Going private as a dental practice: converting from NHS in 2026
Converting an NHS dental practice to private is a contract decision, a patient decision and a marketing decision at the same time. This guide sets out the rules that apply in England in October 2026 and the order to do things in.
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Going private as a dental practice means ending or reducing your NHS contract and replacing that income with private fees, membership plans or both. In England you can end a General Dental Services contract by giving three months' written notice, or ask your integrated care board to reduce it. The contract part is quick. The harder parts are your patients, your team and whether enough private patients in your town will choose you.
This guide covers the options, the rules that apply, and a sensible order of work for an owner considering the move in 2026.
Your three options
| Option | How it works | Main risk |
|---|---|---|
| Full hand back | Give notice to end the NHS contract. Every patient becomes private or moves elsewhere | All NHS income stops on one date |
| Reduce the contract | Agree with your ICB a permanent reduction in UDAs and value, known as rebasing | Needs ICB agreement. The rest of the contract still has to be delivered |
| Stay mixed, shift the balance | Keep the contract and offer more private options within it, with patient consent | Deliver less than 96% of the contract in a year and money is recovered |
Many practices that "go private" do it in stages. A mixed model is allowed: under paragraph 10 of Schedule 3 to the GDS contract regulations, any part of an NHS course of treatment can be provided privately with the patient's consent, with exceptions for sedation, orthodontics and parts of the new complex care pathways. The same paragraph says you must not tell a patient that treatment they need is not available on the NHS, or mislead them about the quality of NHS care, to persuade them to go private.
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Ending an NHS contract: the notice rules
NHS England's Policy book for primary dental services sets out the process:
- A GDS contractor can end the contract by written notice at any time. It ends three months after the notice is served.
- If that date is not the last day of a month, the contract ends on the last day of that month.
- Failing to give three months' notice is a breach of contract. The commissioner can waive part of the notice in exceptional cases such as ill health, but that is its decision alone.
- PDS agreements are agreed locally, so the notice terms are whatever your agreement says.
Delivery in the final year is still reconciled. If you deliver less than 96% of the UDAs due for the period, the commissioner recovers the money for the shortfall.
Reducing the contract instead
A permanent change to the contract value and UDAs is a recurrent rebase. The policy book says commissioners should consider a contractor's request in line with the regulations, and any change is made by a variation signed by both sides. A reduction is not automatic, and your ICB will weigh local access to NHS care.
Since April 2026, contracts of 100 UDAs or more also carry a required number of urgent courses, set at 8.2% of relevant contract value, as NHS England's contractual guidance explains. A smaller contract means a smaller urgent requirement, but it does not remove it while you hold a contract of that size.
Is it better to go private or stay NHS?
There is no general answer. It depends on four things you can measure before you decide:
- What your NHS work earns. Divide your contract value by your contracted UDAs. Values vary a lot: Practice Radar's study of NHS contract values found contracts a mile apart paid a median £3.15 per UDA apart, and one pair in three £5 or more. A low-value contract makes private work look better.
- How many of your patients would stay. Your patient list split by age, exemption status and treatment history tells you who is most likely to move. Patients exempt from NHS charges, such as children and people on certain benefits, face the largest change in cost.
- Private demand in your town. How many people search for private dental care locally, and for which treatments.
- Competition for that demand. Who already holds the Google map places for private searches, and what it takes to beat them.
The last two are where conversions most often go wrong. An owner can model the NHS side to the penny and still have no idea whether the private patients exist.
What happens to NHS patients when a practice goes private?
Patients in England are not registered with an NHS dentist in the way they are registered with a GP. The NHS website tells patients that filling in a practice's registration form does not mean they will always get NHS care there, and that if they cannot find an NHS dentist they can contact their ICB.
When a contract is handed back, the policy book says the commissioner and practice should agree a joint letter to patients, including other NHS practices they can contact. Patients part-way through a course of treatment should be told that if they finish it elsewhere they will pay the relevant charge again, and the same applies to free repairs or replacements done by another practice. The commissioner also tells local stakeholders and updates the NHS website.
Will patients lose their NHS dentist if the practice goes private?
If you hand back your whole contract, yes, at that practice. They can stay as private patients or look for NHS care elsewhere. Saying so plainly in your letter is better than letting patients discover it at the desk.
Can a patient have a private and an NHS dentist at the same time?
Nothing in the NHS contract stops a patient seeing one practice privately and another on the NHS for a separate course of treatment. A mixed practice can also provide both to the same patient within one course, with consent.
Telling patients: what the law allows
A letter or email telling existing patients that the practice is changing, what it means for them and what their options are is an administrative message. The ICO's guidance says service messages are not direct marketing, but a message that also promotes something counts as marketing even if that is not its main purpose.
That matters if you want to invite patients to join a membership plan by email or text. Electronic marketing needs consent, or must meet all the conditions of the soft opt-in, including that you collected the details during a sale and offered an opt-out then and in every message. A posted letter that explains the change and encloses plan details is the simplest route for many practices. Take advice if you are unsure.
CQC and GDC duties
CQC. Your CQC registration is for the regulated activities you carry out, which do not change because the payer changes. Your statement of purpose may, if it describes NHS services. The CQC registration regulations require you to keep it under review and send any revision to the CQC within 28 days.
GDC. The GDC's Standards for the Dental Team require a simple price list displayed in reception and clear prices in your practice literature and on your website, so patients do not have to ask (standards 2.4.1 and 2.4.2). Every treatment plan must include a realistic indication of cost (2.3.7). A private practice will be judged on these more often than an NHS one, because price is now the patient's decision.
Your team and your associates
Associates working on the NHS contract have their own agreements, and a hand back changes what they are paid for. Talk to them early. Reception staff will take most of the questions from patients, so give them a written explanation, the plan details and a short list of honest answers before the patient letter goes out.
If you or your associates are members of the NHS Pension Scheme, take pensions advice before reducing NHS work. The policy book notes, for example, that partial retirement requires reducing NHS commitment by at least 10%.
Finding new private patients
Most practices that go private lose some patients. Replacing them depends on new patients choosing you, and most start with a Google search. Three things decide whether they find you:
- Your Google Business Profile showing the right services, hours and photos. Google says local results are mainly based on relevance, distance and popularity, meaning how well known a business is.
- Reviews. Google says more reviews and positive ratings can help your local ranking. Across 1,489 UK places, the median practice holding a map place had 113 reviews, and the figure rises to a median 249 where 12 or more practices compete. Our guide to working out your review target shows how to find your town's number.
- Treatment pages on your website for the private work you want more of, with prices.
The guide to local SEO for dentists covers each of these in detail.
A sensible order of work
- Calculate your UDA value and your NHS income by clinician.
- Measure private demand and competition in your town.
- Decide between hand back, reduction or a mixed model.
- Draft your private fees and any membership plan, with prices you are happy to publish.
- Talk to associates and the team.
- Speak to your ICB, then serve notice or request a variation in writing.
- Agree the patient letter, update your website, Google Business Profile and statement of purpose.
- Track new private patients by source every month for the first year.
Size your private market first
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Run on our own practice first: ninth of the 14 practices measured in its town in May, first of 18 in September, on UK-wide search value. Page-one keywords: 6 in May, 194 in September.
Thirty days free. No card, and nothing starts automatically when it ends.