For UK private dental practices
Your NHS contract is losing money and private income is hiding it
UDA rates have eroded in real terms for well over a decade. Most NHS practices are now cross-subsidising NHS work without a clear picture of how much it is costing them or what to do about it.
Two minutes. Solva follows up with specific contract restructuring options.
- Dentists feeling pressured to rush appointments to meet UDA targets
- Difficulty recruiting and retaining dental professionals for NHS roles
- Long waiting lists for NHS dental appointments
- Practices increasingly offering private-only treatment options
- Staff recruitment and retention challenges
- Reduced capacity for NHS patient intake
- Reduced practice profitability and potential insolvency
- Increased reliance on private income to subsidise NHS work
- Reduced access to NHS dental care for patients
- Deterioration of oral health in the population
- Negative public perception of NHS dentistry
- Erosion of trust in dental professionals and the NHS
- The primary root cause is the long-term underfunding of NHS dentistry, where UDA values have not kept pace with inflation and rising operational costs.
- This systemic issue is compounded by the rigid and often punitive nature of the 2006 NHS dental contract, which incentivises activity over patient need and quality of care.
- Behavioural factors include a reluctance among some practices to critically assess the financial viability of their NHS contracts or to explore alternative service models.
Real-term government spend on NHS dentistry across the UK remains well-below 2010-11 levels, representing a 38 per cent cut since 2010 (BDA, 2023-2024 submission to DDRB)
Source: https://www.bda.org/media/3eyfkckk/ddrb-23-24-round-bda-submission.pdf
How to fix it
An NHS contract review covering UDA value, cost per UDA, and the options for contract renegotiation, partial surrender, or transition to mixed practice produces a clear financial picture and a set of options within two weeks.
Frequently asked questions
Why does this problem persist?
NHS dental contract rates have not kept pace with cost inflation. The UDA value has eroded in real terms every year since 2006. Most NHS dental practices are now subsidising NHS work with private income without a clear strategy for addressing it.
What is the cost of leaving it unaddressed?
Many NHS dental practices operate at a financial loss when delivering NHS care, as UDA remuneration often does not cover the true cost of provision (Nature, 2026)
This is exactly what I do with UK private practices. Answer the few questions above and I'll come back personally with where to start. Paul.