Iain Stevenson, Head of Dental at Wesleyan Financial Services, shares the big topics that were discussed at the British Dental Conference and Dentistry Show 2023...
National gatherings of dentists and dental specialist providers from across the UK can tease out trends and key topics that grip the profession, and this year’s Dentistry Show was no exception.
Here’s a breakdown of the key talking points:
Is there a future in NHS dentistry?
It’s a subject that splits many, with stalwart advocates of the NHS convinced that not only is the NHS still viable but essential to the UK’s oral health.
The detractors on the other hand are disillusioned with the NHS contract as it currently stands due to what they perceive to be limitations on the quality of dental care they provide for their patients, as well as the underfunding of the service resulting in poor remuneration for their efforts.
The crux of the issue and the resulting sentiment of the profession was neatly summarised by Len D’Cruz, mixed NHS and private practice owner and dento-legal advisor at BDA Indemnity, who stated: "The question isn’t really whether there is a future in NHS dentistry, but should there be? And there should. There’s no doubt that there is a significant proportion of people in this country who cannot afford private dentistry – the working poor and people who are exempt.
"The next questions would then be how does the NHS currently operate and how should it operate to support these members of society and set fair expectations for dentists operating under the service? We know the system and contract are fundamentally flawed and we need a solution from the Government."
Topping up NHS fees
Somewhat related but hotly debated across the industry was a judgment on the GDC versus Williams court appeal in May. In it, the Court of Appeal confirmed that “top-up” private fees in addition to NHS treatment were permitted by NHS regulations.
The debate centered around what this means for NHS dentistry moving forwards. On the one hand, the GDC and BDA suggest in their press release that the ruling was specific to the treatment provided in this particular case*. On the other, the courts haven’t suggested any limitations to this ruling either – potentially opening the door to a wider range of NHS treatments being viable for private top-ups. Further clarity is clearly needed from governing bodies.
The potential wider impact of the mass use of private top-up fees is monumental and potentially an issue for NHS England, where this hasn’t been accounted for in the budget. Could this spur more urgency for the Government to introduce real change when it comes to NHS contract reform? And, if so, how will the profession respond after having the contract slowly tinkered with to suddenly being fast-tracked for reform once the Government has a financial stake in how NHS dentistry operates?
Alternatively, NHS England may simply shut down top-up fees by changing the regulations. Some would argue that flies in the face of the Appeal Court ruling that expressed the importance of patient choice.
The rise of the squat practice
Finally, and more positively, one key theme that is emerging is the potential for entrepreneurial dentists to start up their own squat practices.
While previously this posed a significant challenge due to competition for NHS contracts and patient loyalty to local practices, the current long waiting lists and widely reported ‘dental deserts’ mean that there is potentially more patient demand and opportunity for growth.
The appeal of squat practices also centers around the ‘supervised neglect’ element of buying an established practice with a Full Care Plan. The term is often used as a ‘buyer beware’ warning about carrying out due diligence before purchasing.
An example of the potential risks would be the previous owner leaving the business upon completion of the sale only for the new owner to realise that most patients require dental treatment due to poor dental work carried out previously. How would the new owner broach this delicate subject with patients that they may face hours of treatment and increased costs to get them back to health?
This inherited issue does not pose a problem for squat practices – a blank slate on which practice owners have the potential to create a thriving business from scratch.
This article is for information purposes only and does not constitute financial advice. For financial support in creating your own practice, a Specialist Financial Adviser can help you start strong as well as signposting to other dental specialists to truly make your practice thrive.
Book a no obligation financial review to speak to a Specialist Financial Adviser from Wesleyan Financial Services.
* British Dental Association