For NHS Contract Holders and Associate Dentists in England based on the Dental Update / Practice Plan Webinar, 7 April 2026
Around 1,500 people tuned into our NHS Dental Contract changes in England webinar live or have viewed it on demand since. On the night, nearly 90 questions were submitted to the chat. Clearly, this is a subject where many of you want more information or greater clarity.
To help provide this, we have grouped together the questions we received and provided some answers, where possible. In some cases, further guidance is still to be issued which means we can’t answer that question yet. Where that’s the case, we have made that clear.
We hope you find these helpful. If you would like to have a chat with one of our NHS experts to discuss your options, you can book a no obligation confidential chat here.
Unscheduled (urgent) care — overview
Q: What is the new definition of unscheduled care?
A: Unscheduled care is defined as a prompt course of treatment that is clinically necessary because, in the opinion of the contractor, the person’s oral health is likely to deteriorate significantly, or the person’s presentation indicates a need for treatment within seven days — and the treatment is provided only to the extent necessary to prevent that deterioration or treat that need.
Importantly, the previous requirement for ‘severe pain’ has been removed. This widens access to those with broken teeth, lost crowns, wobbly teeth or broken dentures, even where pain is not the primary presentation.
Q: Which patients does the unscheduled care obligation apply to?
A: All patients — there is no restriction. This includes your own existing patients who contact the practice, patients referred via NHS 111, and new patients phoning the practice. You do not need to be accepting new NHS patients generally in order to see someone for unscheduled care.
Q: Does this apply to children as well as adults?
A: Yes. The unscheduled care obligation applies to both adult and child patients.
Q: What codes should we use to submit unscheduled care claims?
A: Your dental software (e.g. Software of Excellence, Dentally) should be updated to reflect unscheduled care claims. Speak with your software provider if you are uncertain which codes apply. At the time of the webinar, some practices were experiencing initial configuration issues which were expected to be resolved within the first month or two of the new arrangements. Guidance from the BSA should also be checked directly if claims are being rejected.
Q: Our ICB has asked us not to submit unscheduled care claims to the BSA for a couple of months. What about the two-month rule for claims?
A: This is an area of local variation. If your ICB has specifically advised you to delay submission, you should follow that local guidance and seek written confirmation from them. The two-month rule is a standard submission deadline, but ICBs can provide local direction during transitional periods. Contact your Local Dental Committee (LDC) or ICB directly for confirmation in writing.
The 8.2% unscheduled care target
Q: Is the 8.2% target based on contract value (money) or the number of UDAs?
A: It is based on your Relevant Contract Value (RCV), which is the monetary value of your contract, not the number of UDAs. The formula for calculating the required number of unscheduled care appointments is: RCV ÷ 10,000 × 11.
Q: Are the unscheduled care UDAs deducted from my total contract UDAs, or are they in addition?
A: The 8.2% is carved out from within your existing contract value, it is not additional funding on top. In effect, you have two targets: your 8.2% unscheduled care element, and the remaining 91.8% of your base contract. Clawback can apply to either if targets are not met.
Q: How many emergency slots per week should I provide for a contract of 1,000 UDAs per year?
A: Using the formula (RCV ÷ 10,000 × 11), you can calculate your expected number of unscheduled appointments for the year and divide by 52 to get a weekly figure. This will vary depending on your UDA rate per appointment, but as a rough guide, for a smaller contract of 1,000 UDAs, this is likely to be one or two slots per week.
Q: Can the 8.2% target be reduced if we cannot meet it?
A: Possibly. If you believe you will not meet your unscheduled care target, you can speak with your commissioner (ICB) to reduce the target by up to 15%, giving you some additional flexibility. NHSE has suggested what criteria would need to be satisfied to allow any reduction, and it’s likely they would require the submission of significant evidence to achieve this change.
Q: What happens if we use up all our unscheduled care slots before the end of the year?
A: There is no obligation to stop providing unscheduled care once you have hit the 8.2% target. However, the payment mechanism changes. Once you have exceeded the 8.2% threshold, the NHS will automatically begin paying £75 per additional unscheduled care appointment (converted to UDAs at your practice rate).
Q: What if we run out of overall UDA capacity early, say by January, due to all the new components?
A: There is no contractual obligation to spread your UDA activity evenly across the year. If you exhaust your contract activity, you are required to direct patients to alternative NHS provision where possible or advise them that funding is exhausted and offer them the choice of private treatment or a return appointment when your new contract year commences on 1st April.
