Classification: Official
Publication reference: PRN01295
To:
- NHS primary care dental contract holders
cc.
- NHS England regions:
- directors of commissioning
- directors of primary care and public health
- Integrated care boards:
- primary care leads
- chief executives
Dear colleagues
Update on the Dental Recovery Plan
Following the announcement of the joint plan by NHS England and the Department of Health and Social Care to recover and reform NHS dentistry, we are writing to update you on progress and tell you about the next steps for the New Patient Premium, the minimum Unit of Dental Activity value, the targeted recruitment programme (‘golden hellos’) and mobile dental vans. The New Patient Premium (NPP)
Integrated care board (ICB) colleagues worked rapidly to support implementation of this policy from 1 March 2024. All practices have been contacted to confirm their eligibility to take part and given an opportunity to opt out. This information has been logged onto Compass and contracts that are part of the scheme are now being credited with UDAs to the value of £15 or £50, as appropriate, when care is provided to new patients. To support ICBs and practices with implementation for 2024/25, further details of the scheme are attached to this letter.
To date, over 5,000 contracts have delivered care to new patients not seen in the last 2 years. Thanks to your efforts, this is helping address the difficulties we know many patients have experienced getting access NHS dental care when they have no prior relationship with a dental practice.
We are making it easier for patients to find practices that can see them. Since March, the number of practices reporting that they are taking on new patients via their nhs.uk profiles has increased. Analysis undertaken by the Department of Health and Social Care reports a net increase of 488 dental practices on the NHS Find a Dentist website that are listed as accepting new adult patients between 30 January 2024 and 8 April 2024.
We have listened to feedback on the options given to practices to report their availability and have now amended Profile Manager. Where a practice reports they are accepting new patients, the language will include the additional phrase “where availability allows”. This change was implemented from 2 April 2024 and means that, once a practice updates their profile for quarter 1 of 2024/25, the additional wording “where availability allows” will be added for patients to see.
It is vital that patients have as clear a picture as possible of where practices do have additional capacity that has been enabled through the NPP. Practices are asked to update their profile for quarter 1 as soon as practicable, if they’ve haven’t already done so. This is particularly important for practices that are eligible for and have benefitted from the New Patient Premium. We expect reported statuses to reflect participation in the scheme.
Information on how to update your profile information can be found in the latest NHSBSA dental bulletin.
Implementation of minimum Unit of Dental Activity (UDA) value
All contractors with a minimum indicative UDA value of less than £28 should have been contacted by integrated care board colleagues to agree either a revised contracted activity requirement or a revised contract value. These decisions are currently being ratified through local governance processes and will then be updated on Compass, coming into effect for 2024/25. To support this, please return contract variation documents as soon as is practicable.
If you think your indicative UDA value is less than £28 and you have not been contacted, please talk to your local commissioner.
Update on implementation of dental vans
NHS England is working with colleagues in the affected ICBs (a list of these is attached to this letter) to develop their plans for the procurement and implementation of dental vans. We are supporting this through national work focused on understanding the potential market. A PIN notice was issued on 16 April 2024 and this was followed by a supplier webinar on 22 April 2024. Information on next steps will be shared with colleagues when it is available.
Update on incentivised recruitment (‘golden hellos’)
Alongside this letter, we have published guidance for contractors and dentists who are interested in securing ‘golden hello’ funding to support their recruitment efforts. Guidance has also been shared with ICB colleagues, who will be working with system partners over the next few weeks to describe how the scheme will operate in their areas and how contractors can express an interest. Similar schemes in general medical practice have been highly successful in securing and retaining staff and we encourage all interested colleagues to express an interest in being part of this initiative.
Contract reform
Finally, while the proposals in the dental plan will help us to deliver care to more patients and support practices to deliver their contracts and maximise the opportunities to spend the full dental allocation, we recognise that more fundamental contractual change is necessary. Since the first set of contractual changes in 2022, we have been engaging with colleagues across the different professions. The dental plan sets out a timetable for further reform, with options for consultation to be brought forward this year.
Our intention is to build on the progress to date, recognising that there are still important opportunities to improve support for patients, particularly those with the highest need, who are often not fully supported by the current contractual framework. Moreover, we are aware that there are opportunities to move further on supporting prevention, engaging the full dental team and making far better use of the skills and experience of dental therapists, hygienists and nurses.
Thank you again for your commitment and support as we implement the policies outlined in the plan to improve access to NHS dentistry for patients.
We look forward to continuing to work with you.
Yours sincerely,
Ali Sparke, Director for Pharmacy, Optometry, Dentistry and the NHS Standard Contract.
Jason Wong, Chief Dental Officer England.
