The Association of Dental Groups (ADG) has published its new paper, Priorities for NHS England Dental Contract Reform, setting out clear, practical steps to ensure that contract reform strengthens patient access, supports the dental workforce and delivers a stable, sustainable NHS dental system.
The paper highlights several immediate priorities which include protecting patient access through increased NHS dental funding, preventing the NHS Dental Performer List from becoming the next bottleneck for newly registered dentists, and avoiding the risks following a full rewrite of the dental contract.
Neil Carmichael, ADG’s Executive Chair, said: “Patients need dental care now as a matter of urgency and we know that we have an NHS dental contract for England that, with proper funding and some intelligent flexibility can be adapted to form a solution for the near future, rather than pushed out into the far distance. For the adult contract, we are cautioning against a complete rewrite, which would be disruptive, although we acknowledge that for children further consultation on contract revisions with experts is essential. We have to consider that the needs of adults and children differ, so the DHSC must work closely with all relevant stakeholders to determine what is right for both.
“Our observations are that we have four devolved nations in the UK, each with their own contracts, but they all suffer from workforce planning issues. So, this must be where we focus. We must ensure that the progress made in widening entry routes for overseas dentists does not simply shift the bottleneck to the Dental Performer List.
“NHSE and ICBs need to seek feedback from dental providers, professionals and patient groups to understand the implementation issues being faced by the April 2026 changes – including the Complex Care Pathway, unscheduled and urgent care as well as data and reporting. My message is clear. Talk to us.”
Increased NHS dental funding must protect patient access
The ADG warns that without a meaningful uplift in NHS dental funding, the rising cost of delivering care will inevitably reduce routine activity and restrict patient access. Minimum UDA rates are increasing across England, but unless these higher costs are matched by new investment, the budget will be exhausted more quickly, and patient access will suffer. The ADG is clear that patients must not be left paying the price for a system that becomes more expensive to deliver but is not funded accordingly.
The paper calls for urgent publication of the long-delayed practice cost audit, transparent communication from DHSC and NHSE, and acceptance of DDRB recommendations without applying the GDP deflator. These steps are essential to stabilise NHS dentistry and ensure that contract reform does not unintentionally reduce access for the very patients it aims to support.
The NHS Dental Performer List must not become the next bottleneck
Following the ADG’s successful campaign to expand ORE capacity and increase dental school places, more qualified dentists are now entering the UK system. However, the ADG warns that progress will stall if the NHS Dental Performer List becomes the next barrier preventing clinicians from reaching patients.
Registration with the GDC already confirms that a dentist is safe, competent and fit to practise. The ADG argues that the DPL should complement, not duplicate, this process. Without reform, the system risks recreating the same bottleneck the ADG has been working hard to resolve over the last 18 months with the DHSC – by simply shifting it further along the pathway.
The paper calls for streamlined data capture, modernised mentorship requirements and a revised DPL process that supports new dentists to enter NHS practice swiftly and safely.
The risks of a full contract rewrite
The ADG cautions strongly against a wholesale redesign of the NHS dental contract in England, which experience has shown can be disruptive for providers, clinicians and patients. Instead, the ADG advocates for incremental, evidence-based reform built on meaningful consultation, robust data systems and clear communication.
The April 2026 changes in England were a step in the right direction clinically, but implementation challenges have shown the importance of careful planning and stakeholder engagement. The ADG urges NHSE to resolve current operational issues before introducing further changes, and to ensure that lessons are fully understood before any future reform is considered.
A practical, evidence-based route to reform
The ADG paper sets out recommendations across five areas: implementation of the April 2026 changes, future contract reform, children’s oral health, financial stability and the NHS Dental Performer List. Together, they form a clear roadmap for a contract that is workable, sustainable and fit for purpose.
The ADG will continue to work with the DHSC, NHSE, commissioners and professional bodies to ensure that contract reform strengthens the dental workforce, improves patient access and supports high-quality care across NHS, private and community settings.
