Dentists in England have returned more than £900 million (about C$1.64 billion) to the government over the past two years after failing to deliver the amount of National Health Service (NHS) dental care they had contracted to provide, according to a BBC analysis of NHS financial accounts.
Under the NHS dental contract system, practices agree each year to deliver a set amount of care measured in Units of Dental Activity (UDAs). Dentists are paid monthly based on that contract. If a practice delivers less than 96 per cent of its contracted activity, the NHS recoups the unspent portion of funding the following year.
The scale of returned funding has risen sharply in recent years. Historically, dentists typically returned £100 million to £170 million annually. But the last two years alone saw nearly £1 billion handed back, signalling growing strain within the NHS dental system.
In 2024–25, about £450 million (C$818 million) was returned, following nearly £480 million (C$873 million) the previous year. In both years, more than 40 per cent of dentists had to repay funds.
The findings highlight mounting pressure within NHS dentistry, where many dentists are increasingly shifting toward private care, which can be more financially viable.
Related: Dentists in England to be paid more to expand access to urgent NHS dental care
Despite record levels of funding allocated to NHS dentistry, access remains a major challenge. Surveys suggest more than one in five people report being unable to obtain dental care when needed.
The Competition and Markets Authority (CMA) has also launched a study into private dentistry, examining treatment costs and whether patients are receiving clear information when deciding between NHS and private care.
“We’re concerned many may be uncertain about costs, availability, treatment options and what they’re entitled to,” the regulator said.
Private dental fees have risen by as much as 22 per cent between 2022 and 2024, the CMA added.
Related: British Dental Association slams inquiry call into private dentistry