NHS dentistry in Wales is entering a period of significant upheaval. With major reforms to the contract model on the horizon, practices across the country are preparing for changes that could drastically reshape how care is delivered and how accessible it is for patients.
To explore what this means for the profession, we recently hosted a live webinar, led by Zoe Close from Practice Plan, featuring expert insights from Lauren Harrhy, Principal Dentist and member for Wales on the BDA’s Principal Executive Committee, Practice Plan’s Welsh Regional Support Manager Louise Anderson and Liz Lee, Principal Dentist and Owner.
If you missed it, the full webinar is available here, but here’s a summary of the key takeaways from the discussion.
Where things stand with NHS dentistry in Wales
For some time now, NHS dentistry in Wales has faced growing challenges, from stretched resources and patient access, to rising pressure on teams working under an increasingly rigid contract. The proposed changes are being presented as a solution to long-standing issues, but the reality is that they represent a major shift in how NHS dentistry is structured, funded, and delivered.
What are the proposed changes?
Here’s a breakdown of some of the key reforms under discussion:
- A move away from UDAs/contract reform metrics
One of the headline changes is the proposed shift from UDAs/contract reform metrics to a Care Pathway model. While this is intended to give clinicians more freedom to focus on patient care, there are questions around how it will be implemented and whether it will reduce the target-driven pressures NHS teams currently face, or simply reshape them.
- Introduction of a Dental Access Portal (DAP)
A new, centralised waiting list – the DAP – is expected to be rolled out, matching patients to available appointments across practices. While the goal is to improve access, this could lead to patients being allocated to unfamiliar practices, disrupting the continuity of care many have come to rely on.
- Changes to patient charges
Practices may no longer be responsible for collecting patient charge revenue (PCR), with the process being managed centrally instead. This could ease some administrative burden but also raises questions about control, clarity, and cash flow for NHS practices.
- A greater focus on new patient assessments
Practices will be required to carry out more new patient assessments. While intended to support improved access, this could put pressure on capacity and make it harder to prioritise long-standing patients already receiving care.
Concerns raised by the panel
Throughout the webinar, our panellists shared a number of concerns, many of which are being echoed across the wider profession.
Liz Lee highlighted the risk of losing continuity of care, particularly for families and vulnerable patients who benefit from seeing the same team over time.
Louise Anderson noted the emotional strain the changes are already having on dental teams – with many feeling they’re losing autonomy and control over how they care for their patients.
Lauren Harrhy also emphasised the uncertainty created by a lack of clear communication, with many clinicians still unsure how and when these reforms will come into force – or what support will be available to help them adapt.
Where to find support and guidance
During the session, the panel highlighted several key resources available to support dental professionals through this transition:
- BDA Wales website
The British Dental Association (BDA) Wales will continue to publish updates and clarifications on the contract changes and DAP rollout. It’s worth checking their website regularly for the most current information.
- Health Assured (via BDA membership)
BDA members can access emotional and mental health support through Health Assured – including counselling services designed to help manage stress and burnout.
This free-to-access website offers a wide range of mental health resources tailored for dental professionals. It includes downloadable PDFs with direct links to counselling services, wellbeing guides, and tools to manage workplace pressure.
- Local Dental Committees (LDCs)
Connecting with your local LDC can be a valuable way to stay informed, share feedback, and receive localised advice on how to approach the contract changes in your area.
- Practice Plan
As highlighted during the webinar, Practice Plan is available to support practices in understanding the implications of these changes and exploring the potential for alternative models such as private or mixed practice. We’re just a phone call away!
What can practices do to prepare?
In such an uncertain environment, it’s important that practices take steps to protect their teams, their patients, and their financial future.
- Review your financial position
Now is the time to assess where your income is coming from and what the proposed changes might mean for sustainability. Independent financial advice can provide valuable clarity.
- Begin open conversations with patients
Be transparent with your patient base about what may be changing and what will stay the same. Clear communication will help manage expectations and reduce anxiety as reforms are introduced.
- Understand the new structures
Take time to fully understand the proposed Care Pathway model and DAP. While some details are still to be confirmed, getting ahead of the changes will help you adapt more smoothly when the time comes.
- Consider the long-term future of your practice
For some, these reforms may prompt a more serious look at private or mixed models – not only to safeguard income, but to retain control over how care is delivered.
Final thoughts
While the stated intention behind these changes is to address long-standing challenges within NHS dentistry, they also introduce major structural and operational shifts that many practices will find difficult to navigate.
By staying informed, seeking out the right support, and planning proactively, dental professionals can begin to assess how best to respond – whether that’s adapting within the NHS or exploring new models of care.
To watch the full webinar and hear directly from the panel, click here.