1. Introduction
1.1 NHS Sussex shared a report on Dentistry with the Brighton and Hove Health Overview Scrutiny Committee (HOSC) on 31 January 2024 NHS Sussex Report on Dentistry Jan 2024.pdf The report set out the position of the delegated commissioning responsibility for Dentistry, provided an overview of how dental services are delivered, and described how the NHS Sussex Dental Commissioning and Transformation programme is being delivered across Sussex and supporting the development of NHS dental services across Sussex.
1.2 This report to the February 2026 HOSC meeting provides an overview of developments nationally and across Brighton and Hove since January 2024 to support people to access NHS dentistry. The report is divided into the following sections:
· Section 2: The National Dental Rescue Plan.
· Section 3: How are dental providers delivering contracted activity across Brighton & Hove?
· Section 4: How have NHS dental contract hand backs and terminations affected Brighton and Hove?
· Section 5: What actions has NHS Sussex taken to enhance dental access in Brighton and Hove?
· Section 6: Continuous improvement priorities
· Section 7: Conclusion
1.3 To recap, enhancing access to dental services is a national and local priority. The NHS Planning and Operating Guidance 2024/25 included a national objective to increase dental activity by implementing the national plan to recover and reform NHS dentistry, improving units of dental activity (UDA) towards pre-pandemic levels. The NHS Planning and Operational Guidance 2025/26 includes a national priority to improve access to urgent dental care, providing 700,000 additional urgent dental appointments. Across Sussex this equates to approximately 26,500 appointments.
1.4 The Medium Term Planning Framework NHS England » Medium Term Planning Framework – delivering change together 2026/27 to 2028/29 was published in October 2025. It was intended to “end the short-termism that has held the local NHS back”, provide local leadership teams and boards with “the opportunity to break the cycle of ‘just about managing’ by creating the environment and headroom to fix the fundamental problems faced” and to improve care in the immediate term.
1.5 The framework described the requirements for ICBs to:
· Deliver their contribution to the government’s commitment to deliver an additional 700,000 urgent dental appointments in England against the July 2023 to June 2024 baseline period.
· Successfully implement dental reforms to ensure the additional manifesto target is incorporated into contractual activity.
· Implement locally driven quality improvement approaches for dentistry, ensuring clinical leadership and communities of practice are in place to support improved access and the introduction of new pathways for high needs and complex patients.
1.6 Dental contracting was explained in the January 2024 report but to recap, NHS services are open to anyone from any area and people can NHS receive care in any practice able to offer them an appointment. A practice is only responsible for a patient’s care whilst they are receiving treatment. Many practices will maintain a list of regular patients and only take on new NHS patients where they have capacity to do so, such as when patients do not return for check-ups when recalled or they advise the practice that they are moving from the area. People without a regular dentist, may have to join a waiting list, look for a different dentist who is taking on new NHS patients, or choose to be seen privately.
1.7 NHS dental contracts require dentists to complete a set number of Units of Dental Activity (UDA). UDA do not relate to the number of patients. The various treatments people receive from dentists attract different charges based on bands and are also assessed as representing a different number of UDA.
1.8 This report sets out the actions we have taken over the last two years to enhance routine and urgent care dental access for people across Brighton and Hove. It also outlines our plans to deliver the requirements of the Planning and Operational Guidance for 2025/26 and the Medium Term Planning Framework.
2. The National Dental Rescue Plan
· Reform the dental contract, to rebuild NHS dentistry and make sure everyone who needs a dentist can get one.
· Roll out supervised toothbrushing for 3 to 5-year-olds, to prevent children forced to hospital to have their rotting teeth pulled out.
· Flood ‘dental deserts’ with new dentistry graduates, with ‘golden hellos’ of £20,000 for those who spend at least three years working in underserved areas.
Detail about each area is included below.
Reform the national dental contract
2.2 In July 2025 the Department of Health and Social Care consulted on quality and payment reforms to the national dental contract. These changes represented the first step in the government’s commitment to fundamentally reform the dental contract and focused on addressing a number of issues raised by patients, the dental profession and those representing these groups. The package of reforms they consulted on over the summer were designed to:
· secure delivery of the government’s commitment to provide additional access to urgent dental appointments and ensure a safety net is in place to allow any patient with an unscheduled care need to get rapid support on the NHS
· introduce new clinical and payment pathways to improve care for patients with unmanaged progressive disease (complex care needs)
· incentivise more evidence-based interventions including through greater use of dental professional skill mix
· improve the quality of care which is delivered through better supporting learning and development activities
· help dental professionals to feel part of the NHS.
