The 2026 dental reforms now pay for your annual appraisal

From 2026, NHS England credits a fixed £213 towards an annual appraisal for dentists, dental therapists and dental hygienists who deliver NHS care, and the guidance names locums and dental contractors explicitly. The money does not arrive as cash in your account: it is converted into UDAs on someone else's contract, and the claim expires two months after the appraisal. That shape, real money routed through the practice with a date attached, runs through most of this year's changes.

What the £213 appraisal payment actually is

NHS England's contractual guidance, published on 26 March 2026 and updated on 29 July 2026, sets out the contribution for eligible dentists and dental care professionals treating NHS patients. Each self-declared annual appraisal is credited a fixed sum of £213, converted into UDAs at the practice's Monetary Value of a UDA and credited against the contract value rather than paid directly to the individual.

NHS England's expectation is that, as a minimum, the contractor passes on the proportion of UDAs equivalent to the one set out in the individual's contract of engagement. In practice that means your usual percentage split, and it is an easier conversation before the appraisal than after the credit lands.

For NHS Pension Scheme members, appraisal earnings are subject to superannuation contributions, so the payment behaves like the rest of your NHS activity.

Who can claim, and the window that closes

Eligibility has three parts and you need all of them: you are providing direct NHS dental care; you work a minimum equivalent to two whole working days per month, or 12 days across a continuous six-month period, for the duration of the financial year; and, within the last 26 weeks of that period, you have been continuously employed or engaged performing NHS dental services. Salaried dentists on NHS terms and conditions are not eligible, including DFT and DTFT trainees, and neither is work in secure and detained estates.

Claims are self-declared through the Contract Management and Payment System, one claim per individual per financial year. If you work across several contracts, NHS England recommends claiming under the one where you do the most NHS activity. The deadline is the trap. A claim must be submitted no later than two months after the date the appraisal was completed, and the guidance is blunt about the consequence: "Late claims submitted after this period will not be credited". An appraisal completed in November and remembered in February is simply gone.

What the reformed contract pays for urgent and complex care

The reforms followed a consultation that ran from 8 July to 19 August 2025, and NHS England confirmed on 16 December 2025 that it would implement everything consulted on, with a few amendments. Two of them alter what a booked session contains.

From 1 April 2026, contractors holding mandatory services contracts of 100 UDAs or more must deliver a Required Number of Urgent Treatments, calculated nationally as 8.2% of Relevant Contract Value. That equates to 11 urgent courses of treatment for every £10,000 of contract value. The previous 1.2 UDA urgent model has gone.

Contractors with no urgent requirement receive £75 per urgent course. The three Complex Care Pathways, live from 23 June 2026, are for patients aged 16 and over with significant caries or unstable periodontal disease, and all carry a Band 2 patient charge unless Band 3 treatment is provided. Recording of phased courses of treatment for this group should end by 31 December 2026. The figures above are NHS England's; Dentistry.co.uk reported the complex care fees as £248 to £709, which does not match the guidance.

A voluntary Quality Improvement programme also pays £3,400 a year, converted to UDAs, for a three-year commitment with a national topic each year and two external peer review meetings. Sign-up for 2026/27 closed at 6pm on 8 May 2026, so that decision was made before you arrived. What has not changed is the UDA system itself. Dentistry.co.uk reported in July 2026 that further consultation on deeper reform had slipped beyond spring 2026, and quoted BDA chair Shiv Pabary calling the package "the biggest tweaks this failed contract has seen in its history".

Therapists and hygienists now have a funding trail

The GDC's annual renewal figures, published on 18 August 2026, put 8,824 dental therapists on the register at 17 August 2026 against 6,787 in 2024, and 11,407 dental hygienists. The dental care professional register overall grew by 5% to 84,746.

The contract has started to follow. From 1 April 2026 a suitably competent dental nurse can apply fluoride varnish without a dental examination, on a prescription from the dentist who examined the child, as a standalone Band 1 course of treatment. All fissure sealants became Band 2 from April 2026; Dentistry.co.uk described this as 1 UDA rising to between 2 and 5 UDAs, which the guidance does not say. Denture repairs moved from 1 UDA to 2 on 23 June 2026.

Put that alongside an appraisal payment that names dental therapists and dental hygienists in their own right, and 2026/27 is the first year this work has a contractual identity separate from the dentist's. If you locum as a therapist or hygienist, that is the basis for being booked for what you deliver rather than as cover. The practicalities differ by role, which is why the notes for dental hygienists and therapists sit separately from those for dentists.

Hospital dental time now counts towards discretionary payments

From September 2026, the eligibility test for discretionary payments, which cover maternity, paternity and adoption leave and long-term sickness leave, counts all NHS dental service towards the two-year requirement. Previously the criterion was time on the Performer Dental List, meaning primary care only; secondary NHS dental care now counts too. The catch is evidentiary: a dentist must provide documented NHS employment history and references when submitting a claim, which the contractor verifies before forwarding to NHSBSA.

What to check before your next NHS booking

• Book the appraisal, then set the claim reminder on the day it happens: two months is the whole window.
• Agree the pass-through in writing first, and ask which contract the claim goes under if you work across several.
• Keep the documented appraisal and personal development plan, and check your performer number is recorded correctly on the Contract Management and Payment System. The DCP CPD cycle runs from 1 August to 31 July, so autumn evidence is worth filing while it is fresh. Sessional's CPD evidence store holds appraisal documents and reflections in one place.
• Keep a dated record of sessions worked: the eligibility test is measured in days per month and in continuous weeks.
• Keep NHS employment history and references, including hospital dental work, in case a discretionary payment ever applies.
• Separate what the contract credits from what you invoice. They are different numbers on different timescales, and the invoicing guide covers keeping them apart.

Sources

• NHS dentistry: quality and payment reforms contractual guidance (NHS England, 26 March 2026, updated 29 July 2026)
• NHS dentistry quality and payment reforms (NHS England, 16 December 2025)
• Annual renewal: number of registered dental care professionals rises by 5% (GDC, 18 August 2026)
• CPD scheme (GDC, accessed September 2026)
• NHS dental contract reform: what's changed and where do we go from here? (Dentistry.co.uk, 21 July 2026)