# Understanding UDA Values and NHS Orthodontic Contracts in 2026 Publisher: Virtual Consultant Online Author: Virtual Consultant Online Published: 2026-10-07 Updated: 0001-01-01 Canonical URL: https://virtualconsultant.online/blog/understanding-uda-values-nhs-orthodontic-contracts-2026 Citation metadata: https://virtualconsultant.online/citation.json?url=https%3A%2F%2Fvirtualconsultant.online%2Fblog%2Funderstanding-uda-values-nhs-orthodontic-contracts-2026 If you run an NHS orthodontic contract, or are thinking of taking one on, the first thing to know is a point of terminology that catches many practice owners out: orthodontic activity is counted in Units of Orthodontic Activity (UOAs), not Units of Dental Activity (UDAs) . UDAs measure general dental services such as examinations, fillings and extractions. UOAs measure orthodontic assessments and courses of treatment. People search for "UDA orthodontics UK 2026" because the two terms are used loosely, but the contract mechanics, the claim form and the performance management are different. This guide explains how NHS orthodontic contract units work in England, what the "value" of a unit really means, and which numbers a practice should track every month to stay on the right side of its contract. Key takeaway An NHS orthodontic contract in England is a promise to deliver an agreed number of UOAs in a contract year for an agreed annual contract value. The value per unit is simply the contract value divided by the units, and it differs from contract to contract. The commercial risk sits in the gap between units contracted and units delivered, so the practices that run these contracts well treat UOA delivery as a monthly management number, not a year-end surprise. ## UDA and UOA: what is the difference? A UDA is a unit used to measure general dental activity under an NHS dental contract; a UOA is the equivalent unit for orthodontic activity. Both systems came from the contract reforms introduced in England in April 2006, under the National Health Service (General Dental Services Contracts) Regulations 2005 and the matching Personal Dental Services arrangements. Under those arrangements, a contract holder agrees to deliver a number of units and is paid an annual contract value in return, rather than being paid item by item. UDA UOA Measures General dental activity (check-ups, restorations, extractions and so on) Orthodontic assessments, treatment starts and completions Claim form FP17 FP17O Patient charge Three bands, set nationally Band 3 charge for adults who qualify; free for under-18s Who qualifies Anyone needing necessary dental care Patients with a clinical need, assessed using the Index of Orthodontic Treatment Need (IOTN) Typical contract holder General dental practice Specialist orthodontic practice, or a general practice with an orthodontic element The practical consequence is that advice written for general dental contracts, including much of what is published about UDA values and clawback, cannot simply be copied across. The unit weightings, the claim timing and the patient pathway are specific to orthodontics. The exact UOA weightings for assessments, appliance placement and completed treatment are set out in the national regulations and NHS Business Services Authority (NHS BSA) guidance, and they are worth reading directly rather than relying on a second-hand summary. ## How does an NHS orthodontic contract work? An NHS orthodontic contract fixes three numbers: an annual contract value, an annual UOA target, and the contract term. Divide the first by the second and you have the contract's value per UOA, sometimes called the UDA value in loose usage. Two practices doing identical clinical work can have very different values per unit, because contract values were set from historical baselines and not from a single national price. Contract value: the annual payment, normally made in monthly instalments regardless of how many units were delivered that month. Unit target: the number of UOAs the contract expects the practice to deliver in the year. Performance reconciliation: after the year ends, delivered units are compared with the target. Under-delivery beyond the tolerance set in the contract or current NHS England guidance can lead to money being recovered. The long-standing tolerance was 96 percent of the target, but thresholds have been varied since the pandemic, so check the current arrangement for your own contract rather than assuming. Patient charges: where an adult patient pays a Band 3 charge, it is collected by the practice and accounted for against the contract; under-18s receive NHS orthodontic treatment free where they meet the clinical need criteria. Commissioning has also moved. From 1 April 2023, responsibility for commissioning NHS dental services in England was delegated from NHS England to integrated care boards (ICBs), so your day-to-day contact for contract variation, activity queries and funding is now usually your local ICB or the regional NHS England team acting for it. New or re-procured NHS healthcare contracts are awarded under the Provider Selection Regime, which has applied since 1 January 2024, rather than the older public procurement rules. ## What is the value of a UOA, and why does it vary? The value of a unit is the contract value divided by the contracted units, and it is not a national tariff. That is the single most misunderstood point. A practice cannot look up "the UOA rate" because there is no single rate. The figure that matters is the one in your own contract, and it is the lens through which you should judge whether a particular case, an extra clinic session or an extra associate is worth taking on for NHS work. Important The worked example below uses invented round numbers purely to show the arithmetic. It is not a statement of any real contract value or national rate. Always use the figures from your own contract and your own NHS BSA reports. Suppose a hypothetical contract is worth £600,000 a year for 6,000 UOAs. The value per unit is £100. If the practice delivers 5,700 UOAs, that is 95 percent of target. Depending on the tolerance applicable to that contract, the unfilled units could expose the practice to recovery of the funding attached to the shortfall. If the practice delivers 6,000 units with the same clinical team, the same overheads and the same contract income, the margin on every extra case in the year comes from using capacity fully, not from a higher price. ## Which numbers should an NHS orthodontic practice track? The most useful management numbers are units delivered against a monthly profile, completions waiting to be claimed, and treatment duration against plan. A year-end reconciliation is far too late to correct a shortfall, because orthodontic treatment takes 12 to 24 months for most fixed appliance cases, so the units you can deliver this year are largely determined by the cases you started and managed in the previous 18 months. 