2.3 The proposed changes are intended to deliver benefits for both patients and the profession and represent a move away from some of the features of the current unit of dental activity (UDA) payment model, which dental teams have told us is a barrier to delivering NHS care.
2.4 On 16 December 2025, NHS England published their response to the consultation. The overall responses to the consultation were positive and the government will be proceeding with implementing the changes with a few amendments. NHSE advise that contract reform will address the challenges that dentists are experiencing and that impact patient access to dental care.
2.5 The reform package focuses on improving patient access, particularly for urgent and complex cases, while addressing workforce pressures and modernising payment structures.
2.6 The objectives are to:
· Improve access to urgent and emergency dental care, with new requirements for practices to offer more same day or rapid response appointments.
· Prioritise patients with the most complex needs, including those with advanced gum disease or significant decay, through new incentives for longer term and preventive treatment plans.
· Reduce oral health inequalities, supported by public health measures such as supervised toothbrushing for young children and expanded water fluoridation schemes.
· Modernise quality and payment mechanisms, adapting elements of the current UDA system to better reflect clinical complexity and quality of care rather than volume alone.
· Support workforce sustainability, with reforms linked to broader NHS workforce planning and improved flexibility in service delivery models.
2.7 The key changes are detailed below.
· Revised payment structure: The government will implement the full package of quality and payment reforms consulted on in 2025, with adjustments based on feedback.
· Enhanced incentives for complex care: Practices will be financially supported to deliver multi visit, high complexity treatments.
· Urgent care access requirements: Practices will be expected to ring fence capacity for urgent appointments, improving responsiveness for patients unable to access routine care.
· Prevention focused initiatives: National programmes for supervised brushing and fluoridation aim to reduce long term disease burden and demand for emergency care.
2.8 Contract changes will be implemented from April 2026.
Roll out supervised toothbrushing for 3 to 5-year-olds
2.9 NHS Sussex has worked with the Public Health teams across Sussex to ensure the national supervised toothbrushing initiative for children aged 3–5 is available for children in areas of higher deprivation.
2.10 The programme, which is commissioned by Public Health, is being delivered through early years settings (nurseries, preschools, reception classes) by Sussex Community NHS Foundation Trust’s (SCFT) Oral Health Promotion Team.
2.11 The focus is on early years settings in more deprived areas, where tooth decay rates are highest. Children brush once daily in a group setting, supervised by trained staff. The programme supplements home brushing and aims to reduce inequalities in oral health.
Deliver an extra 700,000 urgent and emergency dental appointments a year
2.12 NHS Sussex ICB’s share of the 700,000 appointments is 26,546. We are delivering additional urgent dental appointments using the Sussex Urgent Dental Care programme (UDC) and the national Urgent Dental Care Incentive (UDCi) Programme. More detail about these programmes is provided in Section 5 of this report.
“Golden Hello”
2.13 The Dental “Golden Hello” Programme (Dental Recruitment Incentive Scheme) is designed to tackle workforce shortages in NHS dentistry by offering financial incentives or “golden hellos” to dentists who take up posts in hard to recruit areas.
2.14 The purpose is to boost recruitment in areas with persistent workforce shortages, and the scheme provides a financial incentive to encourage dentists to take up roles in these locations. Specific detail about the programme in Brighton & Hove is included in section 5.
3. How are dental providers delivering contracted activity across Brighton & Hove?
3.1 There are currently forty-three NHS Mandatory Dental Service (MDS) contracts across Brighton and Hove (January 2026). These providers are contracted to deliver a total of 415,491 UDAs (2025/26). Whilst the number of contracts has decreased by one since January 2024 there has been an increase in contracted activity of 19,508 UDA in the city. The reduction in the number of contracts is made up of two contract terminations and one new provider in Hove as detailed in section 4.
3.2 Dental access is reduced when NHS dental providers under-perform against their contracted activity. Sussex dental performance data showed a steady decline in delivery of UDA after the Covid-19 pandemic, decreasing from 94% in 2018/19 to 65% in 2021/22. This trend was mirrored at a regional and national level. There was a significant improvement in 2024/25 with 83.8% of UDA being delivered across Brighton and Hove (83.4% in Sussex against a target of 80%).
3.3 Our latest dental performance data for 2025/26 indicates improvements across Sussex with both Sussex and Brighton & Hove providers delivering above target levels. At of 30 September 2025 our target delivery was 911,054 UDA (39%). Providers in Sussex delivered 1,030,133 UDA (44%). Across Brighton and Hove providers delivered 191,501 UDA which equates to 46% of their contracted activity. This is positive and shows that it is likely that most providers will be able to deliver against their contracted activity levels in 2025/26.
