Source · Select Committees · Public Accounts Committee
21st Report - Fixing NHS Dentistry
Public Accounts Committee
HC 648
Published 4 April 2025
Recommendations
3
Accepted
Explain how DHSC and NHSE will strengthen dental analytical capabilities and implement business-critical changes in practice.
Recommendation
DHSC and NHSE’s modelling of what might be achieved, and how much this would cost was wrong and it took too long to identify the error, raising wider concerns about the quality assurance processes in place for such plans. DHSC …
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Government Response Summary
The government is undertaking a lessons learned exercise due Summer 2025 to understand modelling errors and incorporating dental modelling into the 'Business Critical Model' process from April 2025 for additional scrutiny. Analytical teams are also working more closely together to improve quality assurance.
HM Treasury
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Conclusions (12)
2
Conclusion
Accepted
The dental recovery plan was never going to deliver its headline ambition that everyone who needs to see an NHS dentist would be able to, and has failed even to deliver the hoped for 1.5 million additional courses of treatment in 2024–25. The plan’s initial promise to expand access in …
Government Response Summary
The government agrees to publish an evaluation of the dental recovery plan, confirming data will be available from Summer 2025 and NHSE expects to report on individual initiatives by Autumn 2025. An initial evaluation on the plan's continuation into 2025-26 will be completed by Summer 2025.
4
Conclusion
Accepted
The dental recovery plan relied on centrally planned and imposed initiatives that ultimately failed to positively influence the amount of care delivered by dental practices. The dental recovery plan set out national initiatives that relied on take–up and delivery at a local level, hoping to influence the behaviour of individual …
Government Response Summary
The government is extending the dental ringfence into 2026-27, increasing its value to £4,104 million in 2025-26, and uplifting contract values. They are also supporting ICBs through continued Golden Hello payments and the inclusion of an additional 700,000 urgent appointments in planning guidance, with regular monitoring.
5
Conclusion
Accepted
DHSC and NHSE have not undertaken the analysis needed to understand the actual cost of delivering NHS dental care, without which any efforts at reform will fail to address fundamental issues around the affordability of NHS work. The discrepancy between what a dentist can earn delivering NHS work and private …
Government Response Summary
The government agrees to conduct and publish analysis of the actual costs of NHS dental care, engaging with the BDA on this work which is expected to be published in due course. They also note interim changes to UDA payments to incentivize more complex treatments.
1
Conclusion
Accepted
On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department for Health and Social Care (DHSC) and NHS England (NHSE) on NHS dentistry and the dental recovery plan.1
Government Response Summary
The government, noting the committee's work, highlights its commitment to rebuilding NHS dentistry and focuses on prevention by introducing supervised toothbrushing programs, expanding water fluoridation, and efforts to reduce sugar and create a smoke-free generation.
9
Conclusion
Accepted
The NAO report reflects this last point, finding that in 2022–23 £479 million was recovered from dental contracts where practices had not delivered the full amount of care that they had been contracted for.17
Government Response Summary
The government acknowledges the committee's observation by explaining that funding is recovered from dental contracts due to practices reducing commitments, ICBs reallocating funds from under-performing contractors, or reclaiming payment for undelivered activity, all of which supports access and value for money.
12
Conclusion
Accepted
The new government’s commitment to contract reform includes reference to a focus on prevention,27 and also to a programme of supervised toothbrushing for three, four, and five–year olds “most in need”.28 Tooth decay is a leading cause of hospital admissions for children in this country,29 and as DHSC told us …
Government Response Summary
The government agrees with the observation and states that it has already introduced a national supervised toothbrushing programme for 3-5-year-olds in deprived areas and announced the expansion of water fluoridation in the North East. It also highlights ongoing work on sugar reduction and a smoke-free generation as part of its commitment to prevention.
16
Conclusion
Accepted
NHSE did tell us that “roughly 2.7 million new patients” had come through during the year so far, which they claimed was “on track with what we would have expected” based on last year.44 However, DHSC and NHSE published information in February 2025, shortly after our evidence session in the …
Government Response Summary
The government commits to NHSE carrying out analysis of the New Patient Premium, Golden Hellos, and UDA uplift initiatives, with data collected by July 2025 and a detailed breakdown provided by Autumn 2025.
17
Conclusion
Accepted
In terms of the other initiatives, NHSE confirmed that it is too early to say whether the uplift to £28 minimum UDA value has had any impact.46 It said that it will only be after the year end that data will be available on the UDA uplift.47 For ‘golden hellos’, …
Government Response Summary
The government commits to NHSE carrying out analysis of the New Patient Premium, Golden Hellos, and UDA uplift initiatives, with data collected by July 2025 and a detailed breakdown provided by Autumn 2025. The national mobile dental van program will not be included as it was not implemented.
19
Conclusion
Accepted
Shortly before our evidence session in February we received a letter from DHSC and NHSE explaining that an error had been identified in their initial modelling of the dental recovery plan.54 The error related to the cost of the NPP, which NHSE and DHSC had estimated would be £164 million …
Government Response Summary
The government has put additional analytical resources into dental modelling, is undertaking a lessons learned exercise to be reported by Summer 2025, and has incorporated dental modelling into its "Business Critical Model" process from April 2025 to improve quality assurance following the identified error.
21
Conclusion
Accepted
Given this error, NHSE assured us that additional analytical resources would be put in place for the dental service, which would in future be designated a “business–critical model”.59 We were told that there had been 51 DHSC, Faster, simpler and fairer: our plan to recover and reform NHS dentistry, published …
Government Response Summary
The government has put additional analytical resources into dental modelling, is undertaking a lessons learned exercise to be reported by Summer 2025, and has incorporated dental modelling into its "Business Critical Model" process from April 2025 to improve quality assurance, consistent with assurances given.
23
Conclusion
Accepted
The dental recovery plan’s four main initiatives were centrally planned by NHSE and DHSC with instructions given to commissioners as to how to carry them out.65 The plan’s delivery, therefore, was heavily reliant on ICBs implementing these initiatives at a local level and delivery by dental practices. The NAO’s report …
Government Response Summary
The government acknowledges the need to strengthen relationships with ICBs and regions, stating that NHS England has already taken active steps to engage them. This is evidenced by their work with ICBs in preparing for the delivery of 700,000 additional urgent dental appointments from April 2025 and planned 2026 reforms.
31
Conclusion
Accepted
It is also clearly the case that NHS dental workforce issues are much more pronounced in some parts of England than others and that this is leading to some shocking regional inequalities in access to dental care.92 At the lowest end of the scale, Somerset ICB delivered 382 courses of …
Government Response Summary
The government acknowledges regional inequalities and states it is addressing them by delivering 700,000 extra urgent dental appointments from April 2025 and implementing the Golden Hello scheme, which has recruited 45 dentists and has 250 posts advertised to work in areas of most need. Additionally, ICBs are responsible for commissioning tailored local dental programs.