Recommendation 28

There is also a clear sense that UDA rates do not sufficiently distinguish between the different levels of complexity and cost attached to various treatments. This is despite the government decision in 2022 to split up band 2 treatments into three separate bands each attracting a different number of UDAs. This was in acknowledgement of the fact that there are different costs associated with, for example, treating someone for one filling compared with performing molar endodontics on permanent teeth.84 Many stakeholders feel that this does not go far enough, however, with submissions to us pointing out that one filling can still be reimbursed to the same level as a treatment requiring five fillings.85 NHSE confirmed that the later decision to set the minimum UDA value at £28 was not based on modelling relating to costs, but was based on how much they could lift the rate and drive greater activity rather than an actual understanding of the costs of the treatments. NHS England told us that it is committed to modelling this costing going forward and engaging with the sector to understand it properly.86 NHS dental workforce