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Unscheduled care in the 2026/27 NHS dental contract: 11 urgent courses per £10,000, how many a week that is, and what the £15 fixed credit is
NHS dental contracts of 100 UDAs or more owe 11 urgent courses of treatment per £10,000 in 2026/27. The sum, the weekly slots and the £15 and £60 credits.
An NHS dental contract in England of 100 units of dental activity (UDAs) or more must deliver 11 urgent courses of treatment for every £10,000 of contract value in 2026/27. For a £180,000 contract that is 198 a year, or about four a week.
The rule started on 1 April 2026. NHS England calls the figure the Required Number of Urgent Treatments and sets it at 8.2% of contract value.
Who it applies to
Contracts for mandatory services of 100 UDAs or more a year. The guidance lists the contracts left out: 99 UDAs or fewer, non-mandatory services, child-only contracts from before 1 April 2006, and contracts only for community dental services, secure and detained estates, or dental public health.
The commissioner must tell each contractor its number in writing by 15 March each year. Check the letter against your own sum.
The sum
NHS England's formula is:
Required number = relevant contract value ÷ £10,000 × 11, rounded up to a whole course.
Relevant contract value is the negotiated annual contract value less any payments for orthodontics, sedation, domiciliary services and dental public health.
| Relevant contract value | Sum | Required a year | A week over 48 weeks |
|---|---|---|---|
| £35,000 (1,000 UDAs at £35) | 3.5 × 11 = 38.5 | 39 | 0.8 |
| £100,000 | 10 × 11 | 110 | 2.3 |
| £180,000 | 18 × 11 | 198 | 4.1 |
| £250,000 | 25 × 11 | 275 | 5.7 |
| £510,500 | 51.05 × 11 = 561.55 | 562 | 11.7 |
The last row is NHS England's own example, and £35 is the UDA value its examples use. The weekly column assumes 48 open weeks.
A £180,000 contract needs four slots most weeks and a fifth about one week in eight.
What each course is credited
For a contractor with a required number, each required course carries two credits:
- a £15 fixed credit for each required course, credited monthly in equal parts
- a £60 activity credit, applied when a Band 1 urgent FP17 claim is submitted
Courses delivered above the required number get a £75 activity credit. A contractor with no required number gets £75 a course. Each credit is converted to UDAs at the contract's own UDA value.
For the £180,000 contract:
- fixed credits: 198 × £15 = £2,970 a year, which is £247.50 a month
- activity credits at full delivery: 198 × £60 = £11,880
- total: £14,850, the same as 198 × £75
£14,850 is 8.25% of £180,000, which is close to the 8.2% in the rule.
What NHS England says about the £15
Trade summaries describe the £15 as a payment for failed appointments. The guidance does not use those words. It says: "A £15 fixed credit for each of the Required Number of Urgent Treatments will be applied". On under-delivery it says: "Where the Dental Contractor does not deliver the Required Number of Urgent Treatments, the fixed credits (payment) will not be subject to financial recovery."
So the fixed credit is tied to the number the contract requires, and the practice keeps it whether or not a slot is used. Nothing in the guidance links it to any one missed appointment, and it is not a charge to a patient. No fee can be charged to an NHS patient who fails to attend, as the NHS failed-to-attend policy guide sets out.
The two checkpoints
| Date | Test | For 198 required |
|---|---|---|
| 30 September | Under 30% delivered since 1 April: the commissioner may require a written plan or withhold money under paragraph 59 of Schedule 3 | 60 courses reaches 30% |
| 31 March | Under 96% delivered: the activity payment for the undelivered courses is recovered and a breach notice may be issued | 191 courses reaches 96% |
The sums: 30% of 198 is 59.4, so 60. 96% of 198 is 190.08, so 191.
A commissioner may reduce the required number by up to 15% between 30 October and 31 March. The guidance says this applies only where there is evidence of insufficient demand and the practice has taken reasonable steps to make urgent care accessible. For 198, 15% is 29.7, so at most 29 courses. Claims go in as Band 1 urgent FP17s no later than 2 months after the course is completed.
