NHS dental contracts a mile apart are paid a median £3.15 a UDA apart, and one pair in three £5 or more
Every NHS general dental contract in England, read from the NHS Business Services Authority's own files: what each is paid for a unit of dental activity, how that compares with the contract down the road, and how far each is through the first three months of the 2026/27 contract year, the first under the April 2026 contract changes.
Key findings
- £36.73. What the median NHS general dental contract in England is paid per UDA in 2026/27. One in ten is paid £32.24 or less, one in ten £43.36 or more.
- £3.15. The median gap in price per UDA between two contracts within a mile of each other. One pair in three is £5 or more apart, worth £59,115 a year on a median-sized contract.
- At least three quarters. How much of the variation in price per UDA sits inside the same ICB. Which ICB a contract is in explains a tenth to a quarter of it, depending on how you measure.
- 35.6%. The share of England's commissioned UDAs held by contracts running below 90% of pace after April to June 2026. Counting urgent courses the old way it is 39.6%, still down from 48.4% in the same months of 2025.
- 70%. The share of contracts below 90% of pace after last spring that finished 2025/26 below 96% of target.
- 60.4%. The share of the South West's commissioned UDAs in contracts running behind, the highest of any English region.
Changes to the NHS dental contract took effect in England from 1 April 2026, with the new complex care pathways following from 23 June 2026, after the Department of Health and Social Care's response of 16 December 2025 to its consultation on quality and payment reforms. They change how urgent and unscheduled care is paid. Practices must now give 8.2% of their contract value to urgent and unscheduled care. Each urgent course now earns a £60 activity credit, converted to UDAs at the contract's own UDA value, instead of the old 1.2 UDAs, and practices also receive a fixed monthly credit of £15 for each urgent course they are required to provide. April, May and June 2026, the first three months under the changes, were all published by the NHS Business Services Authority in September 2026. They show what the changes moved, and what they left exactly where it was: what each contract is paid for a unit of dental activity.
We read all 5,660 NHS general dental contracts in England that hold 1,000 or more units of dental activity a year. Two terms are used throughout. A UDA, or unit of dental activity, is the unit an NHS contract is measured in: a band 1 course earns one, a crown twelve. The price per UDA is what the contract pays for a year divided by the UDAs it must deliver. It decides what every NHS course of treatment is worth to a practice. No contract, practice or provider is named anywhere in this study or in the data published with it.
"Most owners know their own UDA rate. Very few know what the practice down the road is paid for exactly the same work, and that is the number that matters when you sit down with your ICB," said Jack Henty, co-owner of Bollington Dental Practice in Cheshire and founder of Practice Radar.
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1. Two contracts a mile apart: one pair in three paid £5 or more apart for the same work
There are 10,399 pairs of NHS dental contracts in England at different addresses within a mile of each other. Half of those pairs are paid more than £3.15 apart for every UDA. A third are £5 or more apart. More than one in ten is £10 or more apart.
The work is the same. A band 1 check-up earns one UDA at both practices. The patient pays the same NHS charge at both. What the NHS pays the practice for it is not the same.
In money, the gap is not small. The median contract in England is contracted for 11,823 UDAs a year. At that size, the median gap between neighbours is £37,242 a year, and a £5 gap is £59,115. Every year, for delivering the same number of units.
We checked whether this is just two different ICBs meeting at a border. It is not. 10,208 of the 10,399 pairs are in the same ICB, and their median gap is £3.14. We checked whether it is a small contract against a large one. Holding both the ICB and the contract size band the same, the median gap is still £3.07 and a third of pairs are still £5 or more apart.
Town by town it looks the same. In the 782 built-up areas with two or more contracts, the gap between the highest-paid and lowest-paid contract is a median £4.77 a UDA, and in 23.3% of towns it is £10 or more.
