Every practice rated implementation of the new Welsh NHS dental contract as poor or very poor in a survey covering 15-20% of contract holders, raising serious concerns about the future of NHS dentistry in Wales
The new contract came into force on 1 April, though practices reported that they had not received final details of the changes until just days before implementation.
One anonymous practice manager at a mixed practice in north Wales said: ‘I’m still getting my head round everything this morning and the changes have already happened.’
The British Dental Association (BDA) said ‘poor communication’ meant that the new contract had come into force ‘utterly untested’.
One month on, polling by Welsh dental advisory firm ProPractices has revealed the extent of the implementation problems. In addition to 100% of the practices rating current implementation as poor or very poor, 83% said they were at risk of reducing their NHS commitment without further support.
Half of the practices also said they did not feel the contract was financially sustainable in its current form, with 57% reporting decreased profitability at go-live. All of those surveyed identified the financial model as the most urgent priority for improvement.
‘Wales will have built something the rest of the UK will look to as a model’
Despite these financial concerns, ProPractices CEO Hywel Loveluck, stressed that the problem was not with the contract itself but with how it was introduced.
He said: ‘Wales deserves real credit for having the courage to reform a system that everyone – patients, clinicians, and commissioners alike – knew was no longer fit for purpose. This is genuinely ambitious, progressive policy.
‘Our survey is not a verdict on the reform itself, but a signal that practices need more support to navigate the transition successfully. Get that right, and Wales will have built something the rest of the UK will look to as a model.’
What went wrong with contract implementation?
Louise Anderson, a Welsh-based regional support manager at Practice Plan, said: ‘These stats are consistent with what I am seeing and hearing. Many practices have contacted me for options to reduce contract value or are looking for information as a starting point to see if a move away from the NHS is viable.
‘Practices are feeling disrespected by the way the new contract was introduced and the lack of information with many scrambling on WhatsApp groups for information regarding care packages and what they can and can’t include.
‘Patients too are also feeling bewildered as to the NHS charges which are significantly higher than they have paid previously. Also, due to lack of official guidance, front of house teams are struggling to give accurate cost information.
‘The new contract obliges a practice to give six months’ notice to terminate. So, in the interim, I am helping practices to inform their patients what the changes to the contract mean.’
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