Introduction 

The NHS has a responsibility to ensure people have timely and appropriate access to unplanned urgent and unscheduled dental care, both within and outside of working hours. The provision of urgent dental care is a key NHS planning priority, including the government’s commitment to securing 700,000 additional urgent care appointments per year.

To support the delivery of urgent dental care in 2025/26, NHS England asked integrated care boards (ICBs), under the terms of the Delegation Agreement, to commission additional urgent dental care capacity from April 2025 to March 2026. This additional commissioning is well underway in providing extra urgent care appointments.

Further to this, the national urgent dental care incentive (UDCI) scheme (the ‘Scheme’) launched on 25 September 2025. The Scheme will run from 25 September to 31 March 2026.

The Scheme aims to incentivise eligible Dental Providers and their oral healthcare teams to provide more Unscheduled Care to patients in 2025/26.

The incentive payment will be in addition to the Dental Provider’s current annual contract value. Urgent Courses of Treatment will continue to accrue the usual 1.2 units of dental activity (UDAs) from within annual contract value and will contribute to contract delivery calculations at year end. 

This guidance provides further information to Commissioners and Dental Providers on the Scheme, including eligibility and participation process, calculation of the target, terms and conditions of this Scheme and the payment arrangements. References to urgent and unscheduled dental care are interchangeable, both meaning unplanned urgent and non-urgent dental conditions requiring clinical care within 24 hours or 7 days.

The Statement of Financial Entitlements will be updated to include this Scheme in due course. Contract variations will be required for the contracts that are approved for participation in the Scheme.

Defined terms

“Additional Activity Target” means the number of additional Urgent Courses of Treatment to be delivered by Providers participating in the Scheme. This is equivalent to 25% of the annualised Baseline Activity, rounded up to the nearest whole number.

“Activity Period” means the period 1 April 2025 to 31 March 2026 during which all Unscheduled Care activity is counted towards the achievement of the Total Activity Target (where the course of treatment is commenced on or after 1 April 2025 and completed on or before 31 March 2026 and submitted by year-end close).

“Baseline Activity” means the number of Urgent Courses of Treatment projected under an eligible contract to be commenced on or after 1 April 2025 and completed on or before 31 March 2026. For contracts that started after 1 April 2025 this means the number of Urgent Courses of Treatment projected to be commenced on or after the contract start date and completed on or before 31 March 2026.

“Baseline Period” means the period between 1 April 2025 and 31 July 2025, activity from which the Baseline Activity is calculated and includes activity commenced on or after 1 April 2025 and completed on or before 31 July 2025 and submitted before 8 September 2025

“Commissioner” means the ICB that holds the NHS dental contractual agreement with the Dental Provider.

“Dental Provider” means the provider who holds an NHS dental contract that delivers mandatory services and meets the eligibility criteria of the Scheme.

“Incentive Payment” means the payment a Dental Provider will receive under the Scheme, which is £50 multiplied by the Additional Activity Target, where they achieve the Total Activity Target.

“Lower Activity Threshold” means the total number of Urgent Courses of Treatment required under the Scheme to achieve the Partial Incentive Payment, calculated as 70% of the Additional Activity Target (rounded up to the nearest whole number) in addition to the Baseline Activity.

“Partial Incentive Payment” means the payment (equivalent to half the Incentive Payment) a Dental Provider will receive under the Scheme where they achieve the Lower Activity Threshold but not the Total Activity Target.

“Scheme” means the requirements as set out in this contractual guidance and Statement of Financial Entitlements.

“Sign-up Period” means the period 25 September 2025 to 11:59pm on 17 October 2025 during which the Commissioner will offer out the Scheme to eligible Dental Providers and the Dental Provider can opt-in to participate.

“Total Activity Target” means the sum of the Baseline Activity and Additional Activity Target, and is the total number of Urgent Courses of Treatment required under the Scheme to achieve the Incentive Payment.

“Unscheduled or Urgent Care” 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.