Q: Will it be possible for an associate working for a corporate to opt out of unscheduled care?
A: This is ultimately a contractual and employment matter. The obligation to provide unscheduled care sits with the contract holder (the provider). Whether that flows down to individual associates, and on what terms, should be addressed in associate agreements. The BDA has updated its model associate agreement template to reflect the new contract changes; this can be downloaded from the BDA website. Associates should check their individual agreements and discuss arrangements with their principal.
Payments for unscheduled care
Q: How does the £75 payment work? Does it replace the 1.6 UDAs?
A: The £75 is not paid instead of UDAs, it is converted into UDAs at your practice’s own UDA rate (not a national rate). Your dental software currently shows unscheduled care appointments as 1.6 UDAs as a temporary placeholder because software providers do not hold your individual UDA rate. This will be reconciled once your actual practice rate is confirmed, typically within the first month or two. The £75 converts to a specific number of UDAs unique to each practice.
Q: What is the £15 payment for failed-to-attend (FTA) unscheduled appointments, and who receives it?
A: The £15 is a notional payment to offset the loss of income from missed unscheduled appointments. It is paid to the practice on a monthly basis regardless of whether FTAs occur. You do not need to claim it and it is not subject to clawback. It is divided by 12 and arrives automatically as part of your monthly contract payments.
Q: How do associates get paid for unscheduled care?
A: Unscheduled care activity will appear on the individual performer’s Compass schedule as UDAs (converted from the pound value). Associates should be paid their usual percentage applied to those UDAs in the same way as banded course-of-treatment UDAs. Associates also have access to their own Compass schedule to verify the figures independently.
Q: What about the £15 FTA payment — does that go to associates?
A: This is at the discretion of the practice. The £15 forms part of the overall contract payment, and there is no mandated requirement to pass it directly to associates. Some practices have chosen to pay associates the full £75 (inclusive of the £15), treating it all as a single payment. Others may handle it differently. This should be addressed in associate agreements. The BDA has acknowledged this as an area of legitimate debate and discussion.
Q: If a provider pays associates the £15 FTA payment, how is this done; as additional UDAs or separately?
A: This is a practice-level decision and should be documented in the associate agreement. It could be paid as additional UDAs (added alongside the unscheduled care UDAs on Compass) or as a separate payment. Speak to your accountant and ensure the arrangement is clearly set out in writing.
Q: If there is clawback, and the practice has already paid associates for unscheduled UDAs, does the practice claw back money from associates?
A: This is an important area to address in associate agreements in advance. The clawback risk sits with the contract holder, and how any shortfall flows to associates will depend on the terms of their individual agreements. Associates do not have UDA targets in the same way as contract holders. It is strongly recommended that practices review and update associate agreements to address these possible circumstances.
Q: If we pay associates different UDA values, how do we calculate unscheduled care pay?
A: The unscheduled care UDAs will appear on each performer’s Compass line at the practice’s overall UDA rate. If associates are on different percentage arrangements, you apply their individual percentage to those UDAs in the normal way. The key is that the UDA value on Compass reflects the practice rate, the percentage split then applies according to each associate’s agreement.
Managing unscheduled care appointments — clinical and administrative questions
Q: What treatment is required during an unscheduled care appointment to attract the payment?
A: The treatment provided must address the presenting problem. The aim is to prevent significant deterioration. This may include extractions, temporary fillings, permanent fillings, dressings, recementation, or appropriate pain management. There is no single mandated treatment type; clinical judgement governs what is necessary within the appointment.
Q: Can I provide a temporary filling at a Band 1 appointment and bring the patient back for a definitive restoration at a Band 2?
A: Yes, this approach is clinically valid. The initial unscheduled appointment addresses the immediate presenting need (e.g. a broken tooth), closed as a Band 1 course of treatment. If the patient then returns for definitive restorative treatment, this is opened as a new course of treatment under the appropriate band. Please note that patient charges apply per course of treatment, so two separate courses means two charges.
Q: I see an unscheduled patient but cannot finish treatment in the appointment. How do we charge if they return for completion?
A: If you close the unscheduled course of treatment (e.g. as a Band 1 or Band 2 depending on what was completed), and the patient returns for remaining treatment, this would be opened as a new course of treatment under the appropriate band. If treatment is not yet complete and the course of treatment remains open, the patient charge for the entire course is collected when the course is eventually closed.
