NHS England to Introduce Package-Based Payments for Dentistry Amid Ongoing Access Issues
From April, NHS England will switch to package-based payments for patients needing multiple visits, aiming to incentivise more urgent-treatment slots. These contractual adjustments are described as tweaks rather than a full overhaul and do not address all England-wide dental problems. Similar issues affect Scotland, Wales, and Northern Ireland, but the changes apply only to England.
The existing 2006 NHS dental contract shifted pay from registration or list-based systems to per-unit-of-activity payments, which has contributed to ongoing access problems, particularly in poorer communities. Data shows dentistry-related non-emergency NHS calls rose by 20% in July–September 2025 compared to 2024, and A&E dental attendances have increased by about 45% over the four years from 2019 to 2024.
A patient watchdog report highlights troubling case histories, including instances where people have pulled out their own teeth due to lack of access to NHS dental care. Regions such as the east of England continue to face chronic shortages of NHS dentists. Although 'golden hello' incentives have been introduced to attract dentists, their success has been limited. While progress on reducing child tooth decay and inequality has stalled, supervised toothbrushing programmes in schools are viewed positively.
A new dental contract is promised by the end of Parliament. Ministers are urged to restore the right to register with an NHS dentist and guarantee universal access. They should also clarify how the recent changes relate to the goal of boosting urgent dental appointments by 700,000 annually and publish a public timeline to track progress.