“Urgent Course(s) of Treatment” means band 1 urgent FP17s also known as a band 4 FP17s.

Contract eligibility to participate in the UDCI scheme

Dental Providers eligible to participate in the Scheme are those with a general dental service (GDS) or personal dental services (PDS) contract for mandatory service provision and where the contract:

• commenced on or before the 25 September 2025
• remains in place on the 31 March 2026

Dental Providers holding a contract that meets the requirements set out above but where the contract was novated during the period 1 April 2025 to 31 March 2026, will be eligible to participate in this scheme.

Circumstances where a Dental Provider or a specific contract are not eligible to participate in the Scheme are:

• any contracts or contractual arrangements for:
  • health and justice dental care provision
  • community dental services
  • services commissioned under Schedule 1 of the GDS and PDS Regulations (for example advanced mandatory services)
  • enhanced payments for unscheduled care provision (this would be any locally commissioned arrangement, either through flexible commissioning or a separate contract specifically for unscheduled care)
• where a Dental Provider is undergoing an investigation and not providing services at the time of the sign-up process they will be ineligible to participate in the scheme

For the avoidance of doubt, a Dental Provider who holds a mandatory services contract without flexible commissioning for unscheduled care, and a separate contract for unscheduled care, will still be able to participate in the Scheme through only their mandatory services contract.

Key dates for the scheme

*See Defined Terms section for definitions of these periods.

Sign up process

NHS England has provided Commissioners with information on the Baseline Activity and target requirements for each eligible contract that provided Unscheduled Care during the period 1 April 2025 to 31 July 2025. Further information for the management of any contracts not in place, or with no activity during the Baseline Period is outlined in the section titled Calculation of Baseline Activity.

Commissioners will offer all eligible Dental Providers the option to participate in the Scheme by 11.59pm on 3 October 2025. This offer will set out the Dental Provider’s Baseline Activity, Additional Activity Target, Total Activity Target and Lower Activity Threshold figures alongside the potential incentive payment and information on how to sign up to participate in the Scheme. A template communication to support the offer is included in Annex A.

Eligible Dental Providers wishing to participate must let their commissioning team know by sending an email with the Subject heading: Acceptance to participate in UDCI Scheme in 2025/26. This should be sent to the email provided in the offer letter by no later than 11.59pm on 17 October 2025 and include in the body of the email:

• name of the person accepting participation
• contract number(s) – please specify all that apply in line with those identified in the offer letter
• address, including postcode for each contract

The Commissioner will review and approve the Dental Providers’ participation. The NHS Business Services Authority (NHSBSA) will provide a spreadsheet for completion by the Commissioner to indicate which contracts are eligible and have opted in to the Scheme. The Commissioner should return the completed spreadsheet to NHSBSA via email to dentalserviceimprovement@nhsbsa.nhs.uk  by 11.59pm on 24 October 2025. The Commissioner will also notify the Dental Provider that their sign-up has been approved (a template letter to support this activity can be found at Annex B).

Where a Commissioner has identified a contract that is ineligible to participate, then the Commissioner will be required to inform the Dental Provider accordingly by 11.59pm on 3 October 2025 (a template letter to support this activity can be found at Annex C). Where a Commissioner receives a query from a Dental Provider who considers they should be eligible to participate in the scheme, then the Commissioner is to review and consider this confirming the position to the Dental Provider and informing the NHSBSA accordingly by 11.59pm on 24 October 2025. Any dispute arising from a Commissioner’s decision not to approve a Dental Provider’s participation in the Scheme should follow the relevant dispute resolution process set out in the Policy book for primary dental services.

Where a Dental Provider wishes to participate in the Scheme but has insufficient capacity within their annual contracted UDAs to support the required activity, then the Commissioner should consider this on a case-by-case basis recording the rationale for the decision (for example, past performance or funding). In such circumstances, the Commissioner may agree to a non-recurrent uplift so that the total annual contract activity can be up to 110% of the regular contract amount where feasible and funding allows.