2. The median contract is paid £36.73. The floor is £31.34.
Across all 5,660 contracts, the NHS is contracted to pay £3.02 billion in 2026/27 for 80.0 million UDAs across these 5,660 contracts, an average of £37.79 a UDA once each contract is weighted by its size. The median contract is paid £36.73. Half of all contracts sit between £34.11 and £40.03.
| Share of contracts paid this or less | Price per UDA |
|---|---|
| 10% | £32.24 |
| 20% | £33.58 |
| 30% | £34.48 |
| 40% | £35.48 |
| 50% (median) | £36.73 |
| 60% | £37.70 |
| 70% | £39.10 |
| 80% | £40.37 |
| 90% | £43.36 |
The single most common value in England is £31.34. 325 contracts sit at exactly that figure and only 17 sit below it. That shape, a spike with almost nothing underneath, is what a minimum rate looks like in the data, and you can watch it move. In June 2024 the wall stood at exactly £28.00, the minimum NHS England set that year in its dental recovery plan, with 658 contracts on it. By March 2025 it was £29.30, by March 2026 £30.34, and in the June 2026 file it is £31.34. Uplifts arrive in the data late: the 2025/26 rise first appears in the September 2025 file, and this year's in June's. The number of contracts on it has halved since June 2024, but 10.7% of contracts are still within £1 of it.
3. Your ICB explains a tenth to a quarter of it
Integrated care boards commission NHS dentistry, so the obvious guess is that the ICB sets the rate. Split the variation in price per UDA into the part explained by which ICB a contract is in and the part that is not, and the ICB accounts for somewhere between a tenth and a quarter, depending on how you measure it: 10.0% of the raw variance, 13.9% on a log scale, 16.0% of the average distance from the median and 23.5% on ranks. However you cut it, at least three quarters of the variation sits inside the same ICB.
ICBs do differ. Their median contract runs from £33.04 to £40.29. But how ICBs differ is more useful than where. A few pay close to one rate: in North East and North Cumbria the middle 80% of contracts sit within £1.18 of each other, and in Staffordshire and Stoke-on-Trent within £2.18. Others are wide open: Humber and North Yorkshire's middle 80% spans £15.63, North East London's £14.77. The median ICB spans £8.09. Lancashire and South Cumbria's figure in the table, £29.76, is a special case: 18 of its 20 contracts above £60 a UDA share a postcode with another contract, and 17 of those are small, 2,280 UDAs or fewer, which looks like a local commissioning scheme rather than history.
If you are in a tight ICB, your rate is close to everyone else's and the conversation is about the ICB's rate. If you are in a wide one, your rate is mostly history: whatever the contract carried when it was first set, uplifted by a percentage every year since.
Regions differ once you allow for contract size. Compared with contracts of the same size nationally, the median contract is paid £3.23 more in the North East and £2.28 more in Yorkshire and the Humber, and £2.30 less in the East Midlands and £2.22 less in the South East. Rural and urban contracts are paid almost exactly the same: a median £36.77 in urban areas, £36.38 in larger rural ones.
4. Small contracts sit nearer the floor
Bigger contracts are paid a little more per UDA, but only a little. The median climbs from £34.68 for contracts of 1,000 to 2,000 UDAs to £37.42 for contracts over 20,000. The difference is at the bottom. More than a quarter of the smallest contracts sit within £1 of the floor, against one in twenty of the largest.
| Contracted UDAs a year | Contracts | Median contract value | Median price per UDA | Within £1 of the £31.34 floor |
|---|---|---|---|---|
| 1,000 to 2,000 | 441 | £49,130 | £34.68 | 27.0% |
| 2,000 to 5,000 | 757 | £121,083 | £35.36 | 16.4% |
| 5,000 to 10,000 | 1,219 | £274,434 | £36.79 | 10.6% |
| 10,000 to 20,000 | 1,876 | £527,547 | £37.06 | 8.7% |
| Over 20,000 | 1,367 | £1,001,388 | £37.42 | 5.2% |
Size is a weak guide on its own. The rank correlation between a contract's size and its price is 0.135, close to none. Two contracts of the same size in the same ICB can still be £10 apart.
5. This year's uplift carried every gap forward
The 2026/27 uplift first shows in the June 2026 file: the April and May files still carry last year's values, with the floor at £30.34. We matched 5,604 contracts that appear in both the March 2026 and June 2026 files. 77.9% of them moved by between 3.2% and 3.4%, and the median change was 3.31%, the same for contracts on the floor as for everyone else. The floor itself moved from £30.34 to £31.34.
