The NHS has lost around 600 dental practices providing
general NHS dentistry in England since 2017, with almost every
part of the country seeing a decline as more practices move
towards private care, new analysis from the Nuffield
Trust reveals. This has been covered today in a BBC
News and Mirror joint exclusive.
The analysis shows the proportion of dental practices offering
general NHS dentistry has fallen from around 65% in 2017
to around 56% in 2026. Over the same period, the number
of practices holding an NHS general dental contract has
fallen by around 600 equivalent to around one in ten NHS
dental practices while the number of practices without an NHS
contract, largely private or specialist providers, has increased
by almost 1,000. [1]
The decline has been almost universal across England, with the
number of NHS dental practices falling in 41 of the
country's 42 integrated care boards. However, the impact
is not evenly spread. The South West and East of
England have seen particularly steep declines,
highlighting persistent regional inequalities in
access that reflect longstanding problems with the NHS dental
contract.
The analysis suggests the trend has accelerated since the
Covid-19 pandemic, as growing pressures within the NHS dental
contract have continued to push practices away from NHS work.
While reforms introduced in April, including making urgent dental
care a contractual requirement and increasing payments for some
complex treatments, should improve access to urgent care, the
authors argue they do not address the underlying incentives
driving practices away from NHS dentistry.
The authors warn that this trend may help explain the poor
results from the GP Patient Survey, which showed that half of
adults have not sought an NHS dental appointment in the past two
years. Among those who did not try, one in four said it was
because they did not believe they would be able to get an
appointment. Of those who attempted to get a new appointment,
just 38% were successful.
The Nuffield Trust says the success of the government's promised
fundamental contract reform should be judged not simply by
changes to the payment system, but by whether it succeeds in
bringing practices back into NHS dentistry and reversing the
long-term decline in access. Paying practices to care for a
population, based on local need rather than the number of
individual treatments they complete, would create stronger
incentives for dentists and help restore access based on need,
not ability to pay.
Nuffield Trust Policy Analyst, Mark Dayan said:
"The retreat of NHS dentistry was never an announcement or a
policy. There has been no closure programme for people to oppose.
But it amounts to the quiet transformation of dentistry into a
two-tier service over the last decade, where access increasingly
depends on what people can afford to pay and where they happen to
live.
As the government delivers the contract reform it has promised,
it will face a stark choice. Either it makes NHS work attractive
enough to turn this trend around and bring back enough practices
to cover everyone, or it will need to give up on the promise of a
universal service and prioritise those who need preventive care
most, or do not have the money to pay privately.
If the government tries to dodge this decision, the gradual drift
away from NHS treatment will mean we have abandoned the health
service's promise of comprehensive care for those in need, with
some parts of the country hit much harder than others.
Ends.
Notes to Editors
1. In March 2017, there were roughly 6,260 dental practices
working under the NHS General Dental Contract (the main high
street dentistry contract), and this declined to around 5,650 in
March 2026. This amounts to a loss of at least 600 practices
offering NHS care in our analysis (rounded due to data
limitations). The total number of dental practices (including
those with NHS General contracts and those without) was just over
10,000 in March 2026.
2. Chart shows Nuffield Trust analysis of CQC active-location and
NHS BSA contractor files from March 2017 to March 2026. It uses
April 2023 ICB boundaries. ICBs are currently being reorganised,
so the analysis used boundaries from before this process started.
