Another Urgent Care Initiative – Dust Off the Calculator
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- Published: Friday, 03 October 2025 09:44
- Written by Peter Ingle
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It is after 19 years, a contract that has been recognised as unfit for purpose and whose intended replacement has been debated, trailed, promised, and confirmed. Despite this, the 2006 UDA NHS dental contract is still being ‘tweaked.‘
There is already a national push for the manifesto’s promised 700,000 extra urgent appointments, as well as a selection of ICB based schemes, but it appears that they are not enough.
Whether the latest ‘add on’ represents a triumph of hope over experience, political expediency or just simple desperation, is not clear, but another new scheme to improve access to urgent care has been announced.
The urgent dental care incentive scheme launched on 25 September 2025 offers a headline £50 extra for urgent care courses, on top of the present 1.2 UDAs. It will run in this financial year, and that the money comes in addition to contract values, represents a rare opportunity for contactors to earn additional money from the NHS. There are however, some interesting conditions, and were contractors seeking to optimise their payments, calculations.
To get the extra £50 practices will need to deliver over 125% of their baseline urgent care delivery. Those achieving between 117.5% and 125% will receive an extra £25.
There may be a good deal of caution and spreadsheet completion before practices sign up since those that manage to exceed their baseline, but fail to hit the 117.5% target will continue to receive just 1.2 UDA’s for their work.
The all-important baseline will be worked out on the basis of urgent care delivery between April and July this year. It will be extrapolated to 12 months to set the baseline level of activity. Those figures have already been calculated and will be shared with practices.
Eligible practices will be able to opt into the scheme. ICBs will contact practices to express an interest by 17th October. Some practices will not be eligible if they are already participating in another similar scheme offering enhanced payments for unscheduled care provision. This includes any locally commissioned arrangement, either through flexible commissioning or a separate contract specifically for unscheduled care.
Shiv Pabary, Chair of the BDA’s General Dental Practice Committee, said: "This scheme is a further admission that the NHS underpays for urgent dental care, but there are better ways to pay for it and secure access for patients than what is proposed. We tabled proposals for sessional payments with Ministers as soon as they set out that delivering extra urgent care was a priority last summer. This model has a track record of local success.”
He also referred to the gamble that practices would be taking in signing up, saying: "At this stage in the year, it is difficult for dentists to accurately predict how much urgent care - that is demand-led - will be delivered by the end of March next year. Practices will need to decide for themselves whether the reward on offer is worth the risk of delivering additional urgent care, but missing the threshold and receiving just 1.2 UDAs.”
Inevitably, the calculations involved are fairly complex, a worked example provided by NHS England gives a flavour of how practices may receive extra payments:
Urgent Courses of Treatment for the Baseline Period: 33
- Baseline Activity for 2025/26: 99
- Additional Activity Target: 25
- Total Activity Target:124
- Lower Activity Threshold is: 99 + 18 = 117 (where 18 is the rounded sum of the Additional Activity Target x 70%)
- If the Dental Provider submits claims for 117 to 123 Urgent Courses of Treatment, they meet the Lower Activity Threshold. The payment is 25 x £50 / 2 = £625.
So in this case, it appears that with a total of 123 courses, the practice would have provided an extra 24 urgent care courses over and above its UDA target, and would receive 1.2UDAs x 24 plus an extra £625. If it delivered 117 it would still receive the £625 but only an extra 18 lots of 1.2 UDAs.
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