Source · Select Committees · Public Accounts Committee
Recommendation 26
26
Deferred
Minimum UDA value uplift to £28 lacked evidence, uncertain to increase activity
Conclusion
UDA payment rates are not however, uniform across the country with evidence submitted by the British Dental Association suggesting, for example, that the average UDA rate in North East London ICB is more than £7 greater than the average rate in Lincolnshire ICB.76 Government took the decision in 2022 to introduce a minimum UDA value of £23, with NHSE telling us that this decision did lead to some “slight improvements in activity”.77 As part of the dental recovery plan, NHSE and DHSC agreed to push this minimum value up to £28, leading to 876 individual contracts being uplifted to this new minimum rate. This was a ministerial decision rather than an evidenced–based one, with DHSC’s own analysis unconvinced as to whether the uplift would lead to any real increases in contract delivery.78 The impact of the uplift is not yet known in quantitative terms, but NHSE told us that the qualitative feedback has been positive in terms of supporting the sustainability of the affected practices.79
Government Response Summary
The government agrees with the observation and is conducting analysis on the 'actual costs' of providing dental care, engaging with the BDA, and expects to publish this work in due course. It also notes ongoing work to reform the dental system and interim changes to the UDA system, such as fairer payment for complex band 2 treatments.
Government Response
Deferred
HM Government
Deferred
5.1 The government agrees with the Committee’s recommendation. 5.2 The government is conducting analysis on the ‘actual costs’ of providing dental care and engaging with the BDA on this work, which the government expects will be published in due course. 5.3 The government is working to reform the dental system, and in the interim have made vital changes to how dentists are paid within the current UDA system, for example, through fairer payment for more complex band 2 treatments, in turn incentivising access for patients with a need for higher volume or more complex treatment within band 2. 5.4 The government recognises that different communities will have different needs and that there is a link between deprivation and higher need for dental care. The national contract provides for the breadth of treatments that could be needed by different populations and it also enables flexible commissioning so that ICBs can commission tailored dental programmes and initiatives to meet the specific needs of their local population. ICBs are responsible for commissioning NHS dentistry to meet the needs of the local populations, as well as undertaking oral health needs assessments to identify areas of need.