Primary care trusts (PCTs) award dental providers an annual contract value, payable in equal monthly instalments, in return for an agreed level of service. A PCT can subsequently reduce that contract value only with the agreement of the dental provider or if the agreed service levels are not delivered by the provider. The commissioning of any additional service levels over and above the original contract value is at the discretion of the PCT. The department does not monitor service and contract discussions between PCTs and individual dental providers. PCTs, as the commissioning bodies, are responsible for the management of dental services locally.