Recommendation 10

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