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DHSC: Dental Contract Reform & Arrangements

With only two working days left before 01 April, the Department of Health and Social Care (DHSC) and NHS England have now published the activity expectations and contractual payment arrangements for the first part of 2021-2022 financial year on the NHS website, alongside proposals to expedite reform of the UDA contract.

The threshold for full contract payment for general dental services (UDAs) will move to 60% from 01 April 2021.

The threshold for full contract payment for orthodontic services (UOAs) will move to 80% from 01 April 2021. There is a commitment from the NHS and DHSC to reform the current UDA system with a view to implementing reforms over the coming year and from 01 April 2022.

A reminder about the NHS year-end process for 2020-21

NHS England and NHS Improvement published "Issue 7, Preparedness letter for primary dental care" letter on Tuesday 22 December 2020.

The letter set out how contract payment would be dealt with in respect to quarter four (01 January 2021 - 31 March 2021), as well as for quarters one, two and three.

In addition to the letter, the NHS BSA has published guidance with regards to the NHS England and NHS Improvement contract payment arrangements, setting out how the 2020-21 year-end position for contractors will be calculated.

The guidance is also covered with worked examples in four NHS webinars about contract management and payment reconciliation, which are available from the Primary Care Commissioning (PCC) website.

The NHS England and NHS Improvement dental commissioning team has previously communicated that UDAs delivered above the 45% threshold for contract payment in Q4 will be credited to 2021-22, capped at up to 2% of the annual contracted UDA delivery.

For example, a 12,000 UDAs contract would have a Q4 allocation of 3,000 UDAs, which equates to a Q4 threshold for full payment of 1,350 UDAs. Therefore, those UDAs delivered above 1,350 in Q4 would be credited to the contractor from 01 April 2021, capped at 2% of 12,000 UDAs (240 UDAs).

Primary Care Commissioning (PCC) has been providing clarifications via email for contractors with questions about the 2020-21 year-end and reconciliation process. If you have read the guidance documentation but you are still unclear, you can contact them here:

Outstanding UDA/UOA over and under-delivery in 2019-20

The NHS BSA issued a letter to contractors on Monday 15 March 2021. The letter explains that contractors should advise the NHS BSA directly of their intention, should they wish to have their over or under-delivery from 2019-20 credited to their year-end position for 2020-21.

Unless notified, the NHS BSA will roll the over or under-delivery from 2019-20 into 2021-22.

The calculation methodology for the application of 2019/20 over and under-delivery to the 2020/21 financial year has not yet been published. Therefore, until contractors are clear about how their position at the year-end in 2019/20 might relate to the 2020/21 financial year, they may wish to keep their options open. It may be that NHS BSA will process requests made to them after 31 March 2021 for 2019/20 over and under-delivery to be applied to the 2020/21 year, rather than rolled forward into 2021/22.

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