Lukewarm Response to Vague NHS Contract Proposals
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- Published: Wednesday, 17 December 2025 08:13
- Written by Peter Ingle
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It is a safe bet that Minister for Care Stephen Kinnock does not lay awake at night worrying what GDPs will make of the reforms to the NHS dental contract. How it is received by influential stakeholders and the press will be of more interest.
Indeed, the Department of Health and Social Care (DHSC) announcement highlighted positive responses from two dental bodies, The Association of Dental Groups, and the British Society of Paediatric Dentistry.
The BDA which was not quoted by DHSC, was always going to be in a difficult position given the broad range of its members working arrangements and opinions. It offered the hope that the reforms would be interim changes to the NHS dental contract and “offer a boost for patients and practitioners.” They stressed though that these were not the wholesale changes required to stop the steady decline of NHS dentistry.
One of the changes, the new time-limited ‘care pathway’ for higher needs patients, will improve pay for more clinically complex cases, which have at times been delivered at a loss. The proposal follows BDA calls for dentists to be paid for activity that helps prevent oral disease and decay. The BDA also noted with approval the new payments to support clinical audits and peer review, and improved rates for the now mandatory provision of urgent care.
Despite this, the BDA considered that a decisive break from the target-based contract remains essential, and the latest changes do not constitute a final destination for NHS dentistry in England. Ministers were reminded that they did promise to deliver fundamental contractual change within this Parliament.
The BDA referred to the recent revelation that the latest Adult Oral Health Survey has shown a reversal in the nation’s oral health. The latest package comes with no new money behind it. The dental budget has remained effectively static in cash terms since 2010, with substantial real terms cuts. The latest proposals did nothing to correct this.
Shiv Pabary, Chair of the British Dental Association’s General Dental Practice Committee, said: “These are the biggest tweaks this failed contract has seen in its history. We do hope changes can make things easier for practices and patients in the interim, but this cannot be the end of the road.” He went on to add: “We need a response proportionate to the challenges we face, to give NHS dentistry a sustainable future.”
The Oral Health Foundation (OHF) was, if anything, less impressed than the BDA. In a statement it said that it believed the newly announced measures fell short of the long-term reform needed to fix the underlying problems facing patients and dental teams.
The NHS dental contract changes, were described as “small adjustments.” The OHF concluded that they, “may help some patients in the short term, but they do not go far enough to fix the bigger problems facing NHS dentistry.”
Dr Nigel Carter OBE, Chief Executive of the Oral Health Foundation, said that the changes, “stop short of the fundamental change the system requires.” Like the BDA he did not see the changes being sufficient to save NHS dentistry, and his assessment was that: “Adjusting contractual mechanisms may improve continuity of care for a small cohort of patients, but it does not resolve the structural problems that limit access or drive dentists away from NHS provision.
Denplan’s Chief Dental Officer, Matthew Nolan offered a cautious welcome: “We welcome today’s announcement as a meaningful step in the right direction. Making it easier for patients in severe pain to access urgent appointments is important, and it is encouraging to see the Government recognise the financial pressure practices are under when providing NHS care, especially for more complex cases.” Given the inevitable trade off that will be made, he then turned his attention to the consequent reduction in routine care. This, after all, was the type of work that could prevent emergencies developing, or at least catch them at a stage when they were easier to treat.
His observation that: “the future of dentistry will only be possible when urgent care and preventative care are equally balanced” was a reminder that reforms made with an unchanged budget could only offer more to one group of patients by taking services away from others.
On the GDPUK Forum, many excellent points were made:
"Why can it not just be called out for exactly what it is, in the bluntest of language?
The Government is just diverting the cash in an attempt to end the ’DIY Dentistry’ headlines at the expense of the well behaved NHS patients."
Another colleague wrote:
"we would like to see a fully funded NHS dental service - free at the point of delivery like the rest of the NHS - which provides a fully comprehensive service to the whole of the population - Unfortunately successive governments are not prepared to do this and are not willing to admit this to the public - unless there is a fundamental change in attitude from all of our politicians and they finally recognise the importance of NHS Dentistry - not just at election time - then in the future more and more patients will not be able to access an NHS dentist and will have to look at other options including insurance based systems.
So far, the opportunity to say this was missed"
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Article on which these responses are based - click here.
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