12-24 months Typical length of fixed brace treatment cited by the NHS, which is why unit delivery lags clinical activity 1 April Start of the NHS contract year in England, the point from which delivered units are counted FP17O The orthodontic claim form submitted to NHS BSA for each assessment and course of treatment Units delivered year to date against a straight-line or seasonality-adjusted profile: if you are on 40 percent at month five of twelve, you need to know now, not in March. Claims submitted versus claims accepted: a rejected or unsubmitted FP17O is delivered work that does not count. Track rejections and clear them within the month. Completions due: cases in the final stages whose debond and retention claim will move the number, and which patients are overdue because of missed appointments. Did-not-attend and failed-to-attend rates by clinic: missed appointments lengthen treatment and push completions into the next contract year. Starts per month: the leading indicator for next year. If starts have dropped, next year's delivery will fall even if this year looks healthy. Referral to assessment waiting time: long waits cost goodwill with referring dentists and increase inappropriate re-referrals. Our guide to orthodontic practice KPIs covers the wider dashboard, and using practice analytics to grow shows how to move from monthly spreadsheets to a live view. Pre-screen NHS referrals before they take a clinic slot A large share of NHS capacity is spent assessing patients who turn out not to meet the clinical threshold. Giving enquirers a transparent, IOTN-based indication of whether they are likely to qualify, before they book, protects assessment slots for patients who can be treated. See how an online assessment works → ## Why does patient eligibility matter so much to contract performance? NHS orthodontic treatment is funded only where there is a clinical need, assessed with the Index of Orthodontic Treatment Need, so every assessment slot used on a patient who will not qualify is capacity that does not generate units. The IOTN grades dental health from 1 to 5, and the NHS normally funds treatment for patients at the higher grades, with grade 3 cases decided using the aesthetic component. If you are unfamiliar with how the scoring works, see our explainer on what an IOTN score is , and the public IOTN score checker that patients can use to understand their likely outcome. NHS-funded pathway fits when The patient is under 18 and has an IOTN indication that meets the NHS threshold The referral comes from a dentist with clear clinical findings The patient and family can commit to the 12 to 24 month treatment and regular appointments Private pathway fits when The patient is an adult without an exceptional clinical need The IOTN grade falls below the NHS funding threshold The patient wants an option such as clear aligners or lingual braces that the NHS does not routinely fund Handled well, the private pathway is not a lost patient but a second route. Patients who do not qualify need a clear, kind explanation and a transparent private quote, and they are far more likely to take it if they have already seen the options. Our article on NHS waiting lists and private orthodontics sets out the patient's side of that conversation. ## How should a practice protect unit delivery through the year? ### Build a monthly delivery profile Take the annual target, adjust for the months you expect to be quieter (school holidays and summer leave tend to affect child attendance), and chart actual units against that profile every month. A profile turns a vague worry into a number and a date. ### Close the loop on claims Every course of treatment generates paperwork, and every missed or rejected FP17O is delivered work that does not count. Allocate one named person to check claim status weekly, and make it part of the debond or completion checklist so claims are submitted the same week. ### Manage the waiting list actively Waiting lists are both an asset and a risk. A healthy list guarantees starts, but a list nobody reviews drifts, with patients who have moved, lost interest or been treated elsewhere still counting as demand. Regular contact keeps the list accurate, and our guide to orthodontic waiting list management sets out a practical routine. ### Reduce preventable attrition Patients who stop attending leave treatment half finished, which means units that cannot be completed. Reminders, clear expectations at consent and flexible appointment times all help. For the private side of the same problem, see orthodontic patient dropout . ## What should you check before bidding for or renewing a contract? The contract value, unit target and implied value per unit, compared with your realistic capacity of clinical sessions, chairs and treatment coordinator time. The contract term, break clauses and how performance is reviewed. The commissioner's expectations on waiting times, access and reporting, which are set locally. How your team will record and submit FP17O claims, and who owns the process. Your plan for patients who are referred but do not qualify, so assessment capacity is not wasted. Contract rules and commissioning arrangements change, sometimes at short notice, so treat any summary, including this one, as a starting point and confirm the current position with your commissioner, NHS BSA and your professional body. The British Orthodontic Society publishes information for members on commissioning and contract matters. See the patient side of your NHS and private pathways Virtual Consultant Online gives patients a clear, transparent first assessment and a quote before they ever call your practice, so more of your