BDA Webinar on NHS Contract Reforms. The good the bad and the not quite sure yet
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- Published: Thursday, 24 July 2025 08:51
- Written by Peter Ingle
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The BDA is the sole body recognised by the Department of Health and Social Care (DHSC) when it comes to negotiating the terms, conditions and contracts that dentists in England work under. In a recent webinar key members of the BDA General Dental Practice Committee (GDPC) set out to explain some of the proposals, in the consultation for NHS dental contract quality and payment reforms 2026.
The BDA can claim that this latest set of contract reforms, now up for consultation, have been at least in part been shaped by their input, and there are a number of changes that even if nearly two decades overdue, will be welcome.
What is also clear is that there are also changes that may leave GDP’s feeling no more confident about their NHS future. And then, there are the grey areas, and some parts missing important details.
The presenters, GDPC Chair, Shiv Pabary, Vice chairs Vijay Sudra and Joe Hendron, joined by BDA head of policy and research Tom King, had all been involved in the negotiations and ran through the key proposed changes. Shiv Pabary described them not as a definite “fix” but as a stepping stone to fundamental change. The BDA team had worked to shape the focus towards better remuneration when treating high needs groups, and making NHS work more attractive to the profession.
Perhaps most eye catching are the three new care packages, which if meeting specified levels of caries to be restored, and accompanied by periodontal disease, could attract a fee of £680. Notably these packages carry a standard national fee rather than a UDA multiple. One omission is that broken teeth requiring restoration, as opposed to those with caries, will not count towards the numbers required to attract the packages.
The bugbear of the denture repair whose lab bill exceeds the fee received, has been partly dealt with by a proposed denture modification fee, though here the BDA had wanted Band 3 status.
Prevention is recognised with a 0.5 UDA fee for fluoride varnish application, without an examination being required. Whether this will be enough given the need to find and train the Dental Nurses to deliver this, was a moot point for the BDA team. The move of fissure sealants from band 1 to band 2 may also encourage practices to think about the best use of team members.
The urgent care changes are a mixed bag. At first sight a fee of up to £75 versus 1.2 UDA’s looks a clear win, but there is a downside. The number of emergency slots contractors will have to deliver, will be decided by ICBs, so at present actual numbers cannot be predicted. Given the propensity for no-shows amongst emergency appointments, the £5 allowed for these could quickly eat into some of the possible gains.
Clinical audit and peer review funding sounds like another clear win. However the flat fee may not seem quite so generous when practices must include the full clinical team and will as a result probably require a blocked off appointment book on at least two occasions. There is also the educational value of this being for a topic to be prescribed nationally, so it may cover an area at which some practices already excel. Here, as in some other areas, the problem of how this funding will be shared, or not, with associates is likely to get, in the words of one panel member, “messy”.
Annual appraisals will get 6 UDA’s. In the BDA’s opinion, this is not enough for something that will take two team members an hour plus, to do. These are also amongst changes that could weaken associates claims to self-employed status.
A Q & A session threw up more areas where the proposals, whilst at first sight appealing, might not deliver on the objective of making NHS work more appealing to the profession, or where the devil would very much be in the detail.
The consultation [linked above] will close at 11.59pm on 19 August 2025.
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