The government has unveiled its 10-Year Health Plan, detailing major reforms of the NHS – here’s every change that affects dentistry.
The 10-Year Health Plan lays out the government’s plans for the future of healthcare in the UK. The Department of Health and Social Care (DHSC) said it ‘delivers one of the most seismic shifts in care in the history of the health service’.
Prime minister Kier Starmer said: ‘The NHS should be there for everyone, whenever they need it. But we inherited a health system in crisis, addicted to a sticking plaster approach, and unable to face up to the challenges we face now, let alone in the future.
‘That ends now. Because it’s reform or die. Our 10-Year Health Plan will fundamentally rewire and future-proof our NHS so that it puts care on people’s doorsteps, harnesses game-changing tech and prevents illness in the first place.’
Among the changes detailed in the plan are several measures to ‘tackle the current lottery of access to dentists’. The report says: ‘By 2035, the NHS dental system will be transformed so it provides high quality care at the right time and nobody goes without because they cannot afford it. We will build a service which is attractive to and values dental care professionals.’
The full report can be found here.
What changes are there for dentistry?
Compulsory NHS tie-in for dental graduates
Under the plan, newly-qualified dentists will be required to practise in the NHS for a minimum period. Though not officially confirmed, the period is currently intended to be at least three years.
The report says this change is because training a dentist costs the taxpayer up to £200,000.
Incorporating dental professionals into a Neighbourhood Health Service
The government plans to launch a Neighbourhood Health Service, bringing multiple healthcare services including dentistry under one local team. This aims to shift care out of hospitals and into the community.
Within this model, dental therapists will undertake check-ups, treatments and referrals to dentists for anything beyond their scope. Dental nurses will provide oral health advice and work with local schools and community groups.
Sir James Mackey, chief executive of NHS England, said: ‘The Neighbourhood Health Service is a huge opportunity for us to transform how we deliver care over the next decade – starting right on people’s doorsteps.
‘By bringing together a full range of clinicians as one team, we can deliver care that’s more accessible, convenient and better for patients, as well as reducing pressures on hospitals.’
New health centres will be opened to house the neighbourhood health teams, open 12 hours per day, six days per week.
Health and social care Secretary Wes Streeting said: ‘By shifting from hospital to community, we will finally bring down devastating hospital waiting lists and stop patients going from pillar to post to get treated.
‘This government’s plan for change is creating an NHS truly fit for the future, keeping patients healthy and out of hospital, with care closer to home and in the home.’
Contract reform
The government said it would initially work with dentists to improve the dental contract in the short term. From the 2026-27 financial year, the contract will ‘better reflect the cost of treating patients with higher needs’ and reduce the amount of low-value activity performed by dentists.
This will be achieved through ‘changes to financial incentives and improved system oversight’. The DHSC hopes initial changes will ‘improve access to care and ensure dentists are rewarded fairly’.
The plan also proposes ‘even greater change’ in the long term through more fundamental contract reform. Work will begin this year to create a contract that ‘matches resources to need, improves access, promotes prevention and rewards dentists fairly, while enabling the whole dental team to work to the top of their capability’.
The report reads: ‘With a new dental contract at its heart, NHS dentistry will be more transparent for patients. It will provide more readily accessible, good quality care – including better prevention – to those most in need.’
Dental nursing scope expansion
A proposal within the plan would allow dental nurses to administer fluoride varnish to children in between check-ups.
This is in addition to the greater emphasis on dental nurses delivering oral health education within the Neighbourhood Health Service plans. This change would allow dental nurses to ‘lead individual and community oral health education efforts’.
Preventive action for children
In March, a national supervised toothbrushing scheme was announced to be rolled out from April 2025. Building on this focus on children’s oral health, the government will encourage greater use of fissure sealants to protect young people’s teeth.
Upskilling the dental workforce
Dental care professionals will be encouraged to work to the ‘top of their clinical potential’ beginning in 2026 and 2027. The government said it wants to make use of the wider team, particularly dental therapists.
Water fluoridation
The plan pledges to expand in the north east of England from 2028 to reach 1.6 million more people by April 2030. Existing fluoridation schemes in the north east, west midlands and east of England will also be refurbished to benefit a further six million people.
The government will assess additional rollout in areas where oral health outcomes are currently worst.
What does the profession think of the changes?
We heard from dental professionals from across the sector on several of the measures announced in the plan. Find out what they said here:
How has the dental industry reacted?
Eddie Crouch, chair of the British Dental Association
‘NHS dentistry couldn’t be better placed to deliver the shift from sickness to prevention, from hospital to community. But we can’t make this service fit for the future while a failed contract remains in place.
‘Ministers have made the right diagnosis here, but we can’t wait a decade for them to write the prescription.
‘[The tie-in] won’t stop a single experienced dentist walking away from the NHS in despair. The focus must be ensuring the next generation sees this service as a place they’d choose to build a career.’
Nigel Jones, strategy director at Practice Plan
Given the scale of the challenges across the whole of the NHS, it’s no surprise that dentistry warrants relatively little attention in the plan. Indeed, despite its prominence as an election issue, the lack of mention of dentistry in the prime minister’s foreword will be interpreted by many as symbolic of its priority.
References to expanding water fluoridation and supervised toothbrushing as well as fluoride varnish and fissure sealant use support the desire to move towards prevention but detail at this stage is very sadly lacking. Neighbourhood health centres sound good in theory but as I have observed over many years, finding a model that is financially sustainable and scalable is not easy even if a few passionate committed individuals have achieved localised success.
