Dental Contract Reform 2026: What NHS Dental Teams Need to Know Ahead of April
A clear, practice-focused summary of the NHS England dental contract reforms coming into effect from 1 April 2026.
Key takeaways
- Urgent care payment increases to £75 per patient
- Three new complex care pathways with higher tariffs
- Denture repairs and modifications attract additional UDAs
- Optional Quality Improvement domain funded at ~£3,400 per practice
- Recall intervals remain clinician-led
Overview
Improving patient access to NHS dental care and reducing oral health inequalities across England remains a key NHS priority. In December 2025, the government confirmed a new package of reforms to the English NHS dental contract, due to be implemented from 1 April 2026.
Consulted on between July and August 2025, the proposals received broad support and are intended to better reflect modern clinical practice, support prevention-focused care, and improve access for higher-needs patients.
1. Increased payments for urgent and unscheduled care
From April 2026, urgent care will no longer be remunerated at 1.2 UDAs (approximately £42.60 for the average practice). Instead, payment will increase by an average of 76% to £75 per patient.
- £15 paid upfront to support flexible capacity and DNAs
- £60 paid following FP17 submission
- Applies to all urgent and unscheduled patients, including walk-ins
2. Minimum requirement for urgent care activity
Practices will be required to deliver a mandated level of unscheduled care, set at 8.2% of the total contract value (approximately 11 CoTs per £10,000 of contract value) capacity across NHS contracts.
3. New complex care pathways
Three new complex care pathways will be introduced for adults (16+), remunerated using fixed national tariffs.
| Pathway | Eligibility | Duration | Tariff |
|---|---|---|---|
| 1 | ≥5 teeth with caries into dentine, no unstable periodontal disease | 6 months | £284 |
| 2 | ≥5 teeth with caries into dentine with unstable periodontal disease | 12 months | £709 |
| 3 | New diagnosis of Grade C periodontal disease | 6 months | £248 |
4. Denture modifications, relines and repairs
- Denture modification or reline alongside Band 2 care will be eligible for an additional 2 UDAs.
- Denture repairs will be remunerated at 2 UDAs (previously 1 UDA).
- Denture modifications may be claimed alongside complex care pathways where applicable.
5. New 0.5 UDA fluoride varnish course (Dental Nurse-led)
A new course of treatment at 0.5 UDAs will allow suitably trained dental nurses to apply fluoride varnish without the patient needing a full dental examination.
6. Fissure sealants: now Band 2
Fissure sealants for primary prevention will be claimable as Band 2 rather than Band 1.
7. Optional funded Quality Improvement (QI) domain
Practices can opt into funded quality improvement activities focused on audit and peer review around nationally defined topics. This is funded at an average of £3,400 per participating practice per year and counts toward UDA requirements.
8. Recall intervals remain clinician-led
- Recall decisions remain based on individual patient risk and clinical judgement.
- Practices are asked to apply NICE guidance rigorously to maximise NHS capacity and access.
9. Funded annual appraisals for eligible clinicians
Annual appraisals will be funded for associate dentists, dental therapists and dental hygienists providing NHS clinical services: £213 per eligible clinician, claimable once per year by the clinician after completion, and counting toward UDA requirements.
10. Increased use of tariff payments
While the contract remains UDA-based, several interventions will use national fixed tariffs (e.g. urgent care, pathways, appraisals). For contract reconciliation, these cash values will be translated into UDAs at the practice’s own UDA rate.
Next steps
Further updates will be issued ahead of implementation. Additional clinical guidance is expected by Spring 2026, including detail supporting the complex care pathways and the new Quality Improvement domain.
