UK Inquiry Tracker

Fixing NHS Dentistry

Public Accounts Committee Closed Inquiry

Opened: 15 Jan 2025 Closed: 16 Jun 2025 Parliament page

Two-fifths of the adult population in England saw an NHS dentist in the 24 months up to March 2024 – this is down from just under half of the adult population pre-pandemic. There were 483 fewer dentists providing some NHS care in England in 2023-24 compared with 2019-20. The previous … Read more Two-fifths of the adult population in England saw an NHS dentist in the 24 months up to March 2024 – this is down from just under half of the adult population pre-pandemic. There were 483 fewer dentists providing some NHS care in England in 2023-24 compared with 2019-20. The previous Government published its Dental Recovery Plan in February 2024. This aimed to increase access to NHS dentistry services, aspiring to deliver more than 1.5m additional courses of treatment, or 2.5m appointments total, in 2024-25. The Health and Social Care Committee launched an inquiry into NHS dentistry in 2022, following a survey that showed 90% of practices across the UK were not accepting new adult NHS patients. Its 2023 report called for a Fundamental reform of NHS dentistry to end a ‘crisis of access’. The Public Accounts Committee’s (PAC) 2019 report into penalty charge notices in healthcare found that the rules for claiming free prescriptions and dental treatment were confusing and needed to be changed. The National Audit Office published its own report conclusions from its investigation into the Dental Recovery Plan in November 2024 . It found that the plan was unlikely to deliver its target of 1.5m additional treatments, and that even if the target was reached, it would still be 2.6m fewer treatments per year than pre-pandemic levels. It further highlighted a £392m underspend in 2023-24 across the NHS dental budget. Based on the NAO report, the PAC will hear from senior Government officials on delivery of better access to NHS dentistry and progress on the plan, with likely topics including: The dental contract; Falls in the number of dentists; The current picture on Government spending to support access to NHS dentistry. The Committee is unable to help with individual cases. If you need help with an individual problem you are having, you may wish to read the information on Parliament’s website about who you can contact with different issues . Please look at the requirements for written evidence submissions and note that the Committee cannot accept material as evidence that is published elsewhere. If you have evidence on this issue, please submit it here by 23:59 on Thursday 30 January. Show less

1 Recommendation

32 Conclusions

1 Report

1 Oral session

4 Letters

1 Event

Activity timeline 9 events

8 Jan
2026

Correspondence

Letter from the National Director for Primary Care and Community Services at NHS England relating to Recommendation 2a of the Committee’s T…

1 Dec
2025

Correspondence

Letter from the National Director for Primary Care and Community Services at NHS England relating to the Committee’s Twenty-first Report on…

18 Sep
2025

Report published

Treasury minutes: Government response to the Committee of Public Accounts on the Twenty-first report from Session 2024-26

10 Jul
2025

Report published

Treasury minutes: Government response to the Committee of Public Accounts on the Twenty-first report from Session 2024-25

4 Apr
2025

Report published

21st Report - Fixing NHS Dentistry

27 Mar
2025

Correspondence

Letter from the Interim Permanent Secretary of the Department of Health and Social Care and the Chief Executive Officer at NHS England rela…

13 Feb
2025

Oral evidence

Oral evidence session

13 Feb
2025

Correspondence

Letter from the Interim Permanent Secretary of the Department of Health and Social Care and the Chief Executive Officer at NHS England rela…

13 Feb
2025

Formal meeting (oral evidence session) · The Grimond Room, Portcullis House

Committee event

Oral evidence sessions 1 session

13 Feb 2025

View on parliament.uk

Ali Sparke · NHS England Amanda Pritchard · NHS England Jason Wong MBE · NHS England Jonathan Marron CB · Department of Health and Social Care Sir Chris Whitty · Department of Health and Social Care

Reports 1 report · click to expand

Title	HC No.	Published	Items	Response
21st Report - Fixing NHS Dentistry	HC 648	4 Apr 2025	33	Responded

Recommendations & Conclusions

13 results

2 Conclusion Accepted

21st Report - Fixing NHS Dentistry

Publish a detailed evaluation of the dental recovery plan's spending, initiatives, and impact on NHS dentistry access.

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 … Read more

Government Response

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.

HM Treasury

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3 Recommendation Accepted

21st Report - Fixing NHS Dentistry

Explain how DHSC and NHSE will strengthen dental analytical capabilities and implement business-critical changes in practice.

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 … Read more

Government Response

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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4 Conclusion Accepted

21st Report - Fixing NHS Dentistry

Articulate improved central-local coordination and support for ICBs in future NHS dentistry plans.

