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

14 results

7 Conclusion Deferred

21st Report - Fixing NHS Dentistry

NHS England committed to fundamentally reforming the existing dental contract.

In our evidence session we asked NHSE if it would be better to rip up the NHS dental contract and start again, following a consultation with dentists to establish what their requirements are from a new system. NHSE’s response was … Read more

Government Response

The government agrees with the observation regarding the need to reform the dental contract. It states that work is underway to reform the contract with a focus on prevention and retention, but a realistic timetable will be determined after careful consideration and public consultation, given the complexity and risks involved.

HM Treasury

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8 Conclusion Deferred

21st Report - Fixing NHS Dentistry

Concerns raised over NHS dental contract's UDA rates, incentives, and uncompetitive funding.

In the written evidence submitted to our inquiry, concerns included that: • UDA rates are linked to the figures used in 2006 which no longer reflect current need.13 Rates vary from practice to practice so dentists in the same location … Read more

Government Response

The government agrees with the concerns and states that work is underway on its ambition to reform the dental contract, focusing on prevention and retention. However, it indicates that a realistic timetable will be determined after careful consideration and consultation, highlighting the complexity and risks involved.

HM Treasury

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10 Conclusion Deferred

21st Report - Fixing NHS Dentistry

Previous NHS dental contract reform efforts largely unsuccessful despite recent changes.

DHSC told us that issues with NHS dentistry pre–date the 2006 contract, and that with any change since the 1990s, “things have got worse”.18 DHSC began attempts at contract reform in 2010, testing changes through a prototype programme which combined … Read more

Government Response

The government agrees with the observation and states that work on reforming the dental contract, focusing on prevention and retention, is underway. It notes that a realistic timetable will be determined following careful consideration and consultation, with a target implementation date yet to be advised.

HM Treasury

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11 Conclusion Deferred

21st Report - Fixing NHS Dentistry

Uncertainty surrounds timeframe for fundamental NHS dental contract reforms, hindering access improvements

DHSC told us that it believed that those reforms “made a useful difference” and were a “step in the right direction”.21 We note, however, that the NAO report found that it saw no evidence of a full evaluation of these … Read more

Government Response

The government agrees with the principle of contract reform, stating work is underway but a specific timeframe will be determined following further consultation due to the complexity and risks involved.

HM Treasury

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13 Conclusion Deferred

21st Report - Fixing NHS Dentistry

The 2024 dental recovery plan introduced four distinct headline initiatives

The 2024 dental recovery plan included four headline initiatives, which aimed to provide an additional 1.5 million courses of treatment at a cost of £200 million in 2024–25.34 Funding for these initiatives would be drawn from anticipated underspends in the … Read more

Government Response

The government agrees with the observation of the dental recovery plan's initiatives. NHSE is carrying out analysis of the New Patient Premium, Golden Hellos, and UDA uplift initiatives, with results expected to be published in Autumn 2025. The national programme for mobile dental vans was not implemented.

HM Treasury

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14 Conclusion Deferred

21st Report - Fixing NHS Dentistry

Dental recovery plan failing to deliver expected treatments, with initiatives showing poor progress

The NAO’s report found that the plan was not on track to deliver the expected number of additional courses of treatment.37 When the report was published in November 2024: • fewer new patients had been treated under the NPP than … Read more

Government Response

The government agrees with the NAO's findings on the dental recovery plan's lack of progress. NHSE is now analysing the impact of the New Patient Premium, Golden Hellos, and UDA uplift initiatives, with analysis expected by Autumn 2025. Mobile dental vans were not implemented nationally.

HM Treasury

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15 Conclusion Deferred

21st Report - Fixing NHS Dentistry

Acknowledgement of dental recovery plan failure and inability to quantify additional treatments

At our session in February 2025 DHSC acknowledged that whilst the concept behind the initiatives were “entirely reasonable” the initiatives in the plan had ultimately not been successful, and that one—the new patient premium—”clearly failed”.40 NHSE also agreed that the … Read more

Government Response

The government agrees with the committee's observation that the dental recovery plan's initiatives were not fully successful and NHSE is currently analysing the impact of the New Patient Premium, Golden Hellos, and UDA uplift to determine how many additional appointments were delivered, with findings expected by Autumn 2025.

HM Treasury

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25 Conclusion Deferred

21st Report - Fixing NHS Dentistry

NHS dental contract uses Units of Dental Activity to measure treatment complexity

Under the current NHS dental contract, dentists are contracted to deliver a certain number of Units of Dental Activity (UDAs). Based on current treatment bands, there are six different levels of UDAs that a treatment can attract depending on the … Read more

Government Response

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.

HM Treasury

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26 Conclusion Deferred

21st Report - Fixing NHS Dentistry

Minimum UDA value uplift to £28 lacked evidence, uncertain to increase activity

UDA payment rates are not however, uniform across the country with evidence submitted by the British Dental Association suggesting, for example, that the average UDA rate in North East London ICB is more than £7 greater than the average rate … Read more

Government Response

HM Treasury

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27 Conclusion Deferred

21st Report - Fixing NHS Dentistry

Significant pay gap between NHS and private dentistry causes under-provision of care

DHSC told us that even with these uplifts to UDA rates, there is still a large gap between what dentists are earning through NHS work compared with the larger amounts they can make in the private sector.80 It described this … Read more

Government Response

The government agrees that incentivising NHS dentists and improving retention is key to contract reform, noting this work is underway. It will consider improvements to the current system and publish a 10 Year Health Plan and a refreshed long-term workforce plan by Summer 2025, which will address making NHS dentistry an attractive workplace.

HM Treasury

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28 Conclusion Deferred

21st Report - Fixing NHS Dentistry

UDA rates inadequately reflect treatment complexity and costs, requiring further modelling

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 … Read more

Government Response

HM Treasury

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30 Conclusion Deferred

21st Report - Fixing NHS Dentistry

Decline in NHS dental provision results from dentists choosing private work

NHSE, acknowledging these numbers, said that there has to be an acceptance that we need to train more dentists.89 DHSC, whilst not disagreeing with that assessment, told us that this is not the whole story 81 Q 27 82 Q … Read more

Government Response

The government agrees with the observation regarding dentists not delivering NHS work and states that incentivising NHS work and retention is part of its dental contract reform, which is underway but will take time. It plans to consider interim improvements and will address the issue in upcoming publications, including a 10 Year Health Plan (Summer 2025) and a refreshed long-term workforce plan.

HM Treasury

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32 Conclusion Deferred

21st Report - Fixing NHS Dentistry

DHSC and NHSE initiatives seek to improve dental workforce numbers and distribution.

DHSC and NHSE have begun some strands of work that might usefully improve the workforce situation if they are fully implemented. For example, there is a commitment in the NHS long–term workforce plan to increase training places for dentists by … Read more

Government Response

The government agrees with the observation and confirms it is currently analysing responses from a consultation on a dental graduate 'tie-in' period. It will consider the outcome and decide on future actions, publishing its response to the consultation.

HM Treasury

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33 Conclusion Deferred

21st Report - Fixing NHS Dentistry

NHSE promotes wider dental team utilisation and skill mix for treatment delivery.

Alongside ensuring that there are sufficient numbers of dentists and that they are equitably spread across the country, NHSE also told us that there is a cultural shift for the public in terms of their relationship with a dental practice, … Read more

Government Response

The government acknowledges the importance of incentivising NHS dentists and improving retention, stating that work is underway. It will consider improvements to the current system and proposals to encourage greater use of the wider dental team, and will publish a 10 Year Health Plan and a refreshed long-term workforce plan by Summer 2025.

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