A percentage uplift keeps every contract in the same place relative to its neighbour. A contract paid £5 less than the practice down the road last year is paid slightly more than £5 less this year. Nothing in the annual uplift closes a gap. Only a conversation with the ICB does.
6. Three months into the contract changes, more than a third of England's UDAs are in contracts running behind
The NHS year runs April to March. April, May and June 2026 were all published by the NHS Business Services Authority in September 2026. We define pace as the UDAs a contract has delivered so far this year divided by the share of its annual target those months represent. A contract that has delivered a quarter of its target by the end of June is at 100%.
After three months, 42.9% of contracts are at or ahead of pace. 37.7% are below 90%, and 7.0% are below half. The contracts below 90% hold 28.5 million of England's 79.9 million commissioned UDAs, or 35.6%. Those contracts were 2.25 million UDAs short of their three-month share, worth £84.8 million at their own rates. Counting every contract under 100% of pace, the shortfall is 2.44 million UDAs.
That is an improvement on the same months of the last two years, when 53.8% and then 48.4% of commissioned UDAs sat in contracts below 90% of pace. Two things temper it.
First, urgent courses now earn more. An urgent course used to earn 1.2 UDAs. Now its £60 activity credit is converted at the contract's own UDA value, which at the median is 1.64 UDAs, and urgent and unscheduled courses rose 25.5% on the year as practices met the new 8.2% requirement. Across England, UDAs delivered in April to June rose 7.2% on the year, while courses of treatment rose 2.7%. The new urgent weighting accounts for about 31% of that rise. Count this spring's urgent courses at the old 1.2 UDAs and UDAs rose 4.9%, and 39.6% of commissioned UDAs (41.4% of contracts) would be in contracts below 90% of pace, not 35.6%. That is still down from 48.4%. The £15 fixed credit does not appear to be in the delivered figures: they match the course counts without it. Second, it is three months. April to June carried 24.4% of all UDAs delivered in 2025/26, a little less than a quarter, so the spring slightly understates where a contract will finish.
Contract targets did not fall to flatter the figures. 75.3% of contracts in both springs carry exactly the same target, and among those, the share below 90% of pace fell from 47.4% to 37.3%, the same improvement as the whole.
7. Behind after the spring usually means behind at year end
We followed every contract through last year. Of the 2,710 contracts below 90% of pace after April to June 2025, 69.9% finished 2025/26 below 96% of their target, and 56.9% finished below 90%. Only 13.7% recovered to 100% or more. Among contracts that were on pace after the spring, only 8.4% finished below 96%.
| NHS year | Contracts below 90% after April to June | Finished the year below 96% | Finished below 90% | Recovered to 100% or more |
|---|---|---|---|---|
| 2024/25 | 2,862 | 83.1% | 63.7% | 6.3% |
| 2025/26 | 2,710 | 69.9% | 56.9% | 13.7% |
"Last year seven in ten contracts behind after the spring were still behind in March. The time to talk to your ICB is now, not at year end," said Jack Henty.
96% matters because of how year end works. Under the GDS contract and PDS agreement, a shortfall of 4% or less can be made up early in the following year, with no money recovered. Below 96%, the commissioner recovers the money for the whole shortfall and can also issue a breach notice. Three years in a row below 96% and the commissioner should seek a permanent reduction to the contract (NHS England Policy Book for Primary Dental Services, sections 8.4.3 to 8.4.6). In 2025/26, 41.2% of all contracts finished below 96%.
8. The South West is where patients will feel it
Delivery is not spread evenly. In the South West, 60.4% of commissioned UDAs sit in contracts running below 90% of pace, against 23.7% in the West Midlands. The South West has been lowest in every period we measured: 71.7% of pace in the spring of 2025, 76.7% across the whole of 2025/26 and 77.9% this spring.
By ICB, the share of UDAs in contracts behind ranges from 13.9% in Birmingham and Solihull to 81.4% in Somerset, where contracts together had delivered 56.2% of their pace. Cornwall and the Isles of Scilly (80.6%) and Devon (71.6%) follow. Every ICB's figures are in the table below.