4. How have NHS dental contract hand backs and terminations affected and Hove?
4.1 Since the last report to HOSC in January 2024 there has been two contract terminations, but no contract hand backs in Brighton and Hove. There has also been one new contract mobilised (Sep 2024).
4.2 The terminations are due to a low level of service delivery from the providers in 2024/25 and no delivery in 2025/26. This activity will be recommissioned as detailed in section 5.
4.3 NHS Sussex commissioned a new dental practice to improve access and support people to see an NHS dentist. Damira Dental Studio Ltd in Eaton Road, Hove opened in September 2024 and is contracted to deliver 21,000 UDA per year (the equivalent of 3 full time dentists).
5. What actions has NHS Sussex taken to enhance dental access in Brighton and Hove?
5.1 As highlighted in the report to HOSC in January 2024, NHS Sussex was one of the first ICBs to take on the responsibility for commissioning primary, secondary and community dental services. We developed our Sussex Dental Recovery and Transformation Plan, and this has helped us to plan our commissioning of dental services and enhance access to services as detailed below.
5.2 Overperformance
In June 2025 all dental providers were invited to confirm whether they had capacity to ‘overperform’ by up to 10% of contract value in 2025/26 as per national guidance. The ICB offered this opportunity to providers again in December 2025. In Brighton and Hove nineteen dental contracts applied. All these applications were approved to ‘overperform’ by up to 10%. This represents delivery of up to 20,937 additional UDA in the area. This is the equivalent of around 3 full time dentists.
5.3 Procurement
A commissioning plan has recently been approved which will mean NHS Sussex will commission an additional 101,000 UDA across Sussex, with 10,000 UDA being procured across the Brighton and Hove area. The plan is to procure this activity through “rapid” commissioning and is detailed in Table 1 below. “Rapid” commissioning allows ICBs to offer additional permanent activity to current providers in the area. This support local providers to increase their contracts and means that activity can be mobilised very quickly.
NHS Sussex has written to local providers asking for expressions of interest to increase their contracts. This activity should mobilise and be available from May 2026.
Once this activity is commissioned, UDA per head of population (php) in the Brighton and Hove area would increase to 1.44 UDA php, which is above the aspiration level of 1.42 UDA php.
Table 1 – NHS Sussex Procurement plan January 2026
5.4 Temporary contract variations
NHS Sussex wrote to all “high street” dentists in December asking if any providers have capacity to deliver additional activity temporarily in 2025/26. This would be via a temporary contract variation increasing their contract in year by up to 25%.
Applications were received from eleven dental practices in Brighton and Hove. Due to high demand NHS Sussex agreed to fund all applications allowing contract variations of up to 20%. This will mean an extra 20,567 UDA can be delivered in Brighton and Hove during February and March.
This additional activity is open to all categories of patients, and we have told providers that we hope new and urgent patients are prioritised where possible.
5.5 Sussex Urgent Dental Care Programme
NHS Sussex has expanded its Urgent Dental Care (UDC) Programme. This follows a successful 12-week pilot in 2024/25. The programme is designed to improve access to urgent dental services for people without a regular dentist and to stabilisation treatment for vulnerable patient groups. Patients in need of urgent dental care can access the service by calling the Sussex Dental Helpline on 0300 123 1663 or emailing kcht.dentalhelpdesk@nhs.net The Helpline team have the latest information on the availability of appointments and can book patients into appointment slots directly.
There are currently 5 providers in Brighton and Hove offering around 200 additional urgent appointments per week via this programme. Across Sussex there are 24 providers offering around 500 additional appointments per week.
Some examples of our comms materials are shared below. These have been shared with stakeholders including Healthwatch, GP practices, pharmacies, and opticians. Infographics have also been used in social media marketing including Facebook and the Nextdoor app. These materials have a QR code that takes people to the Sussex Health and Care website which lists providers taking part in the Sussex Urgent Dental care programme and also those taking part in the national Urgent Dental Care Incentive programme. We have also held regular webinars with our providers and supported them to reach out to their local communities to publicise these appointments.
Business Card
Infographic/ poster
Information about providers is available on the Sussex Health and Care website Urgent dental care
5.6 National Urgent Dental Care Incentive (UDCi) Scheme
The Urgent Dental Care Incentive Scheme is an NHS England programme designed to increase the availability of urgent dental appointments. It commenced on 25 Sep 2025 and runs to 31 Mar 2026. The scheme rewards dental practices that deliver more urgent care than their baseline activity.
