The plan was launched in February 2024 with the aim that "everyone who needs to see a dentist will be able to". However, the office has said even if the target was achieved, it would still mean 2.6m fewer treatments compared to six years ago.
Access to NHS dentistry across England remains below pre-pandemic levels, with just 40 per cent of adults recorded seeing an NHS dentist between March 2022 and March 2024. This is compared to 49 per cent in the 24 months prior to the start of the Covid-19 pandemic. There are also 483 fewer dentists providing some NHS care compared to 2019 to 2020.
The report revealed that by August 2024, the Department for Health and Social Care (DHSC) and NHS England (NHSE) had spent £57m of the planned £200m budget, with only two of the four initiatives of the plan fully rolled out.
The report also confirmed that access to NHS dentists varies across the country, with some areas of England on average receiving twice as much care as others. Courses of treatment per 1000 people ranged from 382 in Somerset, to 800 in South Yorkshire in 2023 to 2024.
The office recognised that the general election might have impacted progress in some areas.
The NAO also outlined the challenges the government is facing if it wants to increase access to NHS dentistry. These include:
- The dental contract: The NAO said that the contract is widely perceived as needing reform, with many in the sector viewing the contract as a disincentive to perform NHS care when practices can offer private care too.
- A fall in the number of dentists providing some NHS dental care: The report states the number of dentists providing NHS dentistry has decreased by 483 from 2019 to 2020 (two per cent). In April 2023, there were 34,520 dentists registered with the General Dental Council (GDC) in England. But the GDC’s survey suggested that 22 per cent of the dentists in England only provided private dental care.
- Overall spending: A reduction in overall spending in real terms, dropping from £3.7bn in 2019 to 2020 to £3.1bn in 2023 to 2024. This is a drop from £65.15 to £53.88 per person in England. From 2023 to 2024, there was an underspend of £392m against the total ringfenced NHS dental budget.
Units of Dental Activity
DHSC and NHSE have completed the roll-out of the increased patient premium and an uplift to the minimum amount the government pays dentists for treatments (known as Units of Dental Activity (UDA)) from £23 to £28. NHSE data has suggested an approximately 14 per cent increase in dental practices reporting that they are accepting new adult patients, when availability allows, between December 2023 and September 2024.
There has been a small increase in the number of UDAs delivered in the early months of 2024 to 2025. However, this aligns with DHSC’s expectations that, even without the plan, there would be a small increase in delivery. As NHSE and DHSC are reliant on Integrated Care Boards (ICBs) and dental practices to deliver the plan, there is significant uncertainty about its potential impact.
Government incentives
The ‘golden hello’ incentives of £20,000 (phased over three years) to recruit 240 dentists into specific areas of the country have not yet contributed to the 1.5m additional treatment target. While 274 practices have had their application approved to recruit a 'golden hello' post, the first dentist was not appointed until October 2024.
The mobile dental van initiative, aimed at delivering some dental services to targeted communities has also not been rolled out, as no vans have been procured. Any further progress on this initiative paused when the general election was called.
In November 2024, ministers stated that it would be left to ICBs to decide whether to procure vans from 2024 to 2025.
Shawn Charlwood, chair of the British Dental Association’s General Dental Practice Committee, said, “We warned at the outset that this recovery plan was unworthy of the title. Unfunded, unambitious policies failed to make a dent in a crisis hitting millions.
“A new government must show it is willing to learn from its predecessor’s mistakes.”
An NHSE spokesperson said, “The NHS is determined to improve access to dental care and that’s why we are incentivising dentists to work in underserved areas. But we know there is a lot more to do and we will be working with government to reform the dental contract to make our services better for patients.”
The Association of Dental Groups has said that the NAO report is not a thorough enough examination of the current crisis. Neil Carmichael, executive chair of the ADG, said, “The NAO report is disappointing. It shows a clear lack of understanding of the complexities of the issues that are responsible for the crisis in dentistry. The NAO report has focused on contract reform, rather than workforce planning. Unfortunately, this finds both the Conservative’s dental recovery plan and the report on it ‘pie in the sky’. If you don’t have the workforce to deliver dental treatments, any plan, is never going to work.
“The ADG believes an official public inquiry is the only way forward. The Public Accounts Committee need to have a look at the plan and also why the NAO report lacked meaningful consultation that would have shown how a recruitment and retention focus for the full spectrum of the dental workforce is the solution. The dental workforce includes other dental care professionals (DCPs), such as dental nurses and dental therapists who are critical to providing patient care. Remember DCPs are now trained to carry out 70 per cent of the treatments that dentists can.”
He concluded, “We talk to large and small dental practices up and down the country every day, and our insights from our members should be part of what informs this official inquiry. It is the only way we will get the full picture and a robust recovery plan. The ADG is here to support the new government to deliver on dentistry reform.”