What your NHS dental practice is worth changed on 1 April, and £62.50 decides which way

If you are thinking about selling an NHS practice, start with the thing a buyer will price: the contract. One slice of it now pays a flat national rate instead of your own UDA rate, and whether that helped you or hurt you comes down to a single division. Seventy five pounds over 1.2. If your UDA value is under £62.50 you are better off than you were in March. If it is over, you are doing mandatory work at a discount.

Start with the money, because that is what gets bought

A buyer is not buying your surgery. They are buying the profit a new owner would keep, and for an NHS practice most of that traces back to one contract. So the question "what is my practice worth" is really "what does my contract now pay, and how hard is it to deliver".

Both halves of that changed on 1 April 2026.

Here is the change in one paragraph. If you hold a mandatory services contract of 100 UDAs or more, you now have to deliver 8.2% of your contract value as unscheduled care. Urgent appointments, in other words. Toothache, abscess, broken tooth. And each of those courses of treatment now pays a flat £75 instead of the old 1.2 UDAs.

Flat. Not 1.2 of your UDA value. Seventy five pounds, the same in Bolton as in Kensington.

That one word does more work than anything else on this page.

If you read £70 somewhere, that was the draft

Quick warning before the arithmetic, because this trips up a lot of what has been written about the reform.

The consultation proposed £70 per course plus a £5 fixed payment. The government changed it in the response published on 16 December 2025: the fixed payment went from £5 to £15, and the activity component came down from £70 to £60.

So the final split is £15 + £60 = £75. Trade coverage published as recently as this month is still quoting the £70 and £5 from the draft. If your figures came from an article rather than the guidance, they are probably wrong, and the split matters more than the total, as you will see in a minute.

Your own number, in about thirty seconds

The requirement is 11 urgent courses of treatment for every £10,000 of contract value, rounded up. NHS England calls that base your Relevant Contract Value.

So take a practice on a £300,000 contract:

• 30 lots of £10,000, so 330 urgent courses of treatment for the year.
• At £75 each, that is £24,750, which is your 8.2%.
• Over a 46 week working year, about seven a week.

Seven urgent appointments a week, every week, or the money comes back off you. Go and do this sum on your own contract value before you read on, because everything below hangs off it.

£62.50 is where a pay rise becomes a pay cut

Now the part that decides whether 1 April was good news for you.

Under the old rules an urgent course of treatment earned 1.2 UDAs, so in cash it was 1.2 multiplied by whatever your practice's UDA value happens to be. The government's own evidence note put the average at £41.

Under the new rules it is £75, full stop.

Divide £75 by 1.2 and you get £62.50. That is your crossover.

• UDA value £30. An urgent course used to pay £36. Now £75. You have slightly more than doubled the money for the same appointment.
• UDA value £45. Used to pay £54. Now £75.
• UDA value £70. Used to pay £84. Now £75. You lose £9 every single time, on work you are now obliged to do.

There is a second way to see it that matters even more for how you run the day. The £75 is converted into UDAs at your own UDA value, so it counts against your target. At a £30 UDA value, one urgent appointment now discharges 2.5 UDAs where it used to discharge 1.2. At £70, it discharges 1.07.

Read that again if you have a low UDA value, because it is the best news your practice has had in years. A twenty minute emergency slot has quietly become the most target efficient thing in the building. Two and a half UDAs for one short appointment, when a full check up gets you one.

And none of this is accidental. The evidence note says the point is to "address the variation in remuneration arising from the variation in indicative UDA value at a practice level". The flattening is the policy, not a side effect.

Only £15 of the £75 is actually yours

Back to that split, because this is where owners are going to get caught.

The £15 is a fixed credit. You get it for every course of treatment you are required to do, paid monthly in equal parts, and NHS England is explicit that fixed credits "will not be subject to financial recovery". On our £300,000 practice that is £4,950 a year, dripping in at £412.50 a month whether the patients turn up or not.

The £60 is an activity credit. You only get that for a course you actually complete.

So of the £24,750 sitting in your 8.2%, £4,950 is safe and £19,800 has to be earned. Four fifths of it is at risk. That is a different kind of money from the contract income you are used to, and it does not behave like a block payment you can plan around in March.