Key information about the scheme is detailed below.
· Practices are encouraged to deliver 25% more urgent care courses of treatment than their baseline.
· Practices are paid £50 per additional urgent course of treatment for achieving 125% of their baseline.
· Practices not achieving 25% but achieving over 117.5 % are funded £25 per course of treatment.
· There is no incentive payment for activity below 117.5%.
· The baseline is based on extrapolated urgent care activity from Apr to Jul 2025.
Across Sussex 50% of providers have signed up to this scheme.
5.7 “Golden Hello” (Dental Recruitment Incentive Scheme)
In 2024/25 NHS Sussex offered 17 “golden hellos” to dentists across Sussex. Two of these were for dentists in Brighton and Hove. Unfortunately, the practices did not manage to recruit new dentists. The ICB has offered a further nine “golden hellos” in 2025/26, four of these are for dentists in the Brighton and Hove area. We are working with our workforce team and dental providers to support them with their recruitment plans.
5.8 Paediatric Access and Prevention programme
NHS Sussex recently launched a Paediatric Access and Prevention programme aimed at 0 to 3-year-olds delivered by dental sites across Sussex. This pilot programme builds on the success of the Dental Check by One initiative and aims to welcome new 0 to 3-year-olds at each site.
The pilot aims to increase access to NHS dental appointments for 0-3 year olds and provide enhanced prevention advice to families in need of it by implementing the following:
· Participating dental practices indicate that they are available to see 0-3 years olds
· The dental practices are provided with a baby toothbrush, fluoride toothpaste (50ml) & Twist & Seal cup by the ICB, to distribute to the new families and 0–3-year-olds, which act as an incentive
· All new 0-3s have a first appointment with a dentist who delivers universal prevention advice and advises on the infant’s caries risk
· Based on the caries risk assessment the infant is allocated a dental recall between three and six months
· The dental practice will choose a dental therapist, nurse or hygienist within their practice to become their Oral Health Champion (OHC).
· The OHC is trained by Sussex Community NHS Foundation Trust (SCFT) to deliver enhanced oral health prevention and behaviour change training.
· The OHC will deliver oral health training and intervention to families indicated as having a need at their first appointment.
· Outside of clinical intervention, the Oral Health Champion’s time is also funded to undertake outreach services to develop pathway referral links with local GPs, Family Hubs, early years settings, health visitors and PCN leads for 0-3s who do not have an NHS dentist and who are at risk of caries.
So far, we have successfully onboarded 16 providers across Sussex with Newick Dental in the Moulsecoomb and Bevendean Ward delivering the service in Brighton.
In addition, NHS Sussex has commissioned SCFT to train all health visitors in Sussex to ensure consistent and accurate messaging regarding oral health prevention for families across the county. We have organised three online training sessions, with booking links circulated through our local authority partners. These training sessions are scheduled to take place from December to February. All health visitors trained will be given the list of participating practices they can refer families to, ensuring that babies get their first dental check as soon as possible.
6. Continuous improvement priorities
We continue to take actions, as detailed below, to support continuous improvement:
· Review contracted dental activity, performance and population health management data regularly to inform commissioning decisions to help address variation and health inequalities. This review has enabled us to identify commissioning needs across Sussex and specifically in the Brighton and Hove area.
· Support practices by using the South East resilience framework to assess applications from dental practices experiencing challenges due to exceptional circumstances. This has included supporting providers in Brighton and Hove to ensure they can continue to provide NHS services.
· We have implemented a dental clinical leadership initiative to lead and support projects in our local programme.
· We are working in collaboration with the other South East ICBs to ensure dental checks are available for children and young people in special education settings. We hope this new service will be available during 2026.
7. Conclusion
7.1 This report details some of the actions NHS Sussex has taken over the last two years to enhance routine and urgent dental access for people across Brighton and Hove. It also outlines our plans to deliver additional urgent appointments required as part of the NHS Planning and Operating Guidance 2025/26.
7.2 It sets out how we have improved patient access to NHS dentistry, and our actions to improve oral health. The actions we have taken include initiatives to enhance access to routine and urgent dental care via the rapid commissioning of temporary and permanent UDA, the expansion of the UDC programme and launching a paediatric access and prevention service to support children age 0-3 to access dental care. We are also supporting providers to recruit new dentists who will offer NHS activity. Additionally approved “overperformance” will deliver up to 20,937 additional UDA in Brighton and Hove. All of these initiatives support patients in Brighton and Hove to access NHS dentistry.
7.3 This paper reinforces that enhancing access to routine and urgent NHS dental care remains a key priority for NHS Sussex.