If you have arrived here looking for the national NHS UDA rate for 2026/27, the most useful thing this page can tell you is that there is not one. There never has been. Every article that quotes a single national figure is quoting something that does not exist, and a practice that budgets on it is budgeting on a number that has nothing to do with its own contract.
What does exist is your contract's own per-UDA value, and that figure is the single most important input into NHS practice finances. This guide explains where it came from, how to find yours, what it buys you in each treatment band, and how the year-end reconciliation turns delivery into cash.
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Why there is no national UDA value
When the current General Dental Services contract came in during 2006, each practice's contract value was not set by a national price list. It was set by looking backwards: the practice's fee income in a historic test year became its annual contract value, and the activity it had delivered in that year became its Units of Dental Activity target. Dividing one by the other produced a per-UDA value unique to that practice, and that figure has simply been uplifted annually ever since.
The consequence is that two practices on the same street, delivering identical dentistry, can hold materially different per-UDA values purely because of what their predecessors billed twenty years ago. Across England, per-UDA values typically range roughly £15 to £45 or more, clustering between £25 and £35. Treat that as a range for context, never as a rate you can apply to your own contract.
Scotland does not use UDAs at all. NHS dentistry there is remunerated through the item-of-service Statement of Dental Remuneration, so none of the UDA mechanics on this page apply to a Scottish practice.
How to find your own per-UDA value
The calculation is simple arithmetic: your annual contract value divided by your contracted annual UDA target. Both numbers appear on your contract, and the current-year figures appear on the schedule issued by NHSBSA or your commissioner. If you hold more than one contract, each one has its own value and they should never be averaged for decision-making.
Our UDA value calculator does that division for you, sets the result against indicative regional benchmark ranges, and shows what the value is worth in real terms after inflation since the year your contract was last signed or restructured. That last figure is often the uncomfortable one, because a contract value uplifted at less than inflation loses purchasing power every year while the delivery target stays the same.
What a UDA actually represents
UDAs are credited by treatment band rather than by time or materials. A Band 1 course of treatment is worth 1 UDA, Band 2 is worth 3 UDAs, Band 3 is worth 12 UDAs, and urgent treatment is worth 1.2 UDAs. The treatment banding rules matter commercially because the clinical cost of delivering a course of treatment varies enormously within a single band, while the UDA credit does not.
This is where the real margin question sits. A Band 2 course of treatment credits 3 UDAs whether it is one simple filling or a long appointment involving several. At a hypothetical £28 per UDA, chosen only because it sits inside the observed England cluster and not because it is your rate, that course is worth £84 of contract value regardless of how long the chair is occupied.
Patient charges are not extra income
One of the most persistent misunderstandings in NHS practice finance is the treatment of patient charges. They do not sit on top of the contract value. They count towards it, so the money a patient pays at reception reduces what the commissioner pays the practice rather than adding to it.
| Band | UDAs credited | England patient charge from 1 Apr 2026 | Charge from 1 Apr 2025 |
|---|---|---|---|
| Band 1 | 1 | £27.90 | £27.40 |
| Band 2 | 3 | £76.60 | £75.30 |
| Band 3 | 12 | £332.10 | £326.70 |
| Urgent | 1.2 | £27.90 | £27.40 |
These charges are uplifted each April, so date-tag them in any model you build. The practical effect of the towards-not-on-top rule is that a change in your exempt patient mix changes your cash collection profile and your bad debt exposure, but not your total NHS income.
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Year-end reconciliation: carry-forward, clawback and tolerance
The contract pays in smooth monthly instalments against an annual activity target, and delivery is reconciled at a mid-year review and again at year end. In England the settlement rules are precise, and the widespread belief that any shortfall is clawed back is wrong.
- 96% to 100% delivery. The shortfall is carried forward into the next contractual year's requirements. It is not recovered as cash. You make the units up the following year.
- Below 96% delivery. The commissioner recovers the overpayment for the activity that was not delivered. 96% is the genuine clawback line.
- Over-delivery. The commissioner may pay for delivery up to a 102% tolerance, up to 104% for activity under pre-approved oral health programmes, and in some cases up to 110% by prior agreement where resources allow. This is discretionary, so never bank it in a forecast.
The two outcomes have different accounting consequences and should never be blended. A clawback below 96% is an accrued liability that reduces income and takes cash out. A carry-forward between 96% and 100% takes no cash, but it loads next year with a heavier delivery target on the same contract value, which is a going-concern and capacity point rather than a balance-sheet one.
From 1 April 2026, Band 1 standalone fluoride-varnish and Band 1 urgent UDA credits count towards contract delivery, so they feed into both the mid-year and the year-end reconciliation. The wider April 2026 quality and payment reforms are being phased in, and the sensible planning assumption is that the UDA mechanism continues with incremental change rather than being replaced.
What this means for associates
An associate on a UDA-based agreement is typically paid an agreed percentage of the per-UDA value of the contract they deliver against. Because that value is contract-specific, the headline percentage in an agreement tells you very little on its own. A higher percentage of a low-value contract can pay less than a lower percentage of a high-value one.
Before signing, ask for the practice's actual per-UDA value in writing, and ask how the reconciliation risk is shared if the contract under-delivers. Those two answers, together with your target, are what determine your income. From there the position feeds into your tax planning as a self-employed associate, including your payments on account and your NHS pensionable earnings.
Modelling the year ahead
Sound planning starts with your own numbers rather than a benchmark. Take your contract value and target, calculate your effective per-UDA value, then look at your last three years of delivery against target month by month. A practice that has repeatedly landed between 96% and 100% is carrying a compounding delivery obligation, not a clean run.
Model the downside explicitly. Work out what a 10% drop in delivery does to your position: whether it takes you below the 96% line, what the cash recovery would be, and whether your reserves cover it. Then model the recruitment gap scenario, because a vacant surgery for a quarter is the most common route to a shortfall.
If an exit is on the horizon, remember that the contract transfers by novation with commissioner consent on an asset sale, and some commissioners treat the sale as an opportunity to revisit contract value. That risk belongs in your acquisition due diligence on either side of a deal, and a deal should be priced on the contract as it stands rather than on assumed reform upside.
Beyond the UDA value
The per-UDA value sets your NHS income, but it does not settle whether NHS work is profitable for you. That depends on how much chair time each UDA consumes in your hands, your materials and laboratory costs, and the administrative load the contract carries. Two practices with the same per-UDA value can sit on opposite sides of break-even.
This is the real question behind the NHS and private mix decision, and it is answered with your own cost per chair hour rather than with a sector average. Many practices land on NHS work as a predictable income floor with private revenue carrying the margin, but that balance is specific to the practice.
If you want a second pair of eyes on your contract economics, contact our team and we will introduce you to a specialist dental accountant from our partner network who can work through the numbers with you.