To:

• Dental providers/practices
• Integrated care board:
  • heads of primary care
  • dental commissioning lead(s)
  • primary care finance lead(s)

cc.

• NHS England regional:
  • directors of primary care
  • executive leads for dentistry
  • heads of primary care and dental commissioners
  • finance directors
• NHS England Chief Dental Office

Dear colleague

Confirmation of urgent/unscheduled care activity requirements for NHS dental contract holders for 2026/27

Government has now confirmed that NHS dental contractors will be required to deliver 8.2% of their contract value as urgent/unscheduled activity in 2026/27. This follows its response to the public consultation on dental quality and payment contractual reforms on 16 December and the associated letter to systems of the same date.

This requirement will support wide geographical access to and more equitable distribution of unscheduled care capacity across practices.

What does this mean for dental contractors?

At the increased remuneration level of £75 for each urgent/unscheduled course of treatment, which is being introduced as part of the reform package from April 2026, the 8.2% requirement is equivalent to 11 urgent/unscheduled care courses of treatment per £10,000 of contract value.

Commissioners will need to communicate practice-level calculations in due course. In advance of this, contract holders can calculate the indicative level themselves by dividing their total contract value by £10,000 and then multiplying by 11, as shown in these worked examples:

Example 1: Contract value of £30,000

• (£30,000 / £10,000) x 11 = 33 urgent band 1 CoT
• if all CoT are delivered, this would result in a payment of (33 x £75 =) £2,475

Example 2: Contract value of £500,000

• (£500,000 / £10,000) x 11 = 550 urgent band 1 courses of treatment
• if all CoT are delivered, this would result in a payment of (550 x £75 =) £41,250

Example 3: Contract value of £1,000,000

• (£1,000,000 / £10,000) x 11 = 1,100 urgent band 1 courses of treatment
• if all CoT are delivered, this would result in a payment of (1,100 x £75 =) £82,550

Many practices are already delivering more than their required urgent/unscheduled care courses of treatment so this may not represent a change to their operations. Other practices may need to consider how they can build delivery of this care into their operating procedures. Practices can deliver more unscheduled care than these minimum requirements if their local populations have a greater demand for unscheduled care. Courses of treatment over and above these requirements will be paid at £75.

All urgent/unscheduled care patients seen under a practice’s general dentistry contract, irrespective of whether or not they have been to that practice before and whether they have been referred (for example, from 111) or present as a walk-in, will contribute to the required number of courses of treatment.

Excluded contracts

Contracts meeting the following criteria are excluded and will not receive a mandated amount for unscheduled care:

• historic (pre-2006) child-only contracts
• separate contracts for additional unscheduled care capacity, for example contracts for out of hours unscheduled care services
  • community dental services contracts
  • contracts for services delivered in secure/detained estates

If a contract is excluded, this requirement will be confirmed by your commissioner.

Commissioner discretion

We recognise that unscheduled care delivery is patient led and demand may vary over time. Where there is evidence that demand for unscheduled care is insufficient to fill the available capacity, commissioners will be given limited powers to reduce these requirements. More detailed information on this will be provided in due course.

Next steps and provision of further information

NHS England will provide commissioners with ICB-level data and further details on the requirements later this month.

NHS England will provide regular updates on the implementation of the quality and payment reforms in advance of implementation in April 2026. This will include a series of webinars in March and April and these will be open to all practice teams. Details of the webinars will follow. Colleagues are advised to sign up to the Oral Health Bulletin, the Primary Care Bulletin and to consult the NHS England dental contract reform webpage for the latest information and updates.

Thank you for your continued engagement and work in preparing for the 2026/27 quality and payment reforms to the NHS Dental Contract. Commissioners are asked to support the profession to understand this and other contract changes.

Yours sincerely,

Ali Sparke, Director for Dentistry, Community Pharmacy and Optometry
Jason Wong, Chief Dental Officer