Classification: official

To:

• Integrated care boards:
  • chief executives
  • directors of finance
• Regional teams:
  • directors
  • finance directors
  • directors of primary care

cc:

• Chief dental office

Dear colleagues,

Launch of an urgent dental care incentive (UDCI) scheme

Thank you for supporting the government’s commitment to securing 700,000 more urgent dental care appointments. As part of this work, we are launching a new incentive scheme for urgent dental care. This in-year financial incentive scheme for mandatory services contract-holders aims to bolster the additional capacity that integrated care boards (ICBs) have already established.

We now require your support and action to implement this from 25 September 2025.

How the scheme works

For the remainder of 2025/26, it is critical that the system takes every available step to put in place a comprehensive safety net for patients with urgent dental care needs.

Urgent care in this context may also be referred to as ‘unscheduled care’ in the related guidance and means unplanned urgent and non-urgent dental conditions requiring clinical care within 24 hours or 7 days respectively, unless the condition worsens, as defined in line with the unscheduled care clinical guidance.

The contractual guidance to support the scheme and its requirements has been published on our website.

In summary, participating contractors will be required to deliver an increase of 25% urgent care courses of treatment compared to their estimated baseline delivery for the current financial year, based on activity from the first 4-months of the financial year as calculated by NHS England.

In return, contractors who have reached their target will be eligible to receive an incentive payment, calculated as £50 per additional course of treatment. Where a contractor achieves 70% of the required additional activity, they will receive a partial incentive payment. Any incentive payments achieved will be in addition to their agreed contract value.

Contractors will need to have sufficient capacity within their annual contracted units of dental activity (UDAs) to deliver the additional courses of treatment. Where contractors are predicted to fully deliver their contract by year end, the ICB may agree to a non-recurrent uplift so that the total annual contract activity can be up to 110% of the regular contact amount where feasible and funding allows.

Funding

The additional spending required for this scheme is expected to be affordable within the existing dental ringfence budget. This is based on the recent history of underspends against this budget.

The overall national ringfenced budget for 2025/26 will therefore not be updated for the implementation of this scheme. We recognise that trade-offs may be required for some ICBs, and we appreciate colleagues’ support in reviewing and updating financial plans as needed for the remainder of the year. The NHS Business Services Authority (NHSBSA) will support the launch of the scheme.

Revenue finance and contracting guidance for 2025/26 included reference to potential flexibilities on the dental ringfence (paragraph 143). The introduction of this scheme supersedes this part of planning guidance, and the relaxation of the dental ringfence will not be applied. In 2024/25, the national team worked with regions and ICBs to assure the year-end position and return unspent dental ringfence funding to NHS England. We expect to take a similar approach later in 2025/26.

NHS Commissioners

Commissioners are asked to complete the following actions by the timeline detailed below:

• encourage practices to participate and cascade this message to them (using provided template letters) and stakeholders, including letting them know that a webinar will be hosted by the chief dental office on Tuesday 30 September 6.30-7.15pm accessible via this link: Urgent dental care incentive scheme webinar
• familiarise themselves with the related contractual guidance
• conduct a review of the provided list of contracts to identify those who will be eligible or ineligible
• write to the contractors they have identified are eligible and ineligible to participate in the scheme by 11:59pm on 3 October 2025
• receive sign-up information from interested contractors by 11:59pm on 17 October 2025 and communicate this to NHSBSA through a provided spreadsheet by 11:59pm on 24 October 2025
• have early conversations with contractors interested in participating who are predicted to fully deliver their contract by year end on whether they can create contractual capacity or to consider an increase to contract delivery up to 110% on a non-recurrent basis, to allow headroom for increased unscheduled care delivery
• process contract variations for the eligible contractors that have expressed an interest in participation
• ensure communications are in place to raise public awareness of additional urgent care capacity
• understand the financial implications of participation by eligible contractors, and engage with regional teams in the first instance if there are concerns regarding affordability within the ringfenced budget or wider POD allocation

Dental practices

Commissioners will be asking dental practices to:

• review the guidance and their individual baseline and target to make an informed decision about whether to sign up
• sign up by sending an email to their commissioner by no later than 11:59pm on 17 October 2025
• develop a plan to deliver urgent care appointments to meet their baseline and target requirements for 2025/26

Further work to put in place urgent care capacity

We recognise that colleagues are already undertaking significant work to improve urgent care access for patients, and many ICBs have put new capacity in place to support patients.

Alongside local commissioning of additional urgent care capacity, the government consulted on changes to the national dental contract in July and August 2025, including on introducing clearer capacity requirements and enhanced remuneration for urgent care dental services. The implementation of proposals following this consultation are expected to begin from April 2026, subject to ministerial approval. This incentive scheme is therefore planned to be time-limited and will end on 31 March 2026.

Next steps

We would be grateful if all ICB chief executives and dental leads could ensure that their commissioning teams are ready to take the actions described above when the scheme is announced.

Should you have any questions, please contact the Director for Pharmacy, Optometry, Dentistry for NHS England at england.dentaloptoms@nhs.net.

Thank you for your support.

Yours sincerely,

Amanda Doyle, National Director for Primary Care, Vaccinations and Community Services
Elizabeth O’Mahony, Chief Financial Officer

Publication reference: PRN02139_ii