NHS dental incentives reshape London activity yet gains stall
Across London, NHS dental surgeries are working under a retooled contract that has pushed national activity back above pre-pandemic levels, with 35 million courses of treatment and 73 million Units of Dental Activity delivered in England in 2024/25, but earlier regional figures still place the capital among the weakest-performing areas for access, especially for adults and children entitled to free care.
The latest NHS Business Services Authority statistics for 1 April 2024 to 31 March 2025 show a 4% year-on-year rise in courses of treatment to 35 million and a small increase in UDAs to 73 million, with 23 million adult and 12 million child courses recorded and Band 1 work accounting for the largest share of activity, signalling that the system is delivering more check-ups and simple interventions even as more complex work remains constrained.
By contrast, earlier regional data for 2022/23 show that London was already behind most of England on coverage, with 37.4% of adults and 47% of children seen by an NHS dentist over the standard monitoring windows, compared with higher percentages in northern regions; those gaps sit behind recent reports of Londoners travelling long distances, moving to private care or not attending at all, even while the aggregate national UDA totals appear stable.
The recovery plan launched in February 2024 layered new incentives on top of that baseline: from 1 March 2024 to 31 March 2025 a “new patient premium” offered payments of £15 or £50 for each patient who had not seen an NHS dentist in the previous two years, while from 1 April 2024 the minimum UDA rate was lifted from £23 to £28 and a “golden hello” of £20,000 per dentist was made available for up to 240 posts in hard-to-staff areas, levers that London commissioners have used alongside local schemes to try to draw in extra capacity.
Evaluation data released in late 2024 suggest the impact of those levers has been mixed: official analysis of the recovery plan indicates that the new patient premium was expected to account for around 1.13 million of more than 1.5 million additional courses of treatment, but monitoring up to September 2024 showed fewer new patients than hoped, and a subsequent parliamentary report in April 2025 concluded that changes to UDA values and premiums had not yet delivered a clear improvement in access.
Set against that backdrop, the latest activity totals look less like a full recovery and more like a partial reset: England now delivers 35 million courses of treatment and 73 million UDAs a year, supported by higher minimum UDA rates and targeted incentives, yet London still starts from lower coverage and high need, leaving its integrated care boards relying on national dentistry recovery levers that have boosted throughput without, so far, closing the capital’s access gap.
