Urgent Dental Care Incentive Scheme: A Short-Sighted Headline?

The Labour government has driven NHS England to launch a new Urgent Dental Care Incentive Scheme, running until March 2026. The scheme provides a short term additional budget to incentivise dental practices to provide 25% extra “urgent courses of treatment”.

On paper, it looks straightforward: more budget to provide more emergency appointments. In reality, the implications for dental practices and patients are more complex.

How the payments work

If dental practices meet or exceed a target of an extra 25% of activity categorised as “urgent treatment” by the end of March 2026, they receive £50 extra funding for each extra urgent course of treatment. For dental practices unable to meet the target, hitting in the range of ~19%-24% extra will earn £25 extra funding per urgent course of treatment. A total below ~19% and any extra delivery beyond the 25% will receive no extra funding.

The additional funding is not however related to the number of emergency appointments that dentists book. Instead the funding is tied to how treatment provided in any type of appointment is reported to the NHS by dental practices in order to receive their funding.

The level of funding provided by the NHS to practices for dental treatment is determined by arbitrary categorisation of the treatment. One of the arbitrary categories is called “urgent treatment” and its only this category which is of importance for the scheme.

The difference between the two scenarios might due to the complexity of the problem or just luck that the next patient had cancelled leaving a long enough appointment on the day. Dentists usually try to be the most efficient they can for each patient with the time available.

Only the first scenario where the patient received a temporary fix would count towards the scheme’s target even though both patients had been provided with an emergency appointment and suitable treatment.

Who gets the payment?

The extra £50 or £25 funding is paid to the dental practice, not directly to your dentist. Each dental practice then will decide how the funding is shared to cover the dentists’ time and practice running costs (including paying the nurses and receptionists).

Emergency appointments, especially with new patients, typically take much longer than a routine checkup, and this extra funding will help cover the cost of providing these extra urgent courses of treatment rather than just being a bonus payment directly to dentists.

Where does the extra capacity come from?

With only short term funding, dentists will be unable to invest in new dental practices, new surgeries within existing practices, or extra permanent staffing. With no investment into extra capacity to deliver this extra work, diverting capacity to extra emergency treatment must either come at the cost of less routine care, or through overtime from an already tired workforce.

• Routine check-ups pushed back to make way for more emergency appointments
• More reliance on short, palliative treatments to move patients through quickly and hit targets
• Repeat attendances from the same patient when temporary care fails
• Increased pressure on staff to work overtime to hit targets, and spend more time triaging more emergencies and booking follow-up appointments

This may help NHS England report more urgent courses of treatment delivered for MPs to use as throw-away headline-grabbing statistics, but it doesn’t mean more patients will have their dental problems properly resolved.

What happens if dental practices miss the target?

Here lies the real gamble. Dental practices that participate in the scheme and shift their patterns towards urgent work could fall short of the target and pay a price. They may:

• Deliver less routine treatment and so loose normal funding
• Take on extra administrative burden from monitoring claims
• Face patient dissatisfaction with fragmented care
• Potentially end up with no extra funding the cost of these changes if the target is missed

In other words, it is possible to reorganise the appointment book, change treatment patterns, and lose funding.

Likely impact on dental practice behaviour

Because only treatment categorised as “urgent treatment” count towards the target in this scheme, dental practices will naturally adapt how they provide treatment:

• Preference for temporary fixes – The scheme incentivises a short term fix like a quick temporary filling or prescription rather than definitive treatment like extraction or permanent filling.
• Appointment book reshaping – There will be fewer appointments for routine check-ups and routine treatment in favour of more urgent appointments to hit targets.

Consequences for patients

For patients in pain, the scheme should improve access – more emergency appointments will be available, and more people will get at least temporary relief quickly. But there are trade-offs:

• Short term treatment – Patients may get temporary relief but then experience multiple episodes of pain and/or infection due to the temporary nature of emergency treatment.
• Fragmented care – Patients may have to attend multiple visits to the dentist for permanent treatment that could have been completed in a single visit, or get stuck in a cycle of emergency treatment unable to receive definitive care.
• More charges – Postponing permanent treatment to hit “urgent treatment” targets may mean extra patient charges for the extra episodes of emergency treatment.
• Waiting list for long-term care – With more patients to treat but no investment into extra capacity, improved access to emergency treatment will come at the cost of less access to routine care.

The bigger picture for NHS dentistry

The scheme is designed to address public concern about lack of access to NHS dentistry, and in the short term it will help more patients in pain get emergency appointments. But the long-term impact may be less positive:

• Higher waiting times for routine and preventive care
• Higher cost to public funds for kicking the can for permanent care
• Higher cost to patients more for fragmented care
• Higher financial risk to dental practices if they don’t hit targets
• No increase in capacity for any real long term change

As ever, well-intentioned tweaks to the NHS dental contract can create as many challenges as they solve. The incentive may prove a sticking plaster for the access crisis, but without a broader strategy for prevention, continuity, and sustainable funding, it risks leaving patients and practices in a cycle of short-term fixes.

The scheme doesn’t formally redefine NHS dentistry, but perhaps reinforces a shift already underway – from the NHS providing ongoing preventive and restorative care towards being a crisis-management service.