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Clawback: Brace yourself for a double whammy

Practices in England need to prepare, as record breaking clawback levels risk becoming the new normal.

In 2023 we warned that underspends were on track to hit over £400m. NHS England refused to act, and we took the message to the press and to parliament.

Early in this financial year, NHS England changed their tune. They moved the goalposts, a reflection of the scale of the damage facing practices. However, we understand changes to thresholds from 96% to 90% have not taken the edge off.

This was never a reprieve. Historic under delivery has not been written off.

Dealing with this would be hard enough if practices had returned to anything resembling ‘normal.’ But we understand levels of performance for 2023/24 have not significantly improved. There have been no meaningful changes to the system to enhance delivery, or to ease chronic recruitment and retention crises. Certainly, the Government has given no indications it is willing to break from the UDA.

Graph Clawback 2

It means many practices will face a double whammy – making good on last year’s under delivery, while working towards this year’s target, still lightyears from business as usual.

“NHS dentists face a perfect storm,” says Shawn Charlwood. “Underspends are set for record highs once again, while promised ringfences are being torn down.

“Hundreds of millions will be lost from the frontline and practices will be forced out of the NHS. Simply because this government won’t grasp the nettle on reform.”

Starved of funds, raids on these underspends are becoming the norm for Integrated Care Boards (ICBs). Without change we can expect more of the same. However, we have seen evidence that some ICBs are demonstrating flexibility with contract holders. For Extra and Expert members, our advisory team can offer tailored advice for navigating the difficult months ahead. We will keep fighting the corner for all dentists.

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