Q: Once a new patient is seen for unscheduled care, are we obliged to take them onto our NHS books and provide ongoing treatment?
A: No. The unscheduled care appointment is a discrete episode of care to address the immediate presenting problem. There is no contractual obligation to offer the patient ongoing NHS care. You can treat it as a one-off episode. Whether or not to offer ongoing NHS care to that patient remains a practice decision. There is no such thing as registration with a practice for NHS patients.
Q: How many unscheduled courses of treatment can a patient have? For example, if a non-registered patient attends twice in 50 days, is that permitted?
A: There is no stated maximum number of unscheduled courses of treatment a patient can access. Each episode is treated as a clinically necessary course of care at the time. A patient who presents twice with separate, genuine unscheduled needs within a short period can be seen and claimed for each separately, provided each attendance is clinically justified.
Q: Could a patient on a private plan (e.g. Denplan Essentials covering exams and prevention only) still access unscheduled care on the NHS for a toothache?
A: Yes. A patient covered by a private maintenance plan that covers only examinations and prevention can still access NHS unscheduled care for an acute dental problem. Mixing NHS and private treatment within a single course of treatment is not permitted, but two separate courses (one NHS unscheduled, one private) for different presenting needs at different times are permissible.
Q: Can one dentist in a multi-dentist practice be designated solely for unscheduled care, while others focus on care pathways?
A: Yes, provided the overall 8.2% target is met for the practice as a whole. How the practice organises its clinical team to meet that obligation is a matter of internal arrangement. The obligation rests with the contract holder rather than individual performers.
Q: How do we manage the appointment book practically to meet the 8.2% target?
A: Reserving dedicated daily or weekly slots is the recommended approach. Train reception and clinical staff to triage calls appropriately, distinguishing between unscheduled/urgent care, routine scheduled appointments, and non-urgent enquiries. NHS 111 may also direct patients to you, so communicate your capacity clearly to your ICB and to 111 if demand is exceeding what your slots can accommodate. Review and adjust slot allocation as you gather data through the first year.
Q: How should an associate demonstrate or record that a patient failed to attend?
A: Recording the failed appointment in the patient record (including date, time, and that the patient did not attend) is good practise. Your dental software should also log the appointment as a non-attendance. While the £15 FTA payment does not require you to claim or police non-attendances, good record keeping protects you clinically and administratively should there be any queries.
Q: If unused unscheduled slots are available on the day, can we fill them from NHS 111 referrals?
A: Yes. If you have capacity remaining in your designated unscheduled slots, you can accept patients directed to you by NHS 111 or by patients contacting you directly. There is no restriction on the source of the patient for unscheduled care appointments.
Q: Does unscheduled care apply if we hold a UDCH contract for the NHS 111 Out-of-Hours service?
A: The 8.2% unscheduled care requirement applies to standard GDS/PDS contracts delivering general NHS dental services. If you hold a separate UDCH or out-of-hours commissioned service, the terms of that specific contract will govern how those appointments are counted and claimed. Check with your ICB or the relevant NHSE team for clarity on how your specific contract type works with the new requirements.
Which contracts are exempt from the new requirements?
Q: Do the new unscheduled care and care pathway requirements apply to a children-only contracts?
A: No. Children-only contracts are not subject to the new unscheduled care 8.2% target or the complex care pathways. If you hold a pre-2006 children-only contract, these changes do not apply to you.
Q: What about a very small contract, e.g. 230 UDAs or 1,000 UDAs?
A: Very small contracts delivering a low number of UDAs are also likely to be outside the scope of the new requirements. The changes do not apply to orthodontic PDS agreements or other bolt-on non-mandatory service agreements. If you are uncertain whether your contract is in scope, contact your ICB or NHS England.
Q: We have an exempt-patient-only contract (free treatment for eligible patients). Do these changes apply?
A: This depends on the nature and size of the contract. Children-only and very small contracts are broadly excluded. If your exempt-patient contract delivers NHS general dental services above the threshold, you should contact your ICB for specific confirmation as to whether the requirements apply to you.
Q: Do the appraisal and fluoride varnish requirements apply to a children-only contract?
A: Fluoride varnish (standalone application for under-16s) and fissure sealants are particularly relevant to practices seeing children. Appraisals are a contractual requirement for NHS clinicians meeting the minimum activity threshold, regardless of contract type. Confirm with your ICB or NHSE which elements apply to your specific contract.