The key challenge facing NHS dentistry is workforce and the availability of clinical hours. Dentists off sick with burnout see fewer patients. Dentists going part time to avoid burnout see fewer patients. Dentists going private to avoid burnout see fewer patients. Dentists retiring early due to burnout see fewer patients. Such issues will not be solved by trapping new dentists into the NHS.
While an expansion in the use of therapists and nurses will help, I doubt it will come close to filling the clinical vacuum being created in large part by a discredited underfunded contract.
‘Another exercise in managing public perception’
We are told that the process of fundamental contract reform will begin this year and it is to be hoped that this latest attempt finds ways to navigate the obstacles that have derailed the many previous attempts to find something that works for patients, the profession and government. References to matching resources to need could simply be reinforcement of a desire to create capacity by avoiding ‘needless’ examinations or may be another hint that a core service is under consideration.
Making more effective use of the available resources makes eminent sense and I’ve seen a therapist led model work very effectively in both private and NHS practices. The challenge will be the speed at which sufficient numbers of therapists can be trained to make inroads to the access restrictions in NHS dentistry.
Although I can understand the concerns about the use of public money, using a tie-in to lock people into the NHS rather than addressing the reasons why it’s increasingly seen as such an unattractive option seems the wrong solution. Questions arise about the potential for NHS dentistry to be increasingly delivered by the least experienced clinicians and the risk of discouraging future applicants to dental schools.
While it’s hard to avoid the feeling this is another exercise in managing public perception of the government’s intent for NHS dentistry, I cling to the hope that detailed work is going on in the background from which will emerge a genuinely sustainable future for NHS dentistry. One that seeks to collaborate rather than collide with private dentistry, to reduce oral health inequality.
Kate Fabrikant, medical leader for northern Europe at Haleon
‘Today’s publication on the long-anticipated NHS 10-Year Health Plan represents a positive step towards shaping the future of our healthcare system. The clear emphasis on prevention is welcomed, as oral health continues to face a crisis point.
‘Our latest research has shown that three quarters of UK adults are not regularly visiting a dentist. This is having a serious impact on the nation’s oral health, with 64% of oral health professionals believing that it has worsened over the last year. Poor oral health hygiene practices at home can lead to more serious health conditions developing, putting further strain on healthcare services.
‘As a champion of everyday health, Haleon is committed to working with government, industry, oral health professionals and the public to improve the understanding of effective oral care routines – a vital step towards achieving better patient outcomes. We look forward to supporting the Government in translating the ambitions of the Plan into tangible improvements for oral health across the UK.’
Paul Schreier, CEO of Simplyhealth
‘The government’s 10-Year Health Plan for the NHS rightly prioritises shifting care away from hospitals and into communities. The move toward more preventative, patient-focused healthcare is necessary and we welcome the government’s specific commitment to tackle the longstanding challenges in patients’ access to dental care, and its recognition of the dental sector’s role in advancing neighbourhood teams particularly in underserved communities. These challenges are long-standing, and require bold, wide-ranging action from all parts of the system.
‘And with ill-health costing the UK economy £150 billion annually and over 2.8 million people economically inactive due to long-term conditions, the government must galvanise every part of the economy in its approach to a healthier nation.
‘Businesses have a vital but underused role to play in community-based care and the shift from sickness to prevention. Employers are central to people’s lives and uniquely positioned to support preventative health through simple, affordable, whole of workforce health support. This support prevents illness, eases pressure on frontline care and boosts productivity.
‘What’s more, there is much the public sector can learn from private innovation, particularly in relation to the expansion of the NHS App, where private companies are already harnessing digital advancements and tools like AI to improve and personalise health-related services.
‘Closer collaboration between businesses and healthcare services can further the objectives of the plan and create a more proactive, community-driven model of care that not only improves health outcomes, but also strengthens our economy to everyone’s benefit.’
Neil Carmichael, executive chair of the Association of Dental Groups
‘The ADG warmly welcomes the general direction of the NHS 10-Year Health Plan announced. On the whole the principles of bringing health care and treatments closer to patients’ homes is a positive one.
‘However, our members will be keen to know where dentistry will fit into these Neighbourhood Health Services. It is crucial to understand how we can work towards a joined-up system that includes dental services.
‘In due course, we expect to receive more detail about how the whole dental team, and by that I mean dentists, dental therapists, hygienists and nurses, can play their part in supporting patients locally.
‘And of course, key to enabling this will be a keen focus on shoring up the massive gap in the dental workforce which is missing over 3,000 dentists across NHS and private services currently. The impact of the 10 year plan for dentistry will be in the detail – and as ever, the ADG is here to engage and support progress.’
Becks Fisher, director of research and policy at Nuffield Trust
‘Our failure to get dentists working in the NHS is at the heart of why a comprehensive service has collapsed. The government is right to think about how to address that, and how to make use of a wider range of staff.
‘But a three-year work requirement for new dentists isn’t a full or simple solution. NHS rates are simply not competitive with the private sector in many areas. While this remains the case, it’s all very well to force dentists to do three years’ work for the health service, but they will still tend to simply drift away afterwards. What we need is a proper reform of a dental contract which successive governments have seen as unfit for purpose for more than 15 years.
‘Making more use of other staff like dental therapists is an excellent idea. But the recent NHS history with roles such as physician associates, which caused confusion and backlash, shows that this needs to be handled very carefully. There must be plenty of time for roll-out, a proper understanding from the start of the role and its limits, and regular monitoring.’
Follow Dentistry on Instagram to keep up with all the latest dental news and trends.
