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Dental Reform Programme

The Dental Reform Programme is sponsored by and hosted within the Welsh Government, there is a multistakeholder Dental Strategic Oversight Group (DSOG) that oversees the Dental Reform Programme. Public Health Wales provides dental public health advice and essential programme management support to the reform programme.

The overarching strategic objectives of the Dental Reform Programme are:

  1. Improve population health, oral health and wellbeing through a greater focus on prevention and addressing causes of inequalities
  2. Improve access, address inequities in access, experience and outcomes of dental care
  3. Enrich the wellbeing and engagement of the dental workforce and ensure workforce capacity and capability is reviewed regularly to meet the healthcare (including secondary prevention) needs of the population
  4. Increase the value achieved from funding of dental services and programmes
  5. Ensure quality, safety and improvement systems are in place for dentistry and oral health

These are covered in four workstreams:

Workstream 1: Finance, data and operations

Workstream 1 addresses the ongoing need for financial analysis, utilisation of data within dentistry and working collaboratively with Health Boards to resolve challenges within the contract management process.

Work of this group includes the following areas:

  • Analysis to understand the financial implications arising from reform
  • Options for future Patient Charge Revenue (PCR) model
  • Developing a data driven performance framework for dentistry, identifying all available data and undertaking benchmarking
  • Developing a standard contract management approach
  • Considering appropriate actions arising from oral health intelligence reports
  • NHS Business services authority (BSA) change requests
  • Providing a picture for how the overall dental system is performing
  • Assessing financial implications of increased access to dental care
Workstream 2: Communication and engagement

Workstream 2 develops and implements a communication strategy for dentistry; engaging with key stakeholders and undertaking a programme of work to inform dental reform.

Workstream 3: Clinical development

Workstream 3 leads on matters relating to clinical guidance, quality and delivery of NHS dentistry on behalf of the programme, providing a formal mechanism for clinical developments to be ‘approved’ before implementation.

Work of this group includes the following areas:

  • Clinical actions arising from data and other sources of information relevant for dental services
  • Changes to clinical guidance and implementation
  • Development Welsh Health Circulars
  • Principles of Care with regard to implementation barriers and facilitators
  • Skill mix within NHS dentistry
  • Issues arising from Strategic Advisory Forum (SAF) and Managed Clinical Networks (MCNs) and any clinical guidance developed by SAFs and MCNs
  • Consider how reform can embed digital and technological advances into service delivery
  • Alignment of specialist services across primary, community and hospital sectors
  • Procedures of Limited Clinical Evidence (PoLCE) and mandatory services/ any other guidance needed for clinical practice if there is no existing guidance on those areas from trusted organisations
  • Community Dental Services
  • Hospital Dental Services
  • Some of the work will be delivered through short-lived Task and Finish groups as necessary
Workstream 4: Workforce

Workstream 4 aims to inform and influence workforce policies, plans and implementation which impact the workforce of NHS dentistry. The workstream allows for consideration and appropriate action to be taken on issues and changes arising outside of the reform programme which will impact the dentistry workforce.

Work of this group includes the following areas:

  • Continuing  Professional Development (CPD) and training requirements arising from the reform programme, including prevention, skill mix and communication
  •  Induction via Mentorship Programme (IMP) and General Dental Council (GDC) changes
  • Quality improvement
  • Primary Care Academies
  •  Primary Care Workforce Intelligence System (PCWIS) data – analysis and interpretation
  • Anti-Racism Wales Action Plan

Why is dental system reform needed?

The Units of dental activity (UDA) contract, introduced in 2006, is failing to meet the needs of patients and the dental profession. The Welsh Government’s “A Healthier Wales” strategy advocates for a more needs-based, preventative, and high-quality dental system. Reforming the contract aims to improve population and oral health, increase access and equity, support workforce wellbeing, and ensure service quality and safety.

A new dental contract is planned for 2026, which will be part of a wider ambition to create a coordinated, sustainable and equitable dental care system. Success will be measured through ongoing monitoring, data analysis, and a focus on patient outcomes and service quality. Stakeholder collaboration is essential for addressing these challenges and leading improved patient care.

The Dental Reform Programme is developing, in partnership with the Welsh Government, within the context described in the following key strategic documents.