Calculation of Baseline Activity

The Baseline Activity will be set for each Dental Provider based on a projection of the number of Urgent Courses of Treatment, which we estimate would otherwise have been completed within 2025/26.

This estimate is calculated by firstly counting the number of Urgent Courses of Treatment commenced on or after 1 April 2025 and completed on or before 31 July 2025 and submitted before 8 September 2025 for each contract (that is a 4-month period). The total for this 4-month period is then multiplied by 3 to give the projected Baseline Activity figure for 1 April 2025 to 31 March 2026. The Baseline Activity is not negotiable locally except where a Dental Provider has no or partial Urgent Care activity data, as described below. Urgent care activity provided by a foundation dentist will count towards the Baseline Activity.

Where an eligible Dental Provider had a contract novation during the Baseline Period, then the Baseline Activity will be the sum of the number of Urgent Courses of Treatment completed both before and after the contract novation during the Baseline Period.

Contracts with partial data (commenced after 1 April 25 and before 1 June 25) in the Baseline Period

Where an eligible Dental Provider had a contract that commenced after 1 April 2025 and before 1 June 2025, then the average number of Urgent Courses of Treatment delivered each month since the contract commenced will be calculated (and rounded up to the nearest whole number) and then extrapolated over the rest of the Activity Period to estimate the Baseline Activity.

Contract that commenced after 1 June 2025 or have no activity in the Baseline Period

Where an eligible Dental Provider has a contract that has no Urgent Care activity (0 Urgent Courses of Treatment) in the Baseline Period or where a contract commenced after 1 June 2025, then the Commissioner will use the following process to determine a reasonable level of Urgent Care activity to set as the Dental Provider’s Baseline Activity. The Commissioner will identify 3 comparable contracts, drawing support from dental public health colleagues, taking into account all of the below:

• contract value
• contract type
• contractual activity levels
• socioeconomic status of the area where the Dental Provider operates
• any available Urgent Courses of Treatment data

The average Baseline Activity of the 3 contracts will be used to calculate the Baseline Activity for the Dental Provider in these two circumstances. This should be discussed and agreed with the Dental Provider. The Baseline Activity should be calibrated to the number of months the contract has been in place over the financial year 2025/26 (for example for a contract that started before 1 April 2025 but had no activity delivered, the Baseline Activity should be based on the full 12 months of activity, but for a contract that started on 5 July 2025, the Baseline Activity should be based on 9 months activity). The Commissioner will be required to include the relevant detail in the spreadsheet for NHSBSA outlined in the sign-up section.

Calculation of Additional Activity and Total Activity Targets

The Additional Activity Target for each Dental Provider is 25% of the Dental Provider’s annualised Baseline Activity (rounded up to the nearest whole number). The sum of the required Additional Activity Target and Baseline Activity will give the Dental Provider’s Total Activity Target as follows:

Total Activity Target = Dental Provider’s Baseline Activity + Additional Activity Target

For contracts with partial data or no data in the Baseline Period, the Additional Activity Target will be based on the annualised Baseline Activity, therefore a 12-month period.

For activity to count towards achievement of the Total Activity Target, all of the following must be true:

• claimed as an Urgent Course of Treatment (band 1 urgent FP17) claim
• commenced on or after 1 April 2025
• completed on or before 31 March 2026
• submitted by year-end close

To note, claims submitted in year but outside of the 62-day window will be included in the calculation of the Total Activity Target but will not attract the 1.2 UDAs, unless there is ICB agreement to do so.

Urgent Care activity provided by a foundation dentist will count towards the Total Activity Target. Targets set under this Scheme will apply to specific contracts; any Dental Provider who holds more than one contract that may be eligible to participate in the Scheme will not be able to combine their activity across contracts. Each contract will have a separate Baseline Activity and Additional Activity Target, and only activity delivered under that contract will count towards achievement of that contract’s targets.

