Source · Select Committees · Public Accounts Committee
Recommendation 28
28
Deferred
UDA rates inadequately reflect treatment complexity and costs, requiring further modelling
Conclusion
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
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.