NHS dental services in England are provided by dental practitioners under contract to deliver general care and treatment. Dental contractor fraud concerns the fraudulent claims submitted to the NHS by dentists and their staff members for a range of NHS services provided to patients.
The amount financially vulnerable to fraud bribery and corruption in this thematic area has seen a decrease, which can be attributed to a reduction in contracted Units of Dental Activity (UDAs), expenditure for General Dental Services (GDS) and contract providers.
£57.6m
vulnerable from an expenditure of £3.06 billion
Strategic intelligence picture
Dental practices submitting false claims for exempt patients remains a probable threat in this thematic area. Potentially enabled by staff accessing patient records on the practice specific system, submitting false claims and falsifying exemption forms.
The manipulation of activity data through altering Units of Dental Activity (UDAs) and patient data to secure additional funding is likely. For example, overcharging NHS patients or splitting courses of treatment to submit multiple claims to the NHS.
In order to boost revenue, it is possible for a contractor at a dental practice to falsely claim for mouthguards that are not necessary and were never fitted to patients. Additionally, a dentist could potentially claim for dental procedures which were not undertaken to claim the maximum of 5 units of dental activity. Dental contractors may also generate false claims to the NHS, where the patient has paid privately, to claim a double income.
It is a realistic possibility that dental practices may onboard NHS patients with the intent of receiving payment but not offering appointments. From March 2024, the government introduced the ‘new patient premium’ to deliver additional dental appointments, where extra payments are made for seeing new NHS patients. Therefore, a dental practice could recruit NHS patients, offer NHS appointments and then cancel them last minute, but continue to take on private work.
At present, overseas dentists are required to pass an exam before they can start work in the UK. However, currently there is the potential for contractors to employ overseas dentists and allow them to treat patients without the relevant training or qualifications.
Dentists within a hospital may be able to manipulate data to claim extra payments. Trusts may also restrict the flow of patients through the service by insisting every patient is seen by a consultant at each stage. Resulting in overtime payments and waiting list initiative payments for reducing the backlog created.
Dental contractors carrying out unnecessary treatments also remain likely in this area. Dental contractors could perform unnecessary dental work to claim for treatments in a higher banding. This could be enabled by contractors having the authority over what treatment a patient needs, enabling them to undertake false treatments and manipulating the patients’ record on the system.
Information reports received for dental contractor fraud
The change in the number of fraud reports received in relation to Dental contractor fraud from 2020 - 2021 to 2024 - 2025 is illustrated in the below chart:
| 2020 - 2021 | 2021 - 2022 | 2022 - 2023 | 2023 - 2024 | 2024 - 2025 |
|---|---|---|---|---|
| 2020 - 202191 | 2021 - 202285 | 2022 - 202374 | 2023 - 202463 | 2024 - 202574 |
Horizon scanning
Under the dental recovery plan dentists will be offered a ‘new patient’ payment with the aim of creating more than 2.5 million NHS appointments. Under the plan the minimum Units of Dental Activity (UDA) rate will be implemented, with the ambition of making NHS work more attractive and sustainable.
With the limited access to NHS dentistry, mobile dentistry vans were introduced to visit rural and coastal communities known as “dental deserts”, areas where patients struggle to access NHS dentists. It is possible that as mobile dentistry is rolled out more, it could attract fraudulent activity by the contractors, using the popularity, numbers and limited supervision to create false claims.