Behind pace is not the same as a failing practice. The data does not say why a contract is behind: a dentist who left, long sickness and a deliberate move to private work all look the same in it. But for a patient trying to find an NHS dentist, it means appointments commissioned and not yet given. And 59.4% of contracts in England now have at least one contract running below 90% of pace within a mile of them. Some of those patients will look elsewhere.
9. A higher UDA rate barely predicts who delivers
It is tempting to assume that contracts paid more deliver more. The data says otherwise. Across all contracts this spring, the rank correlation between price per UDA and pace is 0.008, which is none. Over the whole of 2025/26 it was 0.075. Contracts in the top quarter by price did finish last year better, 35.0% below 96% against 44.8% in the bottom quarter, and the gap holds within some size bands: among contracts of 2,000 to 5,000 UDAs, 37.0% of the best-paid quarter finished below 96% against 51.6% of the worst-paid, and among contracts of 5,000 to 10,000 UDAs, 24.6% against 39.5%. It is not there in every size band, and this spring it has all but gone. ICBs that pay more are not the ones delivering more either.
Every ICB, 2026/27
| ICB | Contracts | Median price per UDA | Middle 80% of contracts | Pace, April to June | UDAs in contracts below 90% of pace |
|---|---|---|---|---|---|
| Thames Valley | 213 | £33.04 | £31.34 to £38.83 | 100.1% | 25.6% |
| Gloucestershire | 51 | £33.58 | £31.34 to £36.49 | 87.6% | 46.1% |
| Bristol, North Somerset and South Gloucestershire | 84 | £33.58 | £33.06 to £37.13 | 85.0% | 53.2% |
| Leicester, Leicestershire and Rutland | 117 | £33.74 | £31.34 to £38.66 | 104.3% | 20.8% |
| Kent and Medway | 197 | £33.85 | £31.34 to £40.26 | 100.3% | 31.4% |
| Lincolnshire | 49 | £34.09 | £32.88 to £36.84 | 86.6% | 57.6% |
| Nottingham and Nottinghamshire | 105 | £34.16 | £31.34 to £39.58 | 98.6% | 38.8% |
| Birmingham and Solihull | 157 | £34.40 | £32.60 to £39.14 | 109.9% | 13.9% |
| Black Country | 144 | £34.41 | £33.57 to £38.34 | 107.0% | 21.3% |
| Surrey and Sussex | 335 | £34.59 | £31.34 to £41.69 | 98.1% | 38.8% |
| Bath and North East Somerset, Swindon and Wiltshire | 83 | £34.76 | £33.58 to £39.18 | 88.3% | 42.7% |
| Derby and Derbyshire | 95 | £34.93 | £31.34 to £44.31 | 101.9% | 29.6% |
| Central East | 276 | £35.02 | £32.37 to £41.24 | 99.2% | 24.0% |
| Staffordshire and Stoke-on-Trent | 105 | £35.30 | £35.03 to £37.21 | 103.9% | 25.2% |
| Herefordshire and Worcestershire | 74 | £35.30 | £34.10 to £40.62 | 93.8% | 34.0% |
| Hampshire and Isle of Wight | 174 | £35.45 | £31.34 to £40.20 | 96.4% | 37.5% |
| Cornwall and the Isles of Scilly | 51 | £36.18 | £35.82 to £38.23 | 72.2% | 80.6% |
| Cheshire and Merseyside | 261 | £36.19 | £32.67 to £41.99 | 87.2% | 50.7% |
| Devon | 90 | £36.56 | £35.82 to £41.65 | 67.9% | 71.6% |
| Essex | 180 | £36.69 | £32.70 to £41.36 | 103.3% | 19.3% |
| Coventry and Warwickshire | 92 | £36.75 | £33.16 to £41.10 | 105.8% | 20.7% |
| Northamptonshire | 58 | £36.77 | £31.57 to £46.56 | 95.6% | 42.3% |
| South West London | 175 | £36.79 | £32.08 to £43.47 | 94.2% | 38.5% |
| Lancashire and South Cumbria | 191 | £37.00 | £31.38 to £61.14 | 99.0% | 31.4% |
| Shropshire, Telford and Wrekin | 57 | £37.21 | £36.92 to £39.13 | 96.4% | 44.3% |
| South East London | 190 | £37.31 | £32.83 to £45.45 | 98.4% | 27.1% |
| Dorset | 70 | £37.44 | £36.74 to £40.03 | 82.6% | 58.2% |
| Somerset | 49 | £37.44 | £33.19 to £40.08 | 56.2% | 81.4% |
| Norfolk and Suffolk | 137 | £37.60 | £37.60 to £40.25 | 88.1% | 41.6% |
| Greater Manchester | 336 | £37.94 | £33.14 to £45.50 | 100.3% | 25.8% |
| West and North London | 463 | £38.16 | £32.91 to £44.72 | 100.7% | 29.7% |
| South Yorkshire | 155 | £38.75 | £35.57 to £43.98 | 95.5% | 39.7% |
