What’s wrong with UDAs?

Michael Watson doesn’t believe a new contract will help NHS dentistry

NHS England needs to tell dentists exactly what it wants for its UDAs, Michael Watson believes.

What’s wrong with UDAs (units of dental activity)?

Don’t all shout at once, because this week I am looking at it from the point of view of the commissioner, NHS England, rather than the providers, dentists.


My train of thought started with a news story from a bakery in Yorkshire that had invested in machinery to deliver thousands of small cakes for a number of companies who would sell them on to the public under their own label.

Outsourcing, as it is known, is very common in the food industry, with ready-meals for example, not being made by the company whose name appears on the label.

Most of the time it works well, sometimes it doesn’t, for example when a manufacturer decided that substituting horse for beef in a lasagne was a good idea.

And you can bet that the manufacturer under whose brand name the product will be sold dictate the size, shape and recipe of the cake, whether it has icing on the top and so on.


Now of course dentistry is ‘outsourced’ by NHS England, under its branding, to dental practices, who provide the service.

But what do they commission? UDAs that’s what.

And what is a UDA? Beyond the simple point that it is a course of treatment and there are three different bands, the commissioners’ hands are tied.

They cannot dictate which patients are seen or what treatment is carried out or the length of time between courses of treatment.

When a couple of weeks ago the crisis over children’s extractions erupted and it was revealed that those most in need of care were some of the least likely to have seen a dentist, NHS England should have been able to say: ‘We will make sure that dentists see these patients.’

All the Department of Health could say was that it was working a new contract that would reward prevention rather than treatment.

New contract

We have been told ad nauseam about this new contract, but realistically will it be any better for these children than the existing one? I for one doubt it.

When all is said and done UDAs represent money paid by the Government to dentists.

Unless NHS England can dictate which patients it is spent on and what treatments (or prevention) the UDAs can buy, then it has no say in what is provided.

And the same applies to capitation, which the Government appears confident will solve all the problems.

NHS England needs to take a lesson from the bakery I mentioned at the beginning.

It needs to tell dentists exactly what it is it wants for the money it pays out through UDAs.

Become a Dentistry Online member

Become a member
Add to calendar