Complex Care Pathways (CCPs)
Q: What are the three complex care pathways and when will they be introduced?
A: Three new complex care packages have been introduced, though they are expected to be operational from 1 June 2026 due to a legislative drafting delay:
CCP1: Five or more carious lesions (interdentine). Duration: 6 months. Payment: £284 (converted to UDAs at your practice rate).
CCP2: Five or more carious lesions plus unstable periodontal disease. Duration: 12 months. Payment: £709.
CCP3: New diagnosis of Grade C periodontal disease. Duration: 6 months. Payment: £248.
Full clinical guidance is expected to be published shortly. These pathways are voluntary; you are not obliged to place patients on them. However, continuing to use the old phased treatment approach (multiple bands of treatment for the same patient) will be viewed unfavourably, as it results in higher patient charges.
Q: Are these care pathways mandatory?
A: No. Participation is voluntary. However, if a patient with five or more carious lesions is treated through multiple separate banded courses of treatment rather than a CCP, they will pay multiple patient charges rather than a single band charge for the pathway. The pathway is a better deal for the patient financially, and the practice should receive broadly comparable income. The BDA recommends transitioning away from phased treatment.
Q: How does the payment work? Is it all paid upfront or over time?
A: Payment is made monthly. The total pathway value (e.g. £709 for CCP2) is divided by 12 and paid to the practice each month for the duration of the pathway. Payments stop when the patient exits the pathway either because the pathway is complete, or because the patient has been removed (e.g. due to repeated non-attendance).
Q: If a patient completes all five restorations in less than six months, how are we paid?
A: The pathway is based on a package of care and a time period, not on completing a fixed number of specific treatments. The aim is stabilisation. If the clinical work is complete before the six months are up, the pathway can still run to its end date while the patient is supported (e.g. with fluoride applications, behaviour change advice, remote check-ins). Further guidance on closing pathways early is expected in the forthcoming clinical guidance.
Q: What happens if a patient on a care pathway fails to attend?
A: If a patient repeatedly fails to attend, you can remove them from the pathway. Once you notify the BSA that the patient has exited the pathway, monthly payments cease. You should not continue to receive payments for a patient who is no longer actively on the pathway. The specifics of how to record and report this will be set out in the clinical guidance.
Q: If a patient on a complex care pathway presents as an emergency during the 6 or 12-month period, do we charge them an unscheduled fee or is it included?
A: This is an area where we’re awaiting further clinical guidance. Current understanding is that if a patient on a CCP presents with a new acute problem during the pathway period, this may be managed as part of the pathway rather than as a separate unscheduled course of treatment. The guidance will clarify this.
Q: Do we need to start a new course of treatment for definitive work (e.g. root canal, crowns) once the patient is stabilised?
A: Yes. The complex care pathway covers stabilisation, managing the immediate disease burden (caries, periodontal disease) to get the patient to a stable state. Once stabilised, any definitive restorative work (e.g. root canal treatment, crowns, bridges) would be provided under a new banded course of treatment, chargeable in the normal way.
Q: Would we need to finish endodontic treatment started during the pathway before it ends?
A: The pathway is a stabilisation period; it is not necessarily a completion period. You are not obliged to complete every treatment item before the pathway ends. The goal is to stabilise the patient’s condition. Definitive treatment may follow under a new course of treatment. Further guidance may clarify expectations around treatments commenced but not yet completed at the end of a pathway.
Q: When do we close the course of treatment for a care pathway patient? What if we finish early?
A: The pathway has a defined duration (6 or 12 months). The course of treatment would typically be closed at the end of the pathway period. If all active treatment is complete before then, the pathway continues for monitoring, preventive support, and behaviour change. The forthcoming clinical guidance should provide clearer direction on early closure.
Q: How does the care pathway work where different clinicians are seeing the patient, such as a GDP and a dental hygienist/therapist?
A: The pathway is a multi-disciplinary package and different team members can contribute to it. For example, a hygienist managing periodontal treatment and fluoride applications, while the dentist provides restorations. All clinicians involved should be registered on Compass as performers and their activity recorded accordingly. We expect further guidance on multi-clinician pathways and how team activity is recorded.
Q: How will care pathway monthly payments be allocated to associates?
