The Welsh Government is set to reform the NHS General Dental Services contract. This article provides an update on some of the actions it’s taking, with the aim of reshaping NHS dentistry in Wales.
Health and Social Care Committee inquiry
The Senedd’s Health and Social Care Committee carried out an inquiry into dentistry and published its report in February 2023. A Senedd Research article outlined some of the issues with accessing NHS dentistry in Wales at the time. In October 2024, the Welsh Government provided an update on action it had taken in response to the Committee’s recommendations.
Evidence given to the inquiry highlighted there was no clear picture of how many people were waiting to see an NHS dentist, and the Committee called for the Welsh Government to consider a single centralised waiting list across Wales. In response, an all-Wales digital Dental Access Portal was rolled out in February 2025, enabling people to register their interest in receiving NHS dental care. The Portal originally had a requirement that people must not have received routine dental treatment on the NHS in the last 4 years but this requirement was removed in June 2025.
Dental contract reform
The NHS General Dental Services contract has been in force since 2006 in England and Wales. It changed individual ‘fee for item’ payment claims to an agreed annual contract value with stable monthly payments through the introduction of the Unit of Dental Activity (UDA). The contract consisted of three bands that determined how much a patient was charged for their treatment, and how much a dental practice was then remunerated by the health board.
The UDA system has been criticised for issues such as not incentivising the treatment of high needs patients; not improving patient access; and payments not reflecting the amount of work undertaken. Since 2017, various pilots relating to contract reform have been trialled in Wales.
Since April 2022, dental practices in Wales can opt-in to a variation of their contract, which uses new metrics to monitor activity. The variation aims to promote prevention and reduce unnecessary recalls, and includes a requirement to see new patients.
Tripartite negotiations took place from September 2023 to October 2024 between the Welsh Government, NHS, and the Welsh General Dental Practice Committee to design and develop a new General Dental Services contract.
Proposed new contract
During Plenary on 18 March 2025, the Cabinet Secretary for Health and Social Care outlined a proposed new contract for NHS General Dental Services in Wales. The new contract aims to deliver a system based on prevention and the provision of dental treatment on a risk and needs basis, meaning the automatic recall of patients every six months for a routine check-up will end.
A consultation on the proposed new contract was held between March and June 2025 with proposals including:
- creating a single route of entry for people to access NHS dental services;
- implementing a different remuneration system;
- adjusting patient charges due to changes in the remuneration system;
- a change in how charges are collected; and
- the development of a high-needs pathway.
Changes following consultation
On 23 September, a consultation summary was published, and in Plenary, the Cabinet Secretary set out changes to the proposed new contract.
The original consultation document proposed that patients would be assigned a dental practice through the Dental Access Portal (DAP). This could result in patients being sent to different practices in their local area depending on their recall status and the capacity in the health board area.
Following the consultation, the Cabinet Secretary confirmed that people with good oral health will not be referred back to the DAP. He said this aims to maintain a patient’s relationship with their dentist, and enable the monitoring of a patient’s oral health based on risk and need.
Other changes following the consultation include an increase in payments made by the NHS to dentists, and the introduction of an online payment system being postponed to April 2027.
Implementation of the new contract
The new contract is planned to come into force in April 2026 and will be implemented by legislation and directions. The regulations will be made under the Senedd's negative procedure for making subordinate legislation, with no date confirmed as yet for when they will be laid.
The British Dental Association Cymru has raised a number of concerns regarding NHS dental contracts and the proposed reforms. Its website includes blogs and news articles setting out these concerns.
Dental workforce
Health Education and Improvement Wales published a five-year Dental Strategic Workforce Plan in 2024 to address the “significant workforce challenges within primary dental care in Wales.”
To encourage dental trainees to work in rural dental practices, the Welsh Enhanced Recruitment Offer (WERO) accepts applications from dental graduates choosing to train in rural areas. The scheme offers enhanced financial, academic and wellbeing support, which currently includes a rural living grant to help with living costs.
In relation to the wider dental team, the Welsh Government has stated that over the course of this Senedd term, the number of dental therapy places available at Cardiff University has doubled. A new dental hygiene training programme at Bangor University has also been created, and the Welsh Government has committed to developing a dental therapy programme at Bangor University.
In response to calls for a new dental school in north Wales during Plenary in January 2025, the Cabinet Secretary said “the ongoing pressures on the health budget mean that it’s not possible to fund a project of this sort at this time.” He encouraged Bangor and Aberystwyth universities to develop a proposal for future consideration, that could be progressed when the opportunity arises. This month, the two universities jointly submitted a high-level proposal to the Welsh Government.
Statistics on dentistry
According to the latest Welsh Government statistical release, (published in November 2025), the percentage of children treated by an NHS dentist has increased in the last year, while adult treatment rates have remained broadly stable over the last 18 months.
In the 12 months ending 30 June 2025, 48.2% of children living in Wales received NHS dental treatment. 40.1% of the adult population received treatment in the 24-month period ending 30 June 2025.
These figures show the volume of treatment delivered, not the number of people who needed care or were unable to access it, so they only provide a partial picture of access.
For the financial year to date (1 April 2025 to 20 August 2025), the release says that just more than 54,000 new patients had routine treatments in Wales, and a further 30,000 urgent treatments were also provided to new patients.
However, while these figures suggest capacity for new patients, the Health and Social Care Committee’s report on dentistry noted BDA Cymru’s concerns that the contract reform’s aim of releasing capacity to provide appointments for new patients could come at the detriment of existing patients. The Committee recommended that the Welsh Government monitors the provision of patient appointments to ensure the right balance is struck.
Article by Rebekah James, Senedd Research, Welsh Parliament
