2026 NHS Dental Contract Changes
Some significant changes have been made, with even more on the horizon following the NHS dental contract quality and payment reforms. In this article, we’ll be looking to succinctly highlight these coming changes, and link to any relevant documentation or information where possible.
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The Changes – A Brief Overview
These changes are different for England, Scotland and Wales. We’ll be providing a brief summary
For England:
- Greater focus on urgent/unscheduled care access
- New urgent care activity requirements for contractors
- Fissure sealants for higher-risk children will be re-banded as Band 2 treatments
- Fluoride varnish applications being claimable separately via trained dental nurses
- Increased emphasis on prevention and quality improvement
- New appraisal/payment support arrangements for clinicians
- Planned future “complex care pathways” reforms later in 2026
If you want to know more about this directly from the source, we’d recommend checking out the following page: https://www.england.nhs.uk/long-read/nhs-dentistry-quality-payment-reforms-contractual-guidance/
For Wales:
- Wales is moving away from the UDA system entirely from April 2026
- The new contract is prevention- and needs-led
- Recall intervals will be risk based rather than automatic 6-monthly recalls
- Care will move toward care packages/pathways instead of traditional Bands 1–3
If you want to know more about the changes is Wales, we’d recommend checking out the following page: https://www.nhsbsa.nhs.uk/dental-reform/dental-contract-reform-wales
For Scotland:
- Scotland has implemented major SDR/payment reform
- The fee structure has been simplified significantly
- Treatments can generally now be claimed for both adults and children where clinically appropriate
In Further Detail – Changes for England.
Greater focus on urgent/unscheduled care access
The changes that emphasise urgent care (from 1 April 2026) mean that high street dental contractors must dedicate some of their contract to patients who have urgent care needs. Additionally, all dental contractors will have their payment arrangements amended to include one of the following:
- “A £15 fixed and £60 activity payment for those Dental Contractors required to prioritise part of their contract for Urgent Care and in respect of their Required Number of Urgent Treatments.”
- “A £75 activity payment for those Dental Contractors is not required to provide a proportion of their contract for Urgent Care.”
New urgent care activity requirements for contractors
Dental Contractors who have a required number of urgent treatments should meet several service requirements when providing Urgent Care. These requirements include:
- Availability for urgent treatment appointments and how to access urgent treatment must be included in patient information leaflets and on the contractor’s website.
- Information regarding urgent care must be kept up to date on the contractor’s ‘Directory of Services’ profile
- The Dental Contractors must inform the Commissioner of any changes in information within 2 working days of identifying a need for such change.
The contractor must make use of all available capacity to provide urgent treatment to patients who either make direct contact with the practice, or who are referred or signposted to it by helpline services.
Fissure Sealant Guidance Changes
For England (from April 2026), fissure sealants for higher-risk children will be re-banded as Band 2 treatments, rather than sitting within Band 1/check-up activity. The guidance specifically references children aged 7+ and young people up to 18 who are at higher caries risk.
Fluoride varnish applications being claimable separately via trained dental nurses
As part of the Government initiative, Delivering Better Oral Health, it is recommended that children undergo routine application of fluoride varnish, with children who are especially at risk receiving four applications or more per year. To support this, suitably competent dental nurses will be able to apply fluoride varnish without a dental examination from the first of April 2026, introducing the procedure as a new Band 1 (standalone fluoride varnish) course of treatment to be provided under prescription. This procedure can still be provided by other practitioners as part of a Band 1 treatment, just so long as it takes place outside of the 3-month window before or after a fluoride varnish treatment delivered by a dental nurse.
Increased emphasis on prevention and quality improvement
The NHS is looking to implement a systemic approach to improving quality of care called Quality Improvement (QI). This approach entails:
- Building a deep and comprehensive understanding of the issue at hand.
- Making an attempt to improve or build upon the current system.
- Testing these ideas using rapid cycles, taking a data-led approach to learning and adapting.
This system will be implemented across NHS dentistry in 2026/2027, with a three-year trial programme. For the full picture of how this looks, we would recommend reading Section eight of NHS dentistry: quality and payment reforms contractual guidance.
New appraisal/payment support arrangements for clinicians.
Under this new guidance, in 2026 and onwards, a financial contribution can be claimed towards a dentist’s annual appraisal. This contribution will be sourced from within the overall contact value and is designed to encourage more regular approvals as a routine part of working with NHS dental practices. This will help to promote higher-quality clinical care and professional development.
More to come: Planned future “complex care pathways” and Discretionary Payments.
It should be noted that further changes are coming, including legislation or complex care pathways and discretionary payments. The rough outline for these changes has them occurring in 2026/2027.
Conclusion
NHS Dentistry is in the midst of a period of change, with a lot of legislation geared towards making patients safer, and reward practitioners for their hard work. With more laws set to be put in place or changed, let’s hope that the future changes help to further address the dental needs of patients and practitioners across the UK.