A: This is at the practice’s discretion and should be agreed in advance and documented in associate agreements. The monthly payment arrives at practice level via Compass as UDAs. The practice would then apportion payment to the clinician(s) who carried out the pathway treatment, in the same way as other UDA-based payments. There is no single prescribed approach; it is something for practices to determine based on their own arrangements.
Q: What about stabilisation restorations? Is there a specific code for a non-GIC temporary restoration placed as a stabilisation measure?
A: This is an area where further coding guidance from the BSA is needed. As mentioned in the webinar, the intention is that a restoration placed as part of stabilisation (whether GIC, IRM, composite or amalgam) would be claimed under the appropriate existing restoration codes. Where there is uncertainty, you can either wait for the clinical guidance or contact the BSA directly for clarification.
Q: If a patient on a CCP returns after failing to attend and asks to resume treatment, do we restart the whole pathway?
A: We expect details of re-entry following patient removal from a pathway to be covered in the forthcoming clinical guidance. As a general principle, if a patient was removed due to non-attendance and then re-presents, a clinical assessment would be needed to determine whether the original pathway conditions still apply or whether a new pathway should be initiated.
Q: How will the BSA know a care plan (CCP) has been carried out?
A: The practice will notify the BSA via Compass when a patient enters a pathway and will confirm ongoing engagement (e.g. monthly) as part of the administrative process. Payments are triggered by this notification. The precise administrative requirements will be set out in the clinical guidance and BSA operational guidance which we expect soon.
Q: We have already started phased treatment plans; what do we do now?
A: Existing phased treatment plans that pre-date April 2026 can be completed under the previous arrangements. For new patients presenting from April onwards who meet CCP criteria, you should consider the pathway approach rather than phasing. Transitioning existing phased patients onto CCPs mid-treatment would depend on clinical appropriateness and is something to seek further guidance on from your LDC or NHS England.
Q: For Grade C periodontal patients, can we still refer them to hospital for advanced mandatory services?
A: Yes. Referral to secondary care for treatment beyond the scope of general dental practice remains appropriate where clinically indicated, regardless of the new care pathways. The CCP3 pathway is for Grade C periodontal disease managed in primary care. If the complexity of the case warrants secondary care, referral is still the correct course of action.
Fluoride varnish and fissure sealants
Q: How does standalone fluoride varnish work under the new contract?
A: A standalone fluoride varnish application can now be delivered for patients under 16, worth 0.5 UDAs. If it’s applied by a dental nurse then they must be appropriately trained, competent, and indemnified to do so. The nurse must be registered on Compass as a performer. It is a separate course of treatment from any other examination or treatment, requiring a written prescription from a dentist. Intervals must be not less than three months between applications.
Q: How many UDAs does fluoride varnish attract for the dentist if they apply it themselves?
A: The standalone fluoride varnish is valued at 0.5 UDAs. It can be applied by either the dentist or a suitably trained and indemnified dental nurse. However, the clinical and commercial intent is for extended-duty dental nurses to deliver this, freeing dentist time for more complex treatment.
Q: The three-month minimum interval for fluoride varnish doesn’t seem compatible with achieving four applications a year for high-risk patients?
A: A three-month minimum interval allows for up to four applications per year if appointments are spaced exactly. The scheduling does require accurate appointment management. For high-caries-risk children, this can be planned as two dentist-led applications and two nurse-led applications per year, for example. In practice, exact three-monthly intervals may be challenging. What matters is that the interval is not less than three months, not that it is exactly three months.
Q: Can a dental therapist carry out fluoride varnish applications and a nurse place fluoride varnish on prescription?
A: Yes. Dental therapists and hygienists are also able to apply fluoride varnish within their scope of practice. Extended-duty dental nurses can do so under a written prescription from a dentist. All clinicians doing so must be appropriately trained, indemnified, and registered on Compass.
Appraisals
Q: Are appraisals mandatory?
A: Yes. Appraisals are a contractual requirement, having been in GDS contracts since 2006 under paragraph 30 of Schedule 3, though they were never previously implemented. There is now an active appraisal system, making this requirement enforceable. Eligible clinicians (dentists, dental therapists and hygienists delivering NHS care) must participate.
Q: Who is eligible for an appraisal?
A: Dentists, dental therapists and hygienists who have delivered NHS dental care for a minimum period. The current minimum threshold is equivalent to two whole working days per month (or 12 days across a continuous six-month period), and the clinician must have been in continuous NHS employment during the last 26 weeks of that period. Hygienists or therapists who work at a practice but deliver only private care do not qualify.