What the front desk has to do
The guidance sets service requirements, and says failing them "may result in a contract breach":
- State the availability of urgent appointments, and how patients reach them, in the patient information leaflet and on the website if the practice has one.
- Keep the Directory of Services profile up to date, and tell the commissioner of any change within 2 working days.
- Use all available capacity for patients who contact the practice directly or are sent by a helpline.
- Do not refuse an available urgent appointment because the patient has no NHS number, no GP registration or no permanent address.
Urgent care in the guidance covers three levels: emergency need triaged within 60 minutes, urgent need treated within 24 hours, and non-urgent unscheduled need within 7 days. Which level a caller falls into is a clinical triage decision, not a reception one.
A leaflet paragraph to copy
Urgent NHS appointments. We keep NHS urgent appointments each week for people with dental pain, swelling or injury. Phone [number] from [time] on [days]. A member of the clinical team decides how soon you need to be seen. You do not need to be a regular patient here, and you do not need an NHS number, a GP or a permanent address. The NHS charge for urgent treatment applies unless you are exempt. When we are closed, call NHS 111.
A weekly plan to copy
| Item | Your figure |
|---|---|
| Required number in the commissioner's letter | |
| Open weeks in the year | |
| Urgent slots held a week (required ÷ weeks, rounded up) | |
| Time of day an unfilled slot is released | |
| Delivered to date, against 30% by 30 September | |
| Courses needed for 96% by 31 March | |
| Who updates the Directory of Services profile |
The failed-to-attend cost calculator prices an empty slot, and the surgery hourly rate calculator shows what a booked hour has to earn.
A GDC-registered professional or the practice manager reviews anything a tool drafts before it reaches a patient. This page is general information, not clinical or legal advice.
Short answers from this page
How many urgent appointments does an NHS dental practice have to provide in 2026/27?
A contract of 100 UDAs or more must deliver 11 urgent courses of treatment for every £10,000 of relevant contract value, rounded up, which NHS England sets at 8.2% of the contract. A £180,000 contract owes 198 a year, about four a week over 48 weeks. The commissioner confirms the number in writing by 15 March.
Source: NHS England, quality and payment reforms contractual guidance (updated 29 July 2026), section 3.4; GDS Contracts Regulations 2005, regulation 17A
What is the £15 fixed credit for urgent care in the NHS dental contract?
NHS England's guidance applies a £15 fixed credit for each of a contract's required urgent treatments, credited monthly in equal parts, plus a £60 activity credit for each course delivered. The guidance says the fixed credits are not subject to financial recovery if the required number is not delivered. Courses above the required number are credited at £75.
Source: NHS England, quality and payment reforms contractual guidance (updated 29 July 2026), sections 3.8 and 3.9
What happens if an NHS dental practice delivers fewer urgent appointments than its contract requires?
There are two checkpoints. If under 30% of the required urgent courses has been delivered by 30 September, the commissioner may require a written plan or withhold money. At 31 March, delivery under 96% means the activity payment for the undelivered courses is recovered and a breach notice may be issued. The £15 fixed credits are not recovered.
Source: NHS England, quality and payment reforms contractual guidance (updated 29 July 2026), section 3; GDS Contracts Regulations 2005, Schedule 3, paragraph 59
Every short answer for dental, physio and aesthetics clinics
Where this comes from: NHS England, "NHS dentistry: quality and payment reforms contractual guidance" (published 26 March 2026, version 2, last updated 29 July 2026), sections 3.1 to 3.9; NHS England letter of 22 January 2026 confirming the 8.2% requirement; GDS Contracts Regulations 2005, regulation 17A (inserted on 1 April 2026 by S.I. 2026/265) and Schedule 3, paragraph 59, on legislation.gov.uk. All read in a browser on 1 October 2026. Not legal or clinical advice; the contract holder checks the figure in the commissioner's letter.
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