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Navigating the new NHS dental contract: what it means for your practice
The new NHS dental contract for England and Wales came into effect in April, and we're now in a position to assess what these changes mean for practices on the ground, says Lee Reeves, UK Head of Healthcare for Lloyds.
Read time: 5 mins Added: 07/07/26
The latest reforms touch on several areas, from urgent care provision through to complex treatments, and appear to point to a future where the Unit of Dental Activity (UDA) system is ultimately phased out in favour of a model centred on preventative care.
I recently had the opportunity to hear Mike Blenkharn, a specialist dental accountant at UNW Dental, share his reflections on the new contract and the challenges and opportunities it presents. His insights highlighted just how different the picture looks depending on where you practice.
A tale of three nations
In England, the introduction of an urgent care safety net requiring a minimum 8.2% allocation has raised some questions1. However, early indications suggest this hasn't caused significant disruption for most practices. The definition of unscheduled care is broad enough that it doesn't need to meet a strict "urgent" threshold, which should help practices meet their targets without undue strain.
Wales has seen the most substantial shift, which arguably represents the biggest change to NHS dentistry in two decades and could signal the direction of travel for the rest of the UK. The UDA system has been scrapped entirely in favour of 12 defined care packages, with a renewed focus on prevention. This is similar to the model that the British Dental Association continues to advocate for.
Under the new Welsh system, patients must contribute 50% towards treatment costs, while NHS payment rates have risen from £135 to £150. With the price gap between NHS and private pricing narrowing, some practices are asking whether more patients will opt for private care. What seems clear is that practices will need to take a more proactive approach to filling their appointment books, as recalls for healthier patients will now be pushed out from every 12 months to 18 or even 24 months.
Scotland has also extended routine recall intervals, this time from six to twelve months. While this changes patient flow, it also creates opportunities to offer enhanced check-up packages. And for those looking to establish or acquire a practice, the Scottish Dental Access Initiative provides grants of £100,000 to £125,000 for practices in areas of need.
The public-private balance
The broader market context is worth considering. Private dental services now account for more than two-thirds of the UK market, and research suggests this shift is partly being driven by difficulties accessing NHS treatment, with six in ten NHS patients saying they would consider paying privately, primarily to access faster care.
Mike Blenkharn reported that, after taking a knock in 2023-24 due to rising costs, private practice profitability has now returned to strong levels. But NHS practices are performing well too and, in many cases, almost match private profitability.
While, the dental sector is proving robust overall, success increasingly depends on having the right team culture in place and, for many practices, a skilled treatment coordinator to guide patients through their options.
What we're seeing
At Lloyds, we support around 20% of the UK dental market. We're seeing demand for finance remains strong, both for acquisitions and investment into existing practices, and we’re committed to supporting dental professionals through what will continue to be a period of significant change.
We're seeing an ongoing shift towards mixed and private models, as practices seek greater control over their income and long-term resilience. For those with growth ambitions, having a clear strategy around patient mix, workforce planning and funding requirements will be key. And those practices that are proactively reviewing their business models and adapting to evolving NHS provision will generally be better positioned to take advantage of opportunities.
Our specialist healthcare banking team understands both NHS and private income models, so whether you're looking to acquire your first practice, buy in as a partner, expand to additional locations, or invest in equipment and refurbishment, we can help. We now offer up to 100% financing for single practice acquisitions, for example, with loan-to-value ratios of up to 90% for portfolios of two to four practices.
Though the dental sector is changing, the fundamentals remain strong, and for practices that are willing to adapt, the opportunities are there.