The Welsh government announced that Wales will replace its 20-year dental contract system with a reward system based on patients’ oral health needs next April.
The reform will end the long-standing “Dental Activity Unit” model, under which dentists were paid for seeing patients every six months, regardless of whether treatment was needed.
Under the new contract, practices will continue to see existing patients, while dentists will be given greater freedom to monitor and assess oral health based on individual risks and needs. Prevention and wellness needs are at the core of the system.
The government also plans to increase the hourly rate paid by the National Health Service (NHS) to dentists to ￡150 from the initially proposed ￡135.
The NHS treatment fee will require patients to pay 50% of the cost of their treatment, regardless of the amount of treatment required, capped at ￡384—down from the previously proposed 55%.
Officials say this cap will help keep NHS dental care affordable and protect patients from unexpected bills.
The British Dental Association (BDA) and practicing dentists welcomed some of the changes but warned that significant issues remain.
Russell Gidney, chairman of the Welsh General Dental Practices Committee, said the plan contained important progress but also “simply papered over some of the biggest gaps.”
He warned that the bill would be difficult to amend once it reaches Parliament and expressed particular concern about the proposal to remove low-need patients from clinic lists and place them on a central database.
Under the plan, patients would be assigned to clinics on a first-come, first-served basis. Dentists say this could undermine continuity of care, prevent families from receiving treatment at the same clinic, and effectively end the traditional family dentistry model.
Gidney and others also warned that despite increases and some progress, such as guaranteed payments for NHS salaried dentists and the removal of certain parental leave restrictions, the proposed clinic payments still fail to reflect the actual costs of care.
They say this shortfall could push NHS practices into losses or lead some to withdraw from the NHS.
The Welsh government said the reforms aim to create a fairer, prevention-focused system and improve access to NHS dental services across the country. The bill will be submitted to the Welsh Parliament for consideration and possible amendment.