New NHS Contract Takes Shape
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- Published: Monday, 29 September 2025 10:05
- Written by Peter Ingle
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The combination of a Labour administration and a UDA style NHS contract is not unique to England. Wales has had its own UDA based arrangement since 2006. The two nations have experienced both major problems with access, and attempts by their administrations to improve matters with marginal changes. There is though, general agreement that that the UDA contracts need replacement rather than fine tuning.
Wales has tended to move in advance of England, and dental teams there will see a new contract beginning in April 2026. When last reported by GDPUK at the consultation stage there was a gulf between Health Minster Jeremy Miles’ proposals, and what most Welsh dentists would accept.
The revised proposals, for introduction next year, which have now been revealed, have had a mixed reception in the press. Wales Online led with, “People in Wales to wait two years between dentist check ups.” As with the proposed English reforms, one means of freeing up capacity will be to eliminate six or even twelve month examinations for the dentally fit. The BBC also began their report with a recall based headline, “Dentistry shake-up could see healthy waiting two years.”
In contrast Nation Cymru’s headline was, “New Welsh dental contract promises fairer access.” This would come from “widening access, prioritising prevention, and tailoring care to patients’ individual needs.”
Following one of the largest public consultations in the history of Welsh devolution, the original proposals were revised over the summer. One improvement in many patients and dentists opinion, will be the abandonment of the original proposal to put those with low-needs onto a centralised database. This would have allocated them to any available practice, and the BDA warning that this could disrupt long-standing dentist-patient relationships and negatively impact families, appears to have been heard.
It is said that the new contract includes an increase in NHS payment rates, with general fee rates rising from the proposed £135, to £150 per hour. Despite other changes including the retention of commitment payments, and abandoning the proposal to cap paid parental leave, the BDA contends that the revised payment levels may still fail to meet the true costs of delivering care, and that more providers may stop offering NHS services.
Changes to patient charges will see those who pay for their NHS treatment contributing 50% of the treatment package value, though there will be a cap of £384 irrespective of how much care they need. This is a reduction from the 55% originally proposed.
Russell Gidney, chair of the British Dental Association’s Welsh General Dental Practice Committee, said: “The Welsh Government says it has listened to the public and our profession, but we need to see the small print. There are some important wins here. But plastering over a few of the biggest cracks is just superficial repairs.”
There are also concerns that the reforms are set to be taken forward under the Senedd’s ‘negative procedure’ for making secondary legislation. This is in effect a ‘take it or leave it’ approach, with the regulations passed or rejected 40 days after they are tabled, without any scope for amendment.
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