| West Yorkshire | 224 | £39.26 | £35.66 to £48.38 | 92.3% | 41.8% |
| North East London | 195 | £39.98 | £34.44 to £49.21 | 102.3% | 24.3% |
| Humber and North Yorkshire | 166 | £40.21 | £35.46 to £51.09 | 89.5% | 50.2% |
| North East and North Cumbria | 261 | £40.29 | £40.16 to £41.34 | 94.9% | 41.5% |
Pace in this table is pooled: all UDAs delivered in the ICB divided by all UDAs its contracts needed for three months. A figure over 100% means contracts in that ICB together delivered more than a quarter of their year.
What to do about it
Work out your own rate before anything else. Divide your contract's annual UDA value by your contracted UDAs. Both are on your contract and in Compass. Then place it against the table above: below your ICB's 10th percentile, and you are among the lowest-paid contracts in your own area, not just in England.
Take the number into every contract conversation. Rebasing, a request for extra UDAs, a handback, a variation, a sale or a purchase. A UDA rate is the price of every NHS course of treatment you deliver, and it is usually set once and carried forward by percentage. Nobody will offer to move it. An owner who can say where their rate sits in their own ICB's distribution is having a different conversation from one who cannot.
Check your pace every month, and treat the spring as a warning. Seven in ten contracts below 90% of pace after April to June last year finished below 96%. If you are behind now, the time to act is before the mid-year review, not after it.
Know what your neighbours are doing. A contract running behind within a mile of you is a sign of unmet demand. Patients who cannot get an appointment there will look elsewhere, and the money for UDAs it does not deliver can be recovered by the ICB. If you are delivering, tell your ICB what more you could take on.
Practice Radar, which compiled this analysis, reads the NHS contracts in every local dental market it measures each month.
How we did this
Source. NHS Business Services Authority, English Contractor Monthly General Dental Activity, from its Open Data Portal (opendata.nhsbsa.net), dataset "english-contractor-monthly-general-dental-activity", resources UDA_CONTRACTOR_202404 to UDA_CONTRACTOR_202606, downloaded on 24 September 2026. Each monthly file lists every contract that provides general dental services in England with its commissioner, principal practice postcode, annual UDA target (UDA_PERF_TARGET), the financial value tied to that target (UDA_FIN_VAL), and the UDAs delivered in that month (UDA_DELIVERED, and separately UDA_DELIVERED_FD for foundation dentists). The June 2026 file was published in September 2026. This is management information, not an official statistic, and it does not match NHS England's annual dental statistics, which count contracts differently.
Price per UDA is UDA_FIN_VAL divided by UDA_PERF_TARGET, taken from the latest month (June 2026), because the NHSBSA's guidance says the latest month holds the current contractual position. For 254 contracts UDA_FIN_VAL differs from the whole general dental value. Using only the contracts where they agree moves the median by 12p, to £36.61.
What we excluded, and why. The June 2026 file has 6,602 contracts. We kept 5,660, which hold 99.4% of all commissioned UDAs. We removed 911 contracts with a target under 1,000 UDAs a year, because most are placeholders or specialist top-ups, some with a target of 0 or 1. We removed 11 contracts held by NHS trusts or community dental services identified by name, which are not high-street practices, 2 with a nominal value under £10 a UDA (values of £1, entered as placeholders) and 18 above £100 a UDA, which the NHSBSA's own guidance says are specialist service lines. The £100 cut also removes a salaried dental service our name pattern missed. Cutting at 100 UDAs instead of 1,000 keeps 6,064 contracts and moves the median by 7p, to £36.66.