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 … Read more

Government Response

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.

HM Treasury

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5 Conclusion Accepted

21st Report - Fixing NHS Dentistry

Publish analysis of actual NHS dental care costs, reflecting treatment complexity and community deprivation impacts.

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 … Read more 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 work is a fundamental issue for improving access. The current NHS dental contract, and its reliance on Units of Dental Activity (UDA) rates that were set nearly two decades ago, is unfit for purpose. Recent attempts to address disparities in what practices can earn for delivering NHS work by increasing the minimum UDA value first to £23 and then to £28, and to better reflect the different costs of treatments of greater complexity, have failed to deliver any identifiable improvements. We agree with DHSC when it says that fiddling around with the contract fails to address the real problem. In April 2023, there were 34,520 dentists registered to provide dentistry in England, but only 24,193 of these provided some NHS dental care in 2023–24. Without proper remuneration it is likely that even more will move exclusively to the private sector. However, it does not appear that NHSE and DHSC yet have a sense of what level of funding would provide a realistic incentive for dentists to prioritise NHS work. Until there is a clear and evidence–based proposal for remuneration that reflects the true costs of dentistry, that issue is unlikely to be resolved. recommendation DHSC and NHSE should commit in their Treasury Minute response to conducting and publishing analysis of the actual costs of providing NHS dental care as part of any future work on reforms to NHS dentistry, reflecting the full range of complexities of treatments that patients might need. This should include an explanation of how the current structure of payments to dentists, in terms of the range and complexity of treatment, has different impacts depending on the deprivation of the community served. Show less

Government Response

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.

HM Treasury

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1 Conclusion Accepted

21st Report - Fixing NHS Dentistry

Committee heard evidence on NHS dentistry and the dental recovery plan.

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

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.

HM Treasury

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9 Conclusion Accepted

21st Report - Fixing NHS Dentistry

Significant funds recovered from dental contracts due to under-delivered care.

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

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.

HM Treasury

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12 Conclusion Accepted

21st Report - Fixing NHS Dentistry

Government commits to preventative oral healthcare measures including supervised toothbrushing and water fluoridation

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 … Read more

Government Response

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.

HM Treasury

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16 Conclusion Accepted

21st Report - Fixing NHS Dentistry

Conflicting data on new patient numbers and high cost of the New Patient Premium

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 … Read more

Government Response

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.

HM Treasury

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17 Conclusion Accepted

21st Report - Fixing NHS Dentistry

Limited progress and insufficient data for evaluating other dental recovery plan initiatives

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 … Read more

Government Response

HM Treasury

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19 Conclusion Accepted

21st Report - Fixing NHS Dentistry

Significant error identified in initial modelling of dental recovery plan, underestimating New Patient Premium cost

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, … Read more

Government Response

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.

HM Treasury

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21 Conclusion Accepted

21st Report - Fixing NHS Dentistry

Modelling for dental recovery plan proved unreliable and lacked robust quality assurance

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 … Read more

Government Response

HM Treasury

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23 Conclusion Accepted

21st Report - Fixing NHS Dentistry

Centrally planned dental initiatives failed to increase activity or influence local behaviour

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 … Read more

Government Response

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.

HM Treasury

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31 Conclusion Accepted

21st Report - Fixing NHS Dentistry

NHS dental workforce maldistribution creates shocking regional inequalities in access to care.

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 … Read more

Government Response

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.

HM Treasury

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Government Response AI assessment · 32 of 1 classified

Accepted 13

Accepted in Part 4

Acknowledged 1

Deferred 14

Total 1 rec + 32 conclusions

Correspondence 4 letters

8 Jan 2026 To committee Letter from the National Director for Primary Care and Community Services at NHS England relating to Recommendation 2a of the Committee’s Twenty-first Report on Fixing NHS Dentistry, 30 December 2025

Parliament page

1 Dec 2025 To committee Letter from the National Director for Primary Care and Community Services at NHS England relating to the Committee’s Twenty-first Report on Fixing NHS Dentistry, 26 November 2025

Parliament page

27 Mar 2025 To committee Letter from the Interim Permanent Secretary of the Department of Health and Social Care and the Chief Executive Officer at NHS England relating to a follow up on the oral evidence session held on 13 February 2025 on Fixing NHS Dentistry, providing updates on “Golden Hellos, Rebasing contracts and contract reform, 18 March 2025

Parliament page

13 Feb 2025 To committee Letter from the Interim Permanent Secretary of the Department of Health and Social Care and the Chief Executive Officer at NHS England relating to the modelling error in the plan to reform NHS Dentistry, 11 February 2025

Parliament page