NHS dental contract reforms: a positive step forward for our profession

We know that NHS dentistry is an important topic for all professions and we asked Jason Wong, Chief Dental Officer for England, to explain what the NHS dental contract reforms from April mean for dental professionals in England.

This April sees the roll-out of a series of important reforms to the NHS dental contract. These changes are the result of wide consultation and genuine partnership with colleagues across the dental profession, patients and their representative groups, and mark a new chapter for NHS dentistry—one that places quality, sustainability, and prevention at its very heart.

Improving patient access to NHS dental care and reducing oral health inequalities across England remain absolute priorities for the NHS. The coming reforms are a clear demonstration of this commitment. The package builds upon the initial reforms from 2022, taking those principles even further, with practical measures designed to better support practices and ultimately deliver the best outcomes for our patients.

A cornerstone of these reforms is the recognition of the vital role dental teams play in our communities, especially in delivering urgent care and supporting those with higher needs.

From April 2026, payments for urgent care will rise by an average of 76%, with upfront funding to help manage capacity and support practices in responding flexibly to patient demand. This is a direct response to your feedback that previous remuneration did not adequately cover the complexity or volume of unscheduled care. Practices will also be required to undertake a minimum level of urgent/unscheduled care to help ensure an urgent care safety net is consistently in place across the country. The required level is designed to be achievable for all –  indeed it will require no change for many – and much of the wider urgent care infrastructure will continue to exist from April as we take the time to get this right for patients and dental teams.

Whilst the contract will continue to be based on Units of Dental Activity (UDAs), the contract does take a step away from aspects of the current model we know many in the profession do not like. Many of the changes introduce new “tariffs”, which are fixed cash values for certain treatment or interventions, and are designed to create more equality between practices.

There is also a greater focus on supporting the care of patients with complex needs. Practices will be able to claim higher fees for three new complex care pathways, ensuring that those with more significant oral health challenges receive tailored and sustained support. These pathways are intended to empower clinicians, recognising your expertise and judgement in delivering the right care at the right time.

Previous feedback from the profession said it was difficult to provide the quality and quantity of care including offering prevention within the framework of the system. These proposals are based on an alternative currency recognising the support required to stabilise patients. They are also based on the two main diseases that dental teams spend most of their time treating. They have been based on the most up to date clinical evidence base. Most of the work in the complex care pathway can be taken on by other team members not just the dentist and their contribution would be wider than in the provision of prevention.

Prevention is being fully embedded into the contract with these steps reinforcing our shared commitment to keeping people healthier for longer, intervening before conditions become acute. A new course of treatment will be introduced at 0.5 UDAs, allowing suitably skilled and educated Dental Nurses to apply fluoride varnish without the patient needing a full dental examination, and fissure sealants for primary prevention will be able to be claimed as Band 2 rather than Band 1. There are also additional payments for denture work.

Recognising the importance of professional growth and support, annual appraisals for associate dentists, dental therapists and hygienists will be funded, underpinning a culture of ongoing development. A new Quality Improvement scheme, offering £3,400 per year for participating practices, will reward best practice and encourage regular reflection and peer review on key national topics.

These reforms have been shaped by broad support from the profession and demonstrate a strong government commitment to listening and acting on your concerns. We will keep you regularly updated as the implementation date approaches, and new clinical guidance to support the complex care pathways and set out details of the new quality improvement domain, will be published in early 2026.

This is an exciting moment for our profession. By working together, we can ensure these changes deliver real benefits—improving patient care, supporting practice sustainability, and helping all members of the dental team thrive. I look forward to continuing our shared journey and to the brighter future these reforms promise.