Neighbours. Each contract's practice postcode was looked up on postcodes.io, which serves the Office for National Statistics Postcode Directory, for coordinates, built-up area, ONS region and the 2021 rural-urban classification. Distances are straight lines between postcode centres. The NHSBSA notes that dentistry is commissioned at ICB level, which is why we also checked every neighbour comparison within a single ICB. Deprivation comes from the Ministry of Housing, Communities and Local Government's English Indices of Deprivation 2025, File 7, joined on each contract's 2021 LSOA code. Size adjustment compares each contract with the national median for its size band: 1,000 to 2,000 UDAs, 2,000 to 5,000, 5,000 to 10,000, 10,000 to 20,000 and over 20,000.
Pace. Delivered UDAs, including those by foundation dentists, divided by the annual target times the months published over twelve. Excluding foundation dentists' UDAs, 40.8% of contracts are below 90% of pace, not 37.7%. For the like-for-like comparison with earlier springs, each 2026/27 unscheduled course was re-counted at 1.2 UDAs in place of £60 divided by the contract's UDA value, rounded up to two decimal places as the NHS England guidance sets out. Placeholder and specialist contracts were left as reported. Contract values and so the conversion rate in each month come from that month's file. The analysis set here is contracts present in all three months, 5,646 contracts holding 79.9 million UDAs, which is why the totals differ slightly from the 5,660 contracts and 80.0 million UDAs in the price figures. A contract is included only if it appears in every month of the period. Year comparisons use the same three months each year, April to June, against the target in that year's June file. Whole-year outcomes use the March file's target. Late forms were checked: the June 2026 file carries 1,464 forms submitted after the two-month deadline against 2,684 in June 2025, out of roughly three million a month, so late forms do not move the result.
What this is not. The price per UDA is what the NHS pays the contract holder. It is not what an associate is paid, and it is not profit. Pace in April to June is a reading three months into a twelve-month year. A contract behind pace is not necessarily failing, and the data does not say why any contract is behind. No contract, practice or provider is named in this study or its data.
Questions we get asked about this data
What is the average UDA rate in England in 2026/27?
The median NHS general dental contract is paid £36.73 per UDA in 2026/27. Weighted by contract size, the average is £37.79. One in ten contracts is paid £32.24 or less, and one in ten £43.36 or more.
What is the lowest UDA rate in England?
The most common single rate in the June 2026 file is £31.34, held by 325 contracts, and only 17 of 5,660 contracts are paid less. In the March 2026 file the same wall stood at £30.34.
How much do UDA rates vary between practices near each other?
For two contracts at different addresses within a mile, the median gap is £3.15 per UDA. One pair in three is £5 or more apart, which on a median-sized contract of 11,823 UDAs is £59,115 a year.
How many NHS dental contracts are behind target in 2026/27?
After April to June 2026, 37.7% of contracts were below 90% of the pace their annual target needs, holding 35.6% of England's commissioned UDAs. Counting urgent courses at the old 1.2 UDAs, it would be 39.6%. In the same months of 2025 the share was 48.4%.
How do I find my own UDA rate?
Divide your contract's annual UDA value by your contracted UDAs. Both are on your contract and in Compass. Then compare it with your ICB's row in the table above.
For editors
The data and charts in this article are free to reuse with attribution to Practice Radar, under Creative Commons BY 4.0. Period and sources: NHS general dental contract values for 2026/27 and delivery for April to June 2026 (with April to June 2024 and 2025 and the full 2024/25 and 2025/26 years for comparison), from the NHS Business Services Authority's English Contractor Monthly General Dental Activity files, published September 2026. The per-ICB figures are in nhs-dental-contract-values-england-2026.csv, with a column glossary. Cuts for a single ICB or region are available on request.
Contact: hello@practiceradar.co.uk
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