16 December 2025

Dear colleagues

The government has today published its response to the NHS dentistry quality and payment reforms consultation. The overall responses to the consultation were positive, and the government will be proceeding with implementing all the changes consulted on with a few amendments to reflect the consultation feedback. The package of contract reform addresses the pressing challenges that dentists and dental teams are experiencing and that impact upon patient access to dental care.

The published response sets out at high level the changes to be implemented. While the Department of Health and Social Care (DHSC) prepares to make the necessary regulatory changes, we recognise ICBs will be making operational planning decisions relating to 2026/27. This letter provides further information on next steps.

Implementation plan

As set out in the publication, the contract changes will be implemented from April 2026.

A series of regional ICB workshops will be held in January 2026 to provide the underpinning detail to these contract changes. The focus will be on setting out the expectations for unscheduled care, complex care and quality improvement, as well as further information on the other changes. We will be in contact separately through regional teams to arrange these workshops. 

A webinar for clinical leaders will be held in January 2026, followed by wider clinical webinars on the changes from February 2026 onwards.

Detailed contractual and clinical guidance will be published in February 2026, together with additional guidance on quality improvement. We will work with regional and ICB communications teams to develop materials that support both local and national communications activities promoting the upcoming changes to contractors and patients. Clinical recall intervals and the use of skills mix materials will also be reviewed and updated.

Actions for commissioners

Commissioners are asked to familiarise themselves with the contract changes outlined in the consultation response and begin to consider the implications. We encourage teams to join one of the workshops that will be set up in January to discuss arrangements in more detail.

We expect to be able to advise on nationally mandated levels of urgent care activity as soon as possible in the new year and recognise that this decision will be important to enabling ICBs to plan effectively for 2026/27. Until this guidance is available, we advise ICBs that:

• where current additionally commissioned urgent care capacity (outside of core contracts) is planned to continue into 2026/27, these arrangements should remain in place until advised otherwise
• in order to avoid creating complexity and burden for contractors and for mid-year and year-end reconciliation, commissioners should ensure no flexible commissioning arrangements that utilise UDA offset are applied to the urgent care element of a general dentistry contract after 1 April 2026

We will provide further updates as soon as possible.

Thank you for all the hard work you are doing this year to prepare for these changes and to support patients and practices through this transition.

Yours sincerely,

Publication reference: PRN02298