Written Statement: Dental Contract Reform 2022-23

We want everyone in Wales who wants NHS dental care to be able to access it. Our Programme for Government, includes a commitment to reform primary care dentistry and increase access to dental care.

The oral health and dental services response to A Healthier Wales set out a whole-system change to dentistry to increase needs-led preventive care. At the heart of this is improving outcomes for people through preventive models of care, supported by reforming the contract that underpins the delivery and payment for dental services.

More practices are now delivering a service focused towards preventive care and treatment rather than the treadmill of delivering Units of Dental Activity (UDA) targets.

The pandemic has inevitably had an impact on the reform work – just as it has had an impact on the number of people who can be seen in dentistry because of the public health measures which need to be in place to protect staff and patients.

Before the pandemic, about 40% of practices holding NHS dental contracts in Wales were engaged in, or had signed up to be part of, contract reform. The pandemic paused that progress, but we have continued to learn and test alternative measures during the recovery and reset phase.

From April 2022, NHS practices were asked to choose between being part of the reform programme or to return to the contractual arrangements based wholly on the delivery of UDA. The expected UDA target for these practices will be 95% of pre-Covid/pre-reform level. 

The practices involved in contract reform will focus on prevention and needs-based care. This means they will move away from routine six-monthly check-ups for all patients. The National Institute for Health and Care Excellence (NICE) recommended moving away from a universal six-month check-up in 2004.

Moving away from twice-yearly check-ups is a significant change from what people are used to. There will be a targeted communications campaign to help support practices and to provide people with information about the benefits of self-care. I hope I can count on Members’ support in conveying this important message to their constituents.

The capacity released will be available to provide appointments for new patients – for those who need continuing care from an NHS dental team; those who need urgent care; of for those who have a particular dental need but do not want continuing NHS care. 

I am pleased that more than three-quarters of NHS dentists across Wales (78%) have moved to the reform contract. This represents 89% of the total contract value of commissioned NHS dental services. The contract value is more important than the number of contracts because it is the contract value that sets the metrics for new patient access. It indicates that the overwhelming majority of practices are now working under the principles of dental reform, focusing on prevention and needs-based treatment. The table at the end of this statement shows opt-in by health board.

Practices will need to balance the need for urgent dental provision with the need to see new patients, however we have calculated some 112,000 people could gain access to an NHS dentist this year as a direct result of contract reform.

I will keep Members updated about contract reform.

This statement is being issued during recess in order to keep members informed. Should members wish me to make a further statement or to answer questions on this when the Senedd returns I would be happy to do so.