Annex A: New Patient Premium guidance
Introduction
While there is no formal system of registration with a practice for dentistry, as there is in general practice, patients with no existing relationship with a dental practice are more likely to struggle to access care. The latest GP Patient Survey (based on January to March 2023 data) suggested that patients with no relationship with a practice had a 30% success rate in accessing care, compared to an 83% success rate for those patients already known to a practice.
Recovering dental services is a priority for the NHS and we want to improve access for new patients. As part of the NHS and government’s dental recovery plan, we will therefore be introducing a new patient premium scheme starting on 1 March 2024. This scheme is expected to run for 13 months. The scheme will end on 31 March 2025.
Participating practices will receive a nominal credit of UDAs equivalent to:
- £15 for each eligible new patient requiring only band 1 care
- £50 for each eligible new patient requiring a band 2 or 3 treatment
This will be in addition to the UDAs a practice would already be deemed to have delivered for this care. In practice, this means the New Patient Premium value for seeing a new patient would be translated into the equivalent UDA rate for each contractor. For example, in a case where a band 2 or 3 treatment has been completed (£50 new patient premium):
- where a contractor has a UDA rate of £30, they will receive a 1.67 UDA credit
- where their UDA rate is £40, they will receive a 1.25 UDA credit
Patient eligibility
The 2-year patient eligibility period is defined as the time between the completion date for the patient’s most recent course of treatment and the acceptance date for the patient’s current course of treatment.
For the purposes of this scheme, a ‘new patient’ is defined as someone who meets all of the following criteria:
- They have not received a band 1, 2, or 3 course of treatment (excluding urgent care) from that provider (for example, the individual or business entity who holds the contract) in the previous 24 months.
- They have not received a band 1, 2, or 3 course of treatment (excluding urgent care) from that contract in the previous 24 months.
- They have not received a band 1, 2, or 3 course of treatment (excluding urgent care) from that clinician (a dentist or dental care professional) in the previous 24 months (this may be on contracts for different providers).
This is to ensure that all new patients have a fair chance of accessing the system. Eligibility is based on the data held by NHSBSA. If a patient does not qualify based on that data, a new patient incentive payment will not be made.
Contractor eligibility for credits under the New Patient Premium scheme
- A contractor’s participation in the new patient premium scheme is voluntary.
- This scheme is only for contractors providing mandatory services.
- The contractor is only eligible to receive credits where such payments do not exceed the contractor’s Negotiated Annual Contract Value or the total contracted units of dental activity.
Contractors who are ineligible for credits under the New Patient Premium Scheme
- A contract providing advanced mandatory services.
- A contract for a referral service where all patients will be ‘new’.
- A contractor participating in a local scheme that incentivises seeing new patients.
National vs local schemes
Contractors providing mandatory services are legally entitled to participate in the national New Patient Premium scheme. However, these contractors cannot also participate in similar local schemes that incentivise seeing new patients. This could result in them being paid twice for the same initiative. If contractors opt for a local scheme as opposed to the national New Patient Premium scheme, they will be deemed to have opted out of the national scheme. In this scenario, commissioners must manually opt the contractor out of the national New Patient Premium scheme to prevent double payments.
Please note:
ICBs may have contracts in place that are paid for on a different basis to UDAs (for example, sessional activity). We don’t anticipate that the new patient premium will apply to such local arrangements and eligibility in these circumstances will be for ICBs to determine.
Credit for contractors
The start date for the scheme is 1 March 2024.
Any treatment started in March 2024 and completed by 31 March 2024 will count toward the financial year 2023/24.
Any treatment started from 1 March 2024 and completed after 31 March 2024 will count toward the financial year 2024/25, as long as that treatment is completed in that financial year (2024/25).
The end date for the scheme will be 31 March 2025. Treatments of eligible patients not completed by 31 March 2025 will not be eligible for a New Patient Premium credit.
Triggering credits
A new patient credit will be made upon submission of an FP17 indicating that treatment has been completed, once patient eligibility has been confirmed by the data held by NHS BSA. If a patient fails to return for treatment, an incomplete treatment claim can be made. A New Patient credit would be made where activity relating to a band 1, 2 or 3 treatment has taken place.
Annex B: List of integrated care boards identified for dental vans
East of England
- NHS Norfolk and Waveney ICB
- NHS Suffolk and North East Essex ICB
- NHS Cambridgeshire and Peterborough ICB
South West
- NHS Cornwall and the Isles of Scilly ICB
- NHS Devon ICB
- NHS Somerset ICB
- NHS Gloucestershire ICB
- NHS Bath and North East Somerset, Swindon and Wiltshire ICB
- NHS Dorset ICB
Midlands
- NHS Northamptonshire ICB
- NHS Lincolnshire ICB
North East and Yorkshire
- NHS Humber and North Yorkshire ICB