Q: How much is an appraisal payment?
A: Appraisals attract a payment of approximately £213–£230 per appraisal. This is a contractual payment, not part of the voluntary quality improvement fund.
Q: Who receives the appraisal payment, the appraiser or the appraisee?
A: The guidance suggests the person being appraised (the appraisee) receives the payment, but someone also has to conduct the appraisal. In practice, this payment should ideally be split between the two parties, or the arrangements should be discussed and agreed as part of associate contracts or employment terms.
Q: How do I claim for an appraisal, either as the appraiser or appraisee?
A: The administrative process for claiming appraisal payments will be set out in NHSE operational guidance. It is expected to be managed via Compass. If you are unsure, contact your ICB or NHSE directly for the claims process.
Q: Is there a specific time allocation required for an appraisal?
A: No specific time requirement has been stipulated beyond what is clinically and professionally reasonable. A meaningful appraisal would typically take at least an hour. Further operational guidance may clarify expectations.
Q: Does the ICB provide the appraisal mechanism?
A: The ICB is responsible for commissioning or facilitating the appraisal framework within their area. The appraisal is a contractual requirement that ICBs must support. Where no ICB-led system is in place, practices may need to develop their own peer appraisal arrangements that adhere to the requirements of the contract.
Quality improvement and recall intervals
Q: What is the quality improvement payment and is it mandatory?
A: The quality improvement initiative is voluntary and attracts a payment of £3,400 paid monthly. It focuses primarily on adherence to NICE guidelines on recall intervals which means ensuring that patients are recalled at clinically appropriate intervals rather than defaulting to six-monthly recalls for all patients regardless of risk.
Q: Is the NICE guidance on recall intervals a new requirement?
A: No. NICE guidance on recall intervals has been in place since 2006. What is new is a greater degree of scrutiny and an expectation of active adherence to these guidelines. Practices that are recalling low-risk, healthy patients every six months may be expected to extend recall intervals in line with NICE guidance. The data submitted to commissioners suggests that a significant proportion of practices are not fully adhering to risk-based recall intervals.
Q: What about patients who want a six-month check-up even when clinical need doesn’t require it?
A: Patient preference does not override clinical guidance on recall intervals. If a patient’s oral health risk assessment indicates that a 12-month or longer recall is appropriate, the clinician should follow NICE guidance and advise the patient accordingly. Patients can choose to attend privately more frequently, but NHS recall frequency should be clinically justified. This may require clear communication with patients.
Skill mix, team working and peer review
Q: How does skill mix work with two full-time dentists and two full-time therapists? What are the optimal arrangements?
A: Skill mix is a key element of the new contract’s intent. Therapists and hygienists can take a greater role in delivering periodontal treatment, fluoride applications, fissure sealants, and preventive advice and so freeing dentists for more complex restorative and urgent care. Consider designating specific therapist/hygienist sessions for pathway-related preventive care and fluoride applications, while dentists focus on diagnosis, complex treatment, and unscheduled care. Your appointment book should be configured to route appropriate patients to the right clinician, with appropriate triaging by reception staff.
Q: Hygienists and therapists at my practice are not under NHS, how do I handle patients who won’t see them privately?
A: This is a significant clinical and commercial challenge. Patients who decline to see hygienists or therapists privately may be managed within NHS appointments where the therapist or hygienist is providing NHS care as part of a care pathway. If your therapists/hygienists are not delivering NHS care, they will not attract NHS payments for those sessions. You might need to consider whether it is feasible to bring therapist/hygienist sessions within the NHS contract, particularly for periodontal and preventive care relevant to the new pathways.
Q: How does peer review work for a solo dentist working with dental therapists?
A: Peer review in this context relates to the quality improvement and appraisal requirements and can involve external peers where in-house colleagues are not available. A solo dentist can get in touch with their LDC, local peer review groups, or the BDA’s support resources to arrange appropriate peer review arrangements. The ICB should also be able to direct you to local structures for this.
Associate-specific questions
Q: What should associates be paid for unscheduled care including FTA slots?
A: There is no nationally mandated formula for how associates are paid for unscheduled care, beyond the requirement that the practice tracks and pays UDAs as they appear on Compass. Many practices are opting to pay the full £75 per appointment (converted to UDAs at the practice rate) to associates. The £15 FTA element is discretionary. Associates should make sure their agreement is updated to reflect the new arrangements and that it includes clarity on unscheduled care payments.
