A UDA is a “Unit of Dental Activity” undertaken by an NHS dentist.
A UDA depends on the type of work undertaken. A dentist is contracted by his PCT (Primary Care Trust) to do a set number of UDAs and dentists have to be within 4% of their targets. If dentists don’t achieve their contracted number of UDAs they are financially penalised by their PCT. If dentists do more than their contracted number of UDAs they don’t get paid any more.
The 3 Band System
This determines what patients pay and the amount of UDAs a dentist gets.
• Band 1 excluding urgent treatment – 1 UDA
• Band 1 urgent treatment only – 1.2 UDAs
• Band 2 – 3 UDAs
• Band 3 – 12 UDAs
• Issue of prescription – 0.75 UDA
• Repair of dental appliance (denture) – 1 UDA
• Repair of dental appliance (bridge) – 1.2 UDAs
• Removal of stitches – 1 UDA
• Stopping bleeding – 1.2 UDAs
Band 1
Diagnosis, treatment planning and maintenance
Examination, x-rays, scale and polish, preventative work, for example an assessment of a patient’s oral health, minor changes to dentures.
Band 2
Treatment
Simple treatment, for example fillings (including root canal treatment), extractions and periodontal (gum) treatment.
Band 3
Complex treatment that includes a lab element, for example bridges, crowns and dentures (excludes mouth guards).
Urgent treatment
Examination, x-rays, dressings. Re-cementing crowns which have become loose, up to two extractions and one filling.
A UDA is variable, one UDA might be worth anywhere between £15 and £25, but can be more than this or less. The actual UDA varies according to where in the country a dentist is located (although it might vary street to street) and the amount of work previously carried out by the dentist before the new contract. It is thought that the more desperate a PCT is for NHS dentists, the more a UDA might be worth.
What does this mean for the dentist?
Example – One Crown
A dentist is allocated 12 UDAs for doing a crown. So if the UDA is valued at £25 it means a dentist is paid £300 for doing one crown (£25 x 12 UDAs). If a dentist does 2 or 3, or more crowns he still only gets paid £300 even though he has a lot more lab work to pay for.
Example – Several fillings, x-rays, scale and polish
A dentist is allocated 3 UDAs for doing the above work, so a dentist is paid £75 (£25 x 3 UDAs).
Example – One filling
A dentist is allocated 3 UDAs for one filling, so a dentist is paid £75 (£25 x 3 UDAs)
Example – One extraction
A dentist is allocated 3 UDAs for one extraction, so a dentist is paid £75 (£25 x 3 UDAs)
Example – Root filling (a complex and time consuming process to do properly)
A root filling might take 1-2 hours or more. A dentist is allocated 3 UDAs for a root filling so a dentist is paid £75 (£25 x 3 UDAs)
So as you can see from the above there is a problem. There is no incentive to do a root filling when a dentist gets paid the same for an extraction.
Well at least now I fully understand why I always go back to my home country when I need to see a dentist! This is absolutely ridiculous.
How about we let Dentists pick up the whole tab for their training if they are not going to work positively with the NHS?
Well Mark maybe you should pay back the cost of your education to! oh yes and the Bankers, accountants, Lawyers, Entreperneurs, not forgetting the politicians. Of course dentists pay for their education they pay TAX like all of us! second thoughts perhaps you should be asking for a refund as your education was obviously flawed or at least lacking!
Dentists are under paid and undervalued, unless you are in pain when you expect immediate treatment! if we continue to pay them through this flawed UDA system only the good ones will only work privately and NHS customers will be reliant on imported overseas trained denitists, after all as with most things in life “you get what you pay for”
Oh and before you ask! no I am not a dentist or even in the industry! I am just a patient, my last word is clean you teeth and value them!
Well Mark are you exposed to Hepatitis B, Hepatitis C or HIV in your job…..Dentists are definitely underpaid and the public should have more respect for them.
Well guys, it’s always been insulting to me (as being a foreigner) when someone says “imported overseas trained dentists”. I do not see any difference if the dentist is local or not. It a a problem for UK that local dentist choose to go to Australia (because of the bad climate in UK) or somewhere else and choose NOT to work in here.
Dentists are generally underpaid I agree, but this doesn’t mean we should blame the foreigners.
I also understand that EU is not very popular in Great Britain, but is it a fact. British dentists go somewhere out of Britain and other EU citizens come here. At the end is all about patients good.
