The Department of Health and Social Care published its response to the NHS dentistry contract: quality and payment reforms consultation in December 2025, committing to the full implementation of the proposed changes with minor adjustments. Officials hail this as the most comprehensive update to the dental contract in years, designing it to shift incentives away from rigid activity targets toward rewarding urgent, complex, and preventative work.
A central element of the reforms involves dentists receiving more payment for urgent and complex NHS treatments, such as pain relief, infection management, and trauma care. New standardised payment packages intend to incentivise practices to provide these services, potentially saving patients up to £225 on treatment costs by facilitating bundled care. Health minister Stephen Kinnock described this as a move to restore confidence in NHS dentistry. The updated contract prioritises patients with the greatest clinical need, including those requiring complex care for severe decay or progressive gum disease. This responds to mounting evidence of unmet urgent dental needs, including reports of people resorting to pulling out their own teeth due to lack of access to NHS appointments.
Another stated goal encourages a greater focus on preventative care. The government plans to move away from the Units of Dental Activity (UDA) model, which critics say prioritises volume over quality, towards a payment structure that supports prevention and maintenance of oral health. While the British Dental Association (BDA) views this as a positive step, they stress that more fundamental reform is needed for long-term sustainability. The reforms tie into a broader commitment to deliver 700,000 more urgent dental care appointments annually. Recruitment efforts include golden hello incentives aimed at attracting dentists to under-served areas, with Integrated Care Boards (ICBs) tasked to advertise posts offering bonus payments for NHS work in high-need regions.
Despite the welcome changes to payment and urgent care incentives, critics caution that contractual tweaks alone will not solve deeper structural issues like workforce shortages, entrenched access inequalities, or the lack of a statutory right to register with an NHS dentist. Surveys show many dentists are opting for private practice due to dissatisfaction with the current NHS contract.
Nonetheless, the government maintains that the 2026 contract changes represent a first step towards a new era for NHS dentistry. Officials hope the reformed contract will better align payment with clinical need and encourage multidisciplinary teamwork, though they acknowledge that further structural reform and investment will be necessary for long-term resolution of access and workforce issues.
The practical impact for patients could include easier access to urgent care, clearer incentives for complex NHS treatments, and a shift toward preventative care. Dentists stand to benefit from fairer reward for high-need work and a reduction in the perverse incentives of the old system. As the sector prepares for implementation in April 2026, the focus will be on how quickly practices adapt and whether the reforms deliver tangible improvements in access and financial viability.