The Total Activity Target will be used to confirm if the Dental Provider is eligible for payment under the Scheme.

Calculation of the Incentive Payment

Where a Dental Provider achieves the Total Activity Target, then they will be due the full Incentive Payment. The Incentive Payment will be the maximum amount a Dental Provider can receive, regardless of whether the Dental Provider exceeds the Additional Activity Target. The Incentive Payment will be calculated as the Additional Activity Target multiplied by £50 as follows:

Incentive Payment = Additional Activity Target x £50

Where a Dental Provider does not meet their Total Activity Target, they may still be eligible for the Partial Incentive Payment if they deliver their Lower Activity Threshold, which is their Baseline Activity plus at least 70% of their Additional Activity Target (rounded up to the nearest whole number). The Partial Incentive Payment will be calculated as follows:

Partial Incentive Payment = Incentive Payment divided by 2

The relevant payment due to the Dental Provider will be calculated by NHSBSA where they are Category 1 contracts or Category 2 contracts where the Commissioner provides the necessary information to the NHSBSA within agreed timelines to enable reconciliation. Commissioners will be required to follow the payment process outlined for Category 3 contracts.

As part of the year-end reconciliation process, NHSBSA will notify the Dental Provider of their achievement and any payment due to them (that is the Incentive Payment or the Partial Incentive Payment) within their end of year letter by 30 June 2026. The Dental Provider will have 28 days from the date of the end-of-year letter to raise a dispute over the amount of the payment.

Where no dispute arises, then the NHSBSA will make the relevant payment to the Dental Provider by no later than August 2026.

Where a Dental Provider raises a dispute through the relevant dispute resolution process, then the NHSBSA will not make any payment until instructed by the Commissioner.

Reporting

To support Dental Providers in monitoring progress against their Total Activity Target, the NHSBSA will provide monthly reports via Compass messaging to those participating in the Scheme. The data will highlight the 62-day lag, so Dental Providers are aware that it is subject to change as relevant claims are submitted. This report will include (in courses of treatment):

• the Baseline Activity
• the Additional Activity Target
• the Total Activity Target for the Activity Period
• the Lower Activity Threshold
• the remaining required activity to reach the Total Activity Target and the Lower Activity Threshold

NHS BSA will also provide this information monthly to NHS England. NHS England will continue to provide Commissioners with monthly reports on the delivery of Unscheduled Care, including this information.

Other relevant information

Payments made under the Scheme will not be superannuable.

Next steps for Commissioners

1. Review the information provided by NHSBSA to identify which Dental Providers are eligible for the Scheme.
2. Offer eligible Dental Providers the opportunity to participate in the Scheme by no later than 11.59pm on 3 October 2025. A template offer letter is included at Annex A. If required, a template letter to send to ineligible Dental Providers is included in Annex B.
3. Review the opt-in information and confirm Dental Provider participation to both the Dental Provider and NHSBSA by 11.59pm on 24 October 2025.
4. For Dental Providers that wish to participate in the scheme but are predicted to fully deliver their contract by year end, have early conversations about whether they can create contractual capacity to cover the 1.2 UDAs required for achievement. In line with regulations, Commissioners have discretion to increase contract delivery up to 110% on a non-recurrent basis, to allow headroom for increased unscheduled care delivery.
5. Process contract variations for the contracts that are approved for participation.
6. Understand the financial implications of participation by eligible Dental Providers, and engage with regional teams in the first instance if there are concerns regarding affordability within the ringfenced budget or wider POD allocation.
7. Ensure communications are in place to raise public awareness of additional urgent care capacity.

Next steps for Dental Providers

1. Review this guidance and their individual baseline and target to make an informed decision about whether to sign up.
2. Sign up by sending an email to their commissioner by no later than 11.59pm on 17 October 2025.
3. Develop a plan to deliver unscheduled care appointments to meet their baseline and target requirements for 2025/26.

Publication reference: PRN02139_i