Q: How can an associate track how many unscheduled care appointments they have done?
A: Associates have access to their own individual Compass schedules, which will show unscheduled care UDAs as a separate line item. Associates should check Compass regularly to verify their activity is being recorded correctly.
Q: My associate agreement doesn’t mention unscheduled care, what should I do?
A: The BDA has updated its model associate agreement template to include provisions for the new contract changes, including unscheduled care. You can download this from the BDA website. The BDA also offers a free contract checking service for members. They will compare your agreement against the current template and flag any gaps.
Q: Will it be more expensive for practice owners to pay associates, since UDAs are no longer being converted against the practice’s actual contract value in the same way as before?
A: This is a concern raised by some practice owners. The key issue is that the conversion of pound values (£60, £75, £15) back to UDAs is done at your practice’s own UDA rate. If your UDA rate is high, fewer UDAs are attributed per appointment; if low, more are attributed. In theory the practice should receive broadly the same income per appointment as if it had been a banded course of treatment, but the specific financial impact will vary by practice. You can model this against your own UDA rate to understand the effect.
Administrative, software and Compass questions
Q: I submitted an unscheduled care claim in early April and it was rejected with a code 252 error. What should I do?
A: Software was not fully configured for the new codes at the start of April, and some claims submitted in the first weeks may have encountered errors. Check with your software provider (e.g. SOE) that your system is correctly configured for unscheduled care claims. If the rejection appears to be a system error, resubmit once the configuration is confirmed. Contact the BSA helpline if the problem persists.
Q: How do I add a dental nurse to Compass?
A: Contact your practice’s Compass administrator or NHS Business Services Authority (BSA) directly to register a dental nurse on Compass as a performer. The nurse will need to be GDC-registered and have appropriate qualifications for any NHS activity they are performing (e.g. fluoride varnish application).
Q: Can we still use the assessment and advice code (1.2 UDAs) alongside the new codes?
A: The assessment and advice course of treatment (Band 1 equivalent at 1.2 UDAs) continues to exist. If you carry out an examination, provide advice, but no further treatment is required, this code remains applicable. It is separate from the unscheduled care pathways.
Q: How are lab fees affected by the new contract changes?
A: The new contract changes do not specifically alter how lab fees are handled. Lab work associated with a band of treatment (e.g. Band 3 crown) continues to be claimed under the existing arrangements. If your software has a specific field for lab fees, this relates to the existing band-based claiming process rather than the new pathways.
Broader context and future direction
Q: Will the 8.2% unscheduled care target increase in future?
A: It is possible. If the government’s target of 700,000 urgent appointments is not met, there is an expectation that the mandated percentage may be increased. The first year will provide data on what level of unscheduled care the profession can realistically deliver, and this will inform future adjustments.
Q: How will these changes increase access if funding is effectively being spread more thinly across more services?
A: This is a widely shared concern. The new arrangements are partly a political response to the significant number of patients unable to access NHS dental care. Whether they materially increase overall access, or simply redistribute existing resources, will be seen through the data collected in the first year. The BDA continues to make the case for increased overall dental funding as the only sustainable long-term solution.
Q: Is a fundamental new contract still planned?
A: Yes. The current Government has made a parliamentary commitment to introduce a new NHS dental contract within the life of this parliament. Negotiations between the BDA’s General Dental Practice Committee and NHS England are actively ongoing. However, the final shape of any new contract is subject to the funding available and there is currently no indication of a significant increase in the dental budget from the Treasury.
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For further guidance:
British Dental Association (BDA): www.bda.org — member support, updated associate agreement templates, and free contract checking service.
NHS Business Services Authority (BSA): www.nhsbsa.nhs.uk — for Compass queries, claims submissions, and BSA guidance.
NHS England Dental: www.england.nhs.uk/primary-care/dentistry — for clinical guidance on the new pathways (expected imminently).
Local Dental Committee (LDC): Contact your LDC for local ICB arrangements and area-specific guidance.
Disclaimer: This FAQ document has been prepared based on the webinar discussion held on 7 April 2026. Some areas of the contract remain subject to further guidance and legislation. This document does not constitute legal or financial advice. Contract holders and associates are advised to seek specific advice from the BDA, their LDC, ICB or professional advisers in relation to their individual circumstances.