combined payment by activity with a fixed amount paid per registered patient. Further prototype contracts ran between 2016 and 2019, but these arrangements ended in 2022 with DHSC concluding that the prototype had led to reductions in access and activity.19 In 2022, the first changes to the 2006 contract were introduced, including: • dividing band 2 treatments into three categories to reflect different complexities of treatment; • introducing a minimum indicative UDA value of £23; and 12 Letter from the Interim Permanent Secretary of the Department of Health and Social Care and the Chief Executive Officer at NHS England relating to a follow up on the oral evidence session held on 13 February 2025 on Fixing NHS Dentistry, 18 March 2025 13 FND0002, see page 4 14 FND0007, see page 3 15 FND0007, see page 2 16 FND0011, see page 2 17 C&AG’s Report, Figure 9 18 Q 82 19 C&AG’s Report, para 1.24 10 • enabling commissioners to address worsening access due to persistently under–delivering dental contractors.20
Government Response Summary
The government agrees with the observation and states that work on reforming the dental contract, focusing on prevention and retention, is underway. It notes that a realistic timetable will be determined following careful consideration and consultation, with a target implementation date yet to be advised.
Government Response
Deferred
HM Government
Deferred
1.1 The government agrees with the Committee’s recommendation. Target implementation date: to be advised 1.2 To rebuild dentistry in the long term, work on the government’s ambition to reform the dental contract with a shift to focus on prevention and the retention of NHS dentists is underway. There are no perfect payment models and careful consideration needs to be given to any potential changes to the complex dental system so that genuine improvements for patients and the profession can be delivered. There are risks of destabilising the current system, and a realistic timetable for the introduction of a new contract will be determined by the scale of changes under consideration and following consultation. 1.3 The government is continuing to work with the British Dental Association and other representatives of the dental sector to deliver the shared ambition to improve access to treatments for NHS dental patients, whilst at the same time, considering what other improvements can be made to incentivise the workforce to deliver more NHS care. The government recognises the importance of working with the wide range of dental care professionals, commissioners and importantly, patients and the public, to inform a new and improved dental contract for England, upon which the government expects to consult publicly.