30 September, and why 96% overall will not save you

This is the live date, and it is two months away.

At mid year, covering 1 April to 30 September, your urgent care is reconciled separately from everything else you do. Not blended in. Its own line. Fall below 30% of your required number and your commissioner has to act on it under the regulations.

Then at year end, the urgent number gets its own 96% test. And here is the bit that catches people: if you deliver less than 96% of your required urgent courses, the activity payment on everything you did not deliver is recovered even if your overall contract delivery is at or above 96%, and a breach notice may follow.

Sit with that. You can hit your headline UDA target, do everything you promised in total, and still have money clawed back and a breach notice on your file because the urgent slots did not fill. Over delivering ordinary dentistry does not patch a hole in urgent care any more.

On our £300,000 example:

• Mid year bar: 99 courses by 30 September.
• Year end bar: 317 courses (96% of 330).
• Deliver 300 and you are at 90.9%, so the 30 you missed cost you £1,800 and you may collect a breach notice for it.

Now the trap almost nobody has spotted. The mid year checkpoint asks for 30% of the year after 50% of the year has gone. Clearing it does not mean you are on course. It means you still owe 70% of the year's urgent care in the half that is left. If you are sitting at 99 on 30 September and feeling fine, you need to nearly double your weekly rate from October to March, through winter, through Christmas closures, through staff sickness.

That is a cashflow event with a date on it, and the date is in this quarter.

Go and read your associate agreements

Small job, real money.

If your associates are paid per UDA, the arithmetic under them just moved. An urgent appointment that credited 1.2 UDAs now credits £75 converted at your UDA value, which at a £30 UDA value is 2.5. Your income from that appointment went up, so the split holding steady is fine and fair.

What is not fine is an agreement that names the old number. Plenty of associate contracts specify urgent or unscheduled treatment at 1.2 UDAs, because until April that was simply what it was worth. That clause now describes something that does not exist. Left alone it is an argument waiting to happen, and arguments with associates have a habit of surfacing during a sale, at the worst possible moment, in front of the person writing the cheque.

Fix the wording while it is boring.

What a buyer will ask you for that did not exist last year

Right, the exit question you came here for.

Nothing about this reform changes your multiple on its own. What it changes is the evidence a buyer will want, and evidence is what gets discounted when it is missing.

Expect to be asked for four things that were not on anyone's list a year ago:

• Your Required Number of Urgent Treatments, which is just your contract value arithmetic.
• Your delivery against it, month by month.
• Whether you cleared the 30 September checkpoint.
• Any breach notice, including one earned while your overall delivery looked healthy.

A practice that can produce a clean urgent care record for 2026/27 is selling a contract that visibly works. A practice that cannot is asking a buyer to take the delivery risk on trust, and buyers do not take that on trust, they take it off the price. This is ordinary due diligence material, and the way to win it is to have it ready rather than to explain it.

Then there is the longer point, and it is the one I would actually think hardest about.

For twenty years, the single biggest thing separating a good NHS practice from a poor one was UDA value. Two practices, same contract value, wildly different amounts of chair time to earn it. That gap has been priced into every NHS practice sale since 2006, and it is the reason "what is your UDA rate" is the second question any buyer asks.

The state has now carved out 8.2% of every contract and paid it at one national rate. Not all of it. A slice.

If you are sitting on a low UDA value, the payer just started closing your gap for you, for nothing, and your contract is worth more to own today than it was in March. If you are sitting on a high one, the premium you have been counting on is the thing being levelled, and 8.2% is the first instalment.

Worth running your own numbers on both scenarios before you decide whether this is a year to sell or a year to hold. The valuation calculator and the SDE calculator will tell you what the profit change is actually worth in price terms, which is usually less dramatic and more useful than the noise around it.

One last thing, and it is the uncomfortable structural fact under all of this. An NHS practice is a business with one customer, on terms that customer rewrites, whose payment rules have now changed twice inside a single financial year. That is client concentration in its purest form, and no amount of clean bookkeeping makes it go away. The only real hedge is private and plan income that answers to nobody but you, which is also, conveniently, the income a buyer pays the highest multiple for.