There is a good deal of speculation about how the profession will respond to forthcoming changes to the English NHS dental contract. Indeed, after the latest drip fed information from NHS England, it became a very active topic on the GDPUK forum.
There might be some clues close at hand, from Wales, about how the English changes will be received. The Welsh and English post 2006 contracts had a good deal in common, both being UDA based. With a Labour administration in Cardiff well before the 2024 general election, work on reform has been going on there for a while. First came a series of 'opt in' changes, and Wales will now see further changes for all contractors on April 1st. These have been revealed in advance of the English proposals.
A very recent story from Wales sheds light on how things are going there, and could be an indicator for possible events in England over the coming few months.
North Wales Live reported that six more practices in North Wales have decided to terminate their NHS contracts after March 31st 2026. Three are in Gwynedd. About 6,700 patients will be affected, which represents the loss of around 3% of the regions dental activity, in one hit.
This time round it was the leader of the Welsh Conservatives who was expressing deep concern over the loss of so many dental practices at a time when provision is already under pressure. Clwyd West MS Darren Millar went on to ascribe the departures to practice's dissatisfaction with the new contract, and their wish to be out of the NHS come April 1st 2026.
Mr Millar said that NHS dental provision in North Wales was becoming extremely concerning. With a story similar to that recounted by so many other opposition politicians, he added: I have constituents who travel to Scotland in order to access an NHS dentist and others who are travelling to Albania to get their teeth sorted.
Mr Millar went on to refer to people attempting their own extractions due to the lack of access, describing it as, absolutely barbaric in this day and age. Worse still, he added, the situation seems to be getting worse by the day.
He had shared his concerns with Welsh ministers and to Betsi Cadwaladr, the North Wales health board. The Welsh Government was warned that unless it acted to address concerns raised by the dentistry profession about its new dental contract, many dentists in Wales would withdraw from the provision of NHS services, he said. "But it refused to listen and we now find ourselves in this position.
Welsh health secretary Jeremy Miles (pictured) announced dental sector reform in September 2025 describing it as the first major reform of the contract in 20 years. It will be an even greater shake up than the UK changes as it will end payment by UDAs. It may be a reflection on Jeremy Miles' grasp of his portfolio, that he saw the old arrangements primarily as paying dentists to recall patients every six months regardless of whether they had any problems.
Despite the ministers' belief that this would solve the access crisis, the BDA has warned the new contract model in Wales risked worsening access, morale and outcomes.
The BDA cited concerns that it would encourage a move to private dental care, and also estimates that for every new private care patient there will be a loss of capacity for two NHS patients, potentially making NHS provision unviable in the long run.