• The dental recovery plan is not on course to fulfil its ambition of an additional 1.5m treatments by the end of 2024/25 – even if the target was reached it would still be 2.6m fewer treatments per year than pre-pandemic levels. 
  • Access to NHS Dentistry remains below pre-pandemic levels, with only 40% of adults recorded as having seen an NHS dentist in the 24 months up to March 2024; compared to 49% in the 24 months prior to the start of the COVID-19 pandemic.   
  • Last year (2023/24) £392m was underspent across the NHS dental budget and it was agreed that £200m of expected underspends in 2024-25 would be used to fund the dental recovery plan. 

The dental recovery plan, launched in February 2024 with the aim that “everyone who needs to see a dentist will be able to,” is unlikely deliver an additional 1.5 million treatments by March 2025, which even if achieved would still mean 2.6 million fewer treatments compared to six years ago, according to a new report from the National Audit Office (NAO). 

The report also reveals that, based on NHS England (NHSE) analysis to date, fewer new patients have received treatment each month since the plan’s implementation, compared to the same period in the previous year (see notes to editors). 

Access to NHS dentistry across England remains below pre-pandemic levels, with 40% of adults recorded as having seen an NHS dentist in the 24 months to March 2024, compared to 49% in the 24 months prior to the start of the COVID-19 pandemic. There are also 483 fewer dentists providing some NHS care compared to 2019-20.  

By August 2024, the Department for Health & Social Care (DHSC) and NHSE had spent £57 million of the planned £200 million budget, with only two of the four initiatives (see notes to editors) fully rolled out – although the NAO does recognise the general election has impacted progress in some areas over that time. 

DHSC and NHSE have completed the roll-out of the new patient premium and an uplift to the minimum amount Government pays dentists for treatments, known as Units of Dental Activity (UDA) (see notes to editors), from £23 to £28. NHSE data suggests that there has been about a 14-percentage point increase in dental practices reporting that they are accepting new adult patients, when availability allows, between December 2023 and September 2024 (see notes to editors). 

There has been a small increase in the number of UDAs delivered in the early months of 2024-25, but this is in line with DHSC expectations that, even without the plan, there would be a small increase (see notes to editors) in delivery. As NHSE and DHSC are reliant on Integrated Care Boards (ICBs) and dental practices to deliver the plan, there is significant uncertainty about the impact the plan will have. 

The ‘Golden hello’ incentives of £20,000 (phased over three years) to recruit 240 dentists into specific areas of the country have not yet contributed to the 1.5 million additional treatment target. While 274 practices have had their application approved to recruit a ‘golden hello’ post, the first dentist was not appointed until October this year.  

The last initiative of mobile dental vans, aimed at delivering some dental services to targeted communities has also not been rolled out, as no vans have been procured. Any further progress on this initiative paused when the general election was called and new ministers stated in November that it will be left for ICBs locally to decide whether they go ahead with procuring vans during the remainder of 2024-25. 

The NAO’s report confirms that access to NHS dentists varies across the country, with some areas of England on average receiving twice as much care as others. Courses of treatment per 1000 people ranged from 382 in Somerset to 800 in South Yorkshire in 2023-24. 

There are several challenges facing the Government if it wants to increase access to NHS Dentistry, including: 

  • The dental contract, which is widely perceived as needing reform, with many in the sector viewing the contract as a disincentive to perform NHS care when practices have the choice of offering private care too. 
  • A fall in the number of dentists providing some NHS dental care, having fallen by 483 since 2019-20, a decrease of 2%. There were 34,520 dentists registered with the General Dental Council (GDC) in England in April 2023, but their survey suggests that 22% of the dentists in England did not provide any NHS dental care, only private dental care.  
  • A reduction in overall spending in real terms, dropping from £3.7 billion in 2019-20 to £3.1 billion in 2023-24, a drop from £65.15 to £53.88 per person in England.  
  • In 2023-24 there was an underspend of £392 million against the total ringfenced NHS dental budget. 

Read the full report

Investigation into the NHS dental recovery plan

Notes for editors

  1. Press notices and reports are available from the date of publication on the NAO website. Hard copies can be obtained by using the relevant links on our website.
  2. The evaluation led by NHS England is ongoing to understand this data more fully.
  3. Dental Recovery Plan four headline initiatives:

A new patient premium, in which participating dental practices receive a credit of units of dental activity (UDAs) equivalent to £15 or £50 (depending on the course of treatment) for eligible new patients

‘Golden hello’ recruitment incentives of £20,000 (phased over three years) for 240 dentists to work in areas with recruitment and retention challenges in NHS dentistry

An uplift to the minimum value of a UDA to £28. Units of dental activity (UDAs) are measures of overall dental activity based on the kind of treatment provided.

Mobile dental vans to deliver some dental services to targeted communities.

  1. The ‘find a dentist’ service provides information on practices are accepting new patients “when availability allows”, but this is not defined by NHS England.
  2. Even without the Dental Recovery Plan, DHSC was forecasting that there would be an increase of 3.7% in delivery of UDAs in 2024-25.

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