From ambition to action: seizing the moment for NHS dentistry

From ambition to action: seizing the moment for NHS dentistry

For the first time in decades, we have a national dental plan that moves beyond rhetoric and dares to imagine a different future – one in which oral health is not a footnote, but a frontline priority.

The publication of England’s Ten-Year Health Plan is more than a policy milestone. That it includes dentistry is a long-overdue acknowledgment that oral health is health – and that dentistry has a critical role to play in prevention, equity, and the wider population health agenda. It gives us, at last, permission to do dentistry differently.

But let’s be clear: the plan is a framework, not a finish line. Delivery will not come from Whitehall. It will come from the decisions made daily by integrated care boards (ICBs), neighbourhood leaders and providers on the ground. That’s where the NHS Confederation’s role becomes pivotal – in helping turn ambition into action, and policy into public value.

The shift didn’t happen overnight

This moment has been years in the making – the result of persistent advocacy, credible policy papers and many quiet conversations across the system. But it is also a reflection of a recent and important change: the tangible interest and influence of the NHS Confederation in championing oral health as part of the wider reform movement. That signal – from one of the most respected national voices in system leadership – has given permission, political weight and renewed energy to what many of us have been working toward for years.

The challenge ahead

The plan sets the right tone: it calls for novel contracting models, opens the door to new providers and urges targeted investment based on need – not history. It aligns with broader NHS aims around prevention-first care, tackling inequalities and using workforce differently.

But implementation will be tough

Many ICBs are still finding their feet with dental commissioning. The infrastructure to support contracting reform is fragile. And in a system scarred by workforce shortages, financial pressures and years of under-delivery, there is a real risk that change will be cautious – and slow.  We cannot afford either.

The Ten-Year Health Plan doesn’t just describe what should change; it creates space for it to happen.

Dental access remains a top issue for the public, and the current model fails to deliver at the pace or scale required. Communities need care – now. And what’s more, the second-order dividends of dental reform are vast: from reducing pressure on GPs and A&E to improving school readiness, employability and healthy ageing. Oral health is not just a cost centre, it’s a lever for system efficiency and economic resilience.

What the plan enables – and what the NHS Confederation can champion

The Ten-Year Health Plan doesn’t just describe what should change; it creates space for it to happen. It gives integrated care systems (ICSs) the permission to commission creatively – to move away from activity-based contracts to outcome metrics of real value to individuals, as well as improving population health, to embed oral health in place-based prevention strategies and promote an integrated dental care workforce that feels like it is part of the NHS not a second order sub-contractor. It signals support for multi-professional, team-based care, and makes clear that new market entrants – including social enterprises, primary care networks, and integrated providers – are not only welcome but needed.

Now is the time for NHS Confederation to lead from the front, supporting ICSs to:

• prioritise oral health in integrated strategies and neighbourhood delivery plans
• shift ambition and investment towards dental contracting models that deliver outcomes, not just activity
• enable innovation at pace, by spotlighting high-performing systems and spreading what works
• convene system leaders to build confidence and capability in commissioning for impact.

What next?

The vision is there. The mandate is there. The real question is how fast and how boldly we can move from plan to practice.

The NHS Confederation is uniquely placed to drive this – not only by advocating for national enablers (like flexible contracts and data reform), but by coaching, convening and challenging systems to act with urgency and ambition.

This is a once-in-a-generation chance to rebuild public trust, close long-standing gaps in care, and make dental care providers true partners in health system reform. Let’s not waste it.

Sara Hurley CBE is former chief dental officer for England.