assessment time goes to patients who are ready to proceed. Try the online assessment → ## FAQs ### What is the difference between a UDA and a UOA in orthodontics? A UDA (Unit of Dental Activity) measures general dental services, while a UOA (Unit of Orthodontic Activity) measures orthodontic assessments and courses of treatment. Orthodontic contracts in England use UOAs and the FP17O claim form. Advice written for UDA contracts cannot be applied directly to an orthodontic contract. ### How is the value of a UOA calculated? It is the annual contract value divided by the contracted number of UOAs. There is no single national price per unit, so the value differs between contracts, depending on the historical baseline on which each contract was set. ### What happens if an orthodontic practice under-delivers its contracted UOAs? Delivery is reconciled after the contract year. Under-delivery beyond the tolerance applicable to the contract can lead to funding being recovered by the commissioner. The long-standing tolerance was 96 percent, but it has been varied in recent years, so confirm the current position with your commissioner. ### Who commissions NHS orthodontic services in 2026? In England, commissioning of dental services was delegated from NHS England to integrated care boards from 1 April 2023. Your local ICB, or the regional NHS England team acting for it, is normally your point of contact for contract queries. ### Who is eligible for NHS orthodontic treatment? Eligibility depends on clinical need assessed with the Index of Orthodontic Treatment Need (IOTN). Under-18s who meet the clinical threshold receive NHS treatment free, and adults are treated only where there is a clear clinical need and pay a Band 3 charge. ### Which numbers should a practice track to stay on target? Track units delivered against a monthly profile, claims submitted and accepted, completions due, missed appointment rates, and monthly treatment starts. Starts are the leading indicator for next year, because most treatment runs 12 to 24 months. ### How do contracts get awarded now? New or re-procured NHS healthcare contracts in England are awarded under the Provider Selection Regime, which has applied since 1 January 2024, rather than the older public procurement rules. Local commissioners set the specific requirements and timetable. ### What is the difference between a UDA and a UOA in orthodontics? A UDA (Unit of Dental Activity) measures general dental services, while a UOA (Unit of Orthodontic Activity) measures orthodontic assessments and courses of treatment. Orthodontic contracts in England use UOAs and the FP17O claim form. Advice written for UDA contracts cannot be applied directly to an orthodontic contract. ### How is the value of a UOA calculated? It is the annual contract value divided by the contracted number of UOAs. There is no single national price per unit, so the value differs between contracts, depending on the historical baseline on which each contract was set. ### What happens if an orthodontic practice under-delivers its contracted UOAs? Delivery is reconciled after the contract year. Under-delivery beyond the tolerance applicable to the contract can lead to funding being recovered by the commissioner. The long-standing tolerance was 96 percent, but it has been varied in recent years, so confirm the current position with your commissioner. ### Who commissions NHS orthodontic services in 2026? In England, commissioning of dental services was delegated from NHS England to integrated care boards from 1 April 2023. Your local ICB, or the regional NHS England team acting for it, is normally your point of contact for contract queries. ### Who is eligible for NHS orthodontic treatment? Eligibility depends on clinical need assessed with the Index of Orthodontic Treatment Need (IOTN). Under-18s who meet the clinical threshold receive NHS treatment free, and adults are treated only where there is a clear clinical need and pay a Band 3 charge. ### Which numbers should a practice track to stay on target? Track units delivered against a monthly profile, claims submitted and accepted, completions due, missed appointment rates, and monthly treatment starts. Starts are the leading indicator for next year, because most treatment runs 12 to 24 months. ### How do contracts get awarded now? New or re-procured NHS healthcare contracts in England are awarded under the Provider Selection Regime, which has applied since 1 January 2024, rather than the older public procurement rules. Local commissioners set the specific requirements and timetable. ## References - NHS Business Services Authority - Dental services (https://www.nhsbsa.nhs.uk/nhs-dental-services) - NHS BSA guidance on dental claims, forms (including the FP17O orthodontic claim form) and how activity is recorded and reported. - The National Health Service (General Dental Services Contracts) Regulations 2005 (https://www.legislation.gov.uk/uksi/2005/3361/contents) - The regulations underpinning the 2006 General Dental Services contract in England, including contract and activity provisions. - NHS - Orthodontic treatment (https://www.nhs.uk/conditions/orthodontics/) - NHS patient information on who can receive NHS orthodontic treatment and how long treatment typically takes. - British Orthodontic Society (https://www.bos.org.uk/) - The professional body for orthodontists in the UK, publishing information on NHS orthodontic commissioning and practice. - NHS Business Services Authority - Dental services (https://www.nhsbsa.nhs.uk/nhs-dental-services) - NHS BSA guidance on dental claims, forms (including the FP17O orthodontic claim form) and how activity is recorded and reported. - The National Health Service (General Dental Services Contracts) Regulations 2005 (https://www.legislation.gov.uk/uksi/2005/3361/contents) - The regulations underpinning the 2006 General Dental Services contract in England, including contract and activity provisions. - NHS - Orthodontic treatment (https://www.nhs.uk/conditions/orthodontics/) - NHS patient information on who can receive NHS orthodontic treatment and how long treatment typically takes. - British Orthodontic Society (https://www.bos.org.uk/) - The professional body for orthodontists in the UK, publishing information on NHS orthodontic commissioning and practice.