Moving from NHS to private? Here’s what you need to know

New data suggests a growing number of dental practices are moving away from NHS dentistry. Making the switch from NHS to private practice can provide greater freedom and flexibility for dentists, but there are some important financial implications to think about too.

According to analysis from the Nuffield Trust, the number of dental practices in England offering general NHS dentistry has fallen from 65% in 2017 to 56% in 2026.

Over the same period, the NHS has lost at least 600 practices holding a general dental contract, while the number of practices without one (largely private or specialist providers) has increased by more than 1,000.

These figures highlight a significant shift in the dental landscape. And while every practice will have its own reasons for moving away from NHS work, making the transition to private dentistry can have consequences for both your business and personal finances.

If private practice is something you’re considering, here are some of the key areas to think about.

1. Understand what happens to your NHS pension

Your pension is likely to be one of the biggest financial considerations when reducing or giving up NHS work.

If you stop carrying out NHS dentistry altogether, you’ll generally stop building up further benefits in the NHS Pension Scheme (NHSPS) through that work. The benefits you’ve already built up are protected, but you may need to think about how you fund the rest of your retirement.

This could mean increasing contributions to an existing private pension or starting one if you don’t already have one.

Rather than looking at your NHS pension in isolation, it can help to consider your retirement plans as a whole:

• How much income might you need?
• When would you like to retire?
• How will your NHS pension, private pensions, savings, investments and practice sale proceeds work together to provide it?

Making this assessment before you move fully into private dentistry can help you identify any potential gaps early.

2. Don’t overlook other benefits associated with the NHSPS

Retirement isn’t the only consideration. Membership of the NHS Pension Scheme can also provide valuable benefits for you and your family, including ill-health retirement and benefits payable following your death.

If your move into private practice changes your eligibility for these benefits, it may be worth reviewing your existing financial protection.

For example, you might want to consider whether your life cover and income protection would provide enough financial support if illness or other unexpected events prevented you from working.

For practice owners, there may be business protection considerations too – particularly where the practice relies heavily on you, a business partner or other key members of the team.

3. Prepare for a different income pattern

Moving into private dentistry may give you more control over how your practice operates and how treatments are priced. But a change in business model can also mean a change in cashflow.

It can take time for patient numbers and private income to settle, particularly if you’re transitioning gradually rather than making the move in one go.

Building cashflow forecasts for different scenarios can help you understand how the practice might cope if private patient numbers grow more slowly than expected, or if costs are higher during the transition.

It’s also worth considering the additional investment the move could require. You might decide to refurbish your practice, invest in new equipment or technology, change your branding or signage, or increase marketing activity.

Planning for those costs before making the switch can help protect the cash reserves in your practice.

4. Think about how patients will pay

Moving away from NHS dentistry can be a significant change for patients too. Patients who are accustomed to NHS charges may need to adjust to paying privately for their routine dental care. How you communicate the change and the payment options you provide can play an important part in the transition.

For some practices, introducing a dental membership plan can help patients spread the cost of routine care while providing the practice with a more predictable source of recurring income.

Whatever approach you choose, it can be helpful to model what different levels of patient retention could mean for the practice financially.

5. Review how you’re structured

A move into private dentistry can also be an opportunity to review the way your business is structured.

Depending on your circumstances, you may be operating as a sole trader, partnership or limited company. Each can have different implications for how you take income, make pension contributions and manage practice finances.

There isn’t one structure that’s right for every dentist. Before making changes, it’s important to consider your business and personal finances together – ideally with support from financial, accountancy and legal professionals who understand dentistry.

6. Consider the impact on your personal finances

Your practice and personal finances don’t exist in isolation. A change in the way you earn could have implications for everything from your tax position and pension planning to protection and borrowing.

For example, practice owners and self-employed dentists can sometimes have more complex income arrangements involving salary, dividends or drawings. This can mean lenders assess their income differently when they apply for a mortgage.

That’s why it’s worth looking beyond whether private practice could increase your income today and considering what the move means for your wider financial plans over the years ahead.

Planning for the bigger picture

While the figures from Nuffield Trust suggest an increase in dentists moving away from NHS practice, this doesn’t necessarily mean it’s the right decision for you or your practice.

Whether you're considering reducing your NHS commitment, moving to a mixed model or becoming fully private, taking the time to understand the financial consequences can help you make the transition with greater confidence.

At Wesleyan Financial Services, our Specialist Financial Advisers understand the nuances of the dental profession and can look at your personal and business finances together – from retirement and protection to mortgages and business planning.

To speak to one of our dental experts, simply book an appointment today. Advice charges may apply.