I’m sure nobody wants to follow USA dentist health system.
I am actually a dentist , one of the ” imported ones” and i work for NHS…i had a patient who needed 20 fillings, 4 root canals treatments and 2 extractions,,the amount of work took me 4 months with long appointments to be finished. At the end i have been paid 3 udas, equivalent to 28 pounds..so for eatch item just over 1 pound..i wonder if any decent professional would accept in a ” high living standards” country as UK to be paid like that..NHS system is a disgrace..
Where is the incentive to do all that work for so little reward?
The NHS’s new contract is a joke, it’s only a matter of time before it all breaks down to chaos. I always wanted to come work in UK when I graduate from dental school, but seeing how this is progressing I’m having second thoughts. Oh, well.
I have a question to ZOITA: Couldn’t you just label each filling, extraction etc as an OWN TREATMENT and thus be paid for each and every thing you did? I mean you could schedule each extraction at different dates and label them each as a separate treatment?
dentist 2b that under the current rules would be fraudulent. any treatment required diagnosed at the initial planning appointment has to be completed before that course or episode of treatment can be closed. thus you get the farcical situation where a dentist gets paid the same to do a small filling in a small tooth taking 15 mins, as doing long protracted risky complex treatments on many teeth over many months.
Thats like saying to a lawyer he’ll get paid the same to write a simple will, as representing someone in a complex lengthy corporate antitrust case- not going to happen
or asking a doctor to accept the same payment for writing a prescription, and performing an amputation- unlikely
or asking an engineer to accept the same for designing a portaloo and a 6 pillar suspension bridge- dreaming
the current system is a cynical ploy by the government to drive conscientious dentists into the private sector in order to survive, making them look greedy, at the same time maintaining that they are committed to NHS dentistry.
My 13 year old son needs to be referred to an orthodontist he has too many lower teeth and an over bite…how will this impact on my NHS dentist financially?
Thankfully in Scotland we still have a “fee per item” system that works well.
how are UDAs valued?
Hi Pete, i am actually a dentist. UDA values vary around the country greatly. Normally ranging from £15-£32 per UDA. This value is calculated primarily on the previous years contract, for instance if you meet your targets your value is maintained, if you however dont meet your targets at the end of the year, value might drop. For instance, a new practice that has a new contract, due to them having no previous history- will be offered in most situations a lower UDA value compared to neighbouring dentists. The UDA value is very flawed, but it is swings and roundabouts as has been said many times. You may as a dentist get paid £75 for a small filling which takes you 10minutes, but moreover there will be times where you will get paid £75 for work that takes you 4 months as Zoita previously mentioned. The system will hopefully be changed, to a capitation scheme, where dentists are renumerated for the total number of patients they see and the quality of their work.
I personally think the system is very flawed, its like saying to a car salesman to charge a nissan and a porsche for the same price. Everyone will think that is absolutely absurd, yet they do exactly that in nhs dentistry. To be honest, I had a very misguided view of dentistry in the past, thinking all dentists rip you off and just want to make a profit. When in reality that’s not the case, and the nhs prioritize very little money towards this field because they don’t regard it to be very important, and in all honesty much of the population in the UK care very little for their oral health, and don’t see it as a cause of concern until their teeth start to fall out.
Just been informed that my son now has to wait 8 months to see an orthodontist at the local hospital his dentist has said that’s ok with him…I’m fuming he’s having pains in his teeth due to the fact that he’s got too many!!
From their own published figures, the NHS can be seen to pay a gross of £31.00 per head of population per year for general dentistry in England – the high street dentists in other words. By the time the patient’s contribution is clawed back, the figure is just £22 for each and every one of you FOR A WHOLE YEAR.
Given that a dental surgery has both a dentist and a nurse to pay as well as a load of very expensive equipment and materials, is it any surprise that it’s over £100 an hour for the facility? A country solicitor with a lot lower overheads charges £200 an hour and even some car garages are charging £100 for an hour’s workshop time.
So…. just how much do you think you’ll get for your miserable £20 each year at the dentist?
The government should stop lying to the public with promises of full line, top class dentistry for all under the NHS if it only wants to pay £20 for it.
Somebody could tell me please where(on the Net) can I find detailed info about the most recent guidelines for dentist reimbursments in the NHS system. Thanks !