The reality on the ground

Across the UK, access to NHS dentistry is no longer just “challenging”, in many areas, it’s effectively unavailable.

Reports of patients queuing for hours simply to register with an NHS dentist are becoming increasingly common. In some regions, patients are calling dozens of practices without success. For many, the only remaining option is to go private, whether they can afford it or not.

This is not a short-term disruption. It reflects a deeper structural issue within NHS dentistry that is reshaping how dental care is accessed across the country.

A system under sustained pressure

At the heart of the issue is a combination of:

• Workforce shortages
• An outdated NHS dental contract (UDA system)
• Underfunding relative to demand
• Rising complexity of patient needs

The current NHS contract model, based on Units of Dental Activity (UDAs), continues to draw heavy criticism from the profession. It does not adequately reflect the time, cost, or complexity involved in delivering care, particularly for high-needs patients.

As a result, many providers are making a commercial and clinical decision to:

• Reduce NHS commitments
• Limit complex NHS treatments
• Transition partially or fully into private care models

The shift to private dentistry is accelerating

The data tells a clear story:

• Private dentistry accounted for just 14% of the market in 1990
• This rose to 42% by 2010
• By 2024, it reached 69% of the market

At the same time:

• A growing proportion of patients report using private dental services year-on-year
• Access to complex NHS treatments (e.g. root canals) has significantly declined
• Patients are increasingly willing to pay for certainty, speed, and quality of access

This is not simply a “last resort” shift, it is becoming a preferred model for many patients who value:

• Faster appointments
• Continuity of care
• Access to advanced or cosmetic treatments
• Transparent service delivery

Will government reforms fix the problem?

The government has announced reforms positioned as the “most significant in 20 years”, including:

• Additional funding (~£350m annually)
• Adjustments to the UDA system
• Ringfencing 8% of NHS contracts for urgent care
• Recruitment of overseas dentists and expanded training places

While these measures may provide short-term relief, many within the sector view them as:

Incremental changes rather than fundamental reform

There is growing consensus that without a complete overhaul of the contract model and long-term investment, NHS dentistry will continue to contract in scope, potentially becoming a service focused primarily on:

• Emergency care
• Vulnerable populations
• Basic interventions

What this means for providers

For dental providers, this shift presents both risk and opportunity.

Key trends we are seeing:

• New clinics launching as fully private services
• Existing providers transitioning away from NHS contracts
• Increased demand for specialist, cosmetic, and preventative services
• Greater focus on patient experience and service differentiation

However, with opportunity comes regulatory responsibility.

Any provider delivering regulated dental activities must ensure compliance with the Care Quality Commission (CQC), including:

• Registration under the correct regulated activities (e.g. Treatment of Disease, Disorder or Injury)
• Robust governance frameworks
• Safe clinical oversight and workforce competency
• Clear patient pathways and consent processes

A growing demand for new private dental clinics

As NHS access continues to decline, we are seeing a marked increase in enquiries from clinicians and organisations looking to:

• Launch new private dental clinics
• Expand existing services into private-only models
• Diversify into specialist or high-demand treatment areas

This transition is not simply a business decision, it requires:

• Careful structuring of your CQC application
• Clear articulation of your clinical model
• Robust policies and evidence aligned to the Single Assessment Framework
• Preparation for registration interviews and ongoing inspection

How HLTH Compliance supports dental providers

At HLTH Compliance, we are actively supporting providers across the UK to respond to this shift in the market.

Our support includes:

• End-to-end CQC registration for new private dental clinics
• Strategic advice on regulated activities and service structure
• Preparation of compliant policies, procedures, and governance frameworks
• Mock inspections and interview preparation
• Ongoing compliance and quality assurance support post-registration

We understand both the commercial drivers behind moving into private dentistry and the regulatory expectations that come with it.

Final thought

NHS dentistry is not disappearing overnight, but it is undeniably evolving.

For many patients, private care is no longer optional, it is the only viable route to timely, reliable treatment.

For providers, this presents a clear inflection point:

Those who adapt early — with the right regulatory foundations in place, will be best positioned to succeed in the new dental landscape.

Speak to us

If you are considering launching a private dental clinic or transitioning away from NHS provision, HLTH Compliance is here to support you.

We offer a complimentary consultation to discuss:

• Your proposed model
• CQC registration requirements
• The most efficient route to becoming operational

Get in touch today to start your journey into private dental provision with confidence.