Leaving an increasingly
unworkable NHS
in favour of Denplan 

After 20 years of NHS dentistry in Bury St Edmunds, Hernán Morillo wanted better for his team, patients and practice.

Together with my wife Helen, I set up Sycamore House Dental Practice in Bury St Edmunds in Suffolk two decades ago. We run a purpose-built, four-surgery practice with three associates. The journey to move away from NHS dentistry started three years ago with a partial conversion.

We realised that the practice just wasn’t going anywhere. There was a healthy turnover, but something was not right. The funds were simply passing through the practice’s accounts. Investments in equipment or upgrading the IT system would not have been affordable. There was a real risk we were managing a failing business. 

My wife and I did a principal-only conversion with another dental plan provider and went from a mix to fully private. The associates continued to look after NHS patients.  Everyone at the practice has noticed how it has gradually become harder to achieve our contracted NHS UDA numbers and work in a sustainable and civilised way.

COVID made NHS dentistry an ‘undeliverable deal’

Like most dentists, we have been extremely busy. You need a constant, steady flow of patients to make the NHS contract work, and the amount of traffic can be exhausting.  With COVID, the patient flow has become more difficult to manage. The relentless pace of NHS work is simply not compatible with the COVID restrictions and safety procedures. It was hard enough before.

This high turnover of patients takes a toll on the whole team. In normal times, the number of patients and the resultant volume of paperwork generated is rather staggering. Think of all the admin, payment processing, note writing, NHS forms etc. Then there is the clinical risk of seeing more patients in a tight time frame - this inevitably increases the risks. Dental impressions have to be right first time, patients have to go numb without delay, and you need to be able to find all three root canals without too much drama. Most dentists realise this is simply fantasy, no matter how competent or efficient one is.

Everyone deserves access to high quality dental care. It is the Government’s job to come up with an affordable, sustainable way to deliver this.

How Denplan gave a way out

We set up a Denplan facility right at the outset and have had a small number of Denplan Care patients on the books for nearly 20 years. We always felt Denplan were a well-respected and professional company, and the name resonates well with patients. The seminars and compliance and regulatory advice have all been really useful over the years. As an independently owned and operated practice, we do all the behind-the-scenes work ourselves. We are always extremely grateful for all the editable templates and policies made freely available by Denplan.

During the COVID lockdowns, Denplan stepped up and organised information seminars and events. We were impressed with all that Denplan did to hold the profession together and help to keep us going during that time.  The whole team made the most of the weekly web seminars.

This made us want to be a bigger part of it. We had a good relationship with our Denplan business development consultant, Frances Lynch, and things moved from there.

Our previous partial conversion was with another plan provider. This worked well for the practice and we were pleased with their work.  We were grateful for their help but came to realise that the company were merely processing direct debit payments on our behalf. We switched all our original conversion patients across to Denplan with the help of their bulk transfer process. The team liaised with my previous provider, so our time was not taken up with any drama or difficulties. Denplan arranged it all. The bulk transfer was fantastically efficient and worked really well for us.

Denplan was able to add value in many different ways – they are a trusted company with lots of brand recognition. For one thing, Denplan’s marketing tools are always excellent - all we have to do is personalise them. Like with everything else, you get what you pay for.  Sure, we could probably save a bit on the monthly admin fee with another provider and the service might be okay. But ultimately, we wanted the peace of mind that comes with knowing that it is all being done properly on our behalf and we don’t have to worry about the level of service patients are getting from a plan provider’s head office.  We wanted a provider that has the resources and cares about the service it provides to patients as much as we do.

The seminars and compliance and regulatory advice have all been really useful over the years. As an independently owned and operated practice, we do all the behind-the-scenes work ourselves. We are always extremely grateful for all the editable templates and policies made freely available by Denplan.

During the COVID lockdowns, Denplan stepped up and organised information seminars and events. We were impressed with all that Denplan did to hold the profession together and help to keep us going during that time.  The whole team made the most of the weekly web seminars.

This made us want to be a bigger part of it. We had a good relationship with our Denplan business development consultant, Frances Lynch, and things moved from there.

Our previous partial conversion was with another plan provider. This worked well for the practice and we were pleased with their work.  We were grateful for their help but came to realise that the company were merely processing direct debit payments on our behalf. We switched all our original conversion patients across to Denplan with the help of their bulk transfer process. The team liaised with my previous provider, so our time was not taken up with any drama or difficulties. Denplan arranged it all. The bulk transfer was fantastically efficient and worked really well for us.

Denplan was able to add value in many different ways – they are a trusted company with lots of brand recognition. For one thing, Denplan’s marketing tools are always excellent - all we have to do is personalise them. Like with everything else, you get what you pay for.  Sure, we could probably save a bit on the monthly admin fee with another provider and the service might be okay. But ultimately, we wanted the peace of mind that comes with knowing that it is all being done properly on our behalf and we don’t have to worry about the level of service patients are getting from a plan provider’s head office.  We wanted a provider that has the resources and cares about the service it provides to patients as much as we do.

The first days after mailing

The initial days after mailing NHS patients with the news of going private were especially busy for our receptionist, Rachel Hall. Being trained by Denplan before the mailing helped her confidence and made it a smoother process. 

Rachel explains, “To start with, there was a certain fear of the unknown. Of course, we had unhappy patients after the mailing who wanted to remain with the NHS. Having Denplan as a product definitely helped soften the blow for them.

A sustainable future

Patients’ expectations have always been high and have only got higher over the years. Dentistry has grown more complex and sophisticated.  The significant cost of operating a practice with the right equipment, the right people, and all the additional responsibilities around compliance and training is one side of things. Then there are all the risks associated with patient care, employment and financial responsibilities. The cost of supplies continues to increase.

NHS dentistry hasn’t been sustainable for a long time. Sure, many of us try and make it workable, maybe mixing NHS and private, but this is just damage mitigation. The UDA-based contract was never designed to improve patient care, access or anything else. It was simply an instrument of budgetary control masquerading as a viable deal. 

Sometimes you start watching a bad movie and you think, surely it will get better; nothing can be this bad. Before you know it, you have wasted two hours of your life. It never got better. It’s a bit like this with the NHS contract and the UDAs.  It never felt right. Even the House of Commons saw it was broken back in 2008. The only question is, why is the profession stuck with this contract 15 years on?

We worked as a mixed NHS and private practice for most of our 20 years.  This means that private patients were almost certainly propping up the NHS side of the business and paying for the privilege. This is not only absurd but also fundamentally unfair - a funding arrangement that is not sustainable should not exist.  

‘Wish I’d done it sooner’

We knew the switch would work and chose Essentials because it is a good fit with our preventive approach. It’s as if we set off a chain reaction. The most noticeable change is that we no longer have to deal with crowds in our waiting rooms or queues at reception, and we are running on time (mostly).

In terms of our clinical work, we are able to book a realistic time for procedures, we charge the going rate for our clinical time and skills, and we don’t see patients that just come to see us because we are cheap.  We value the work we do, and so do our patients. We can focus completely on doing good work, having the time to look after people safely with the support of a team working at a sensible, sustainable pace.

As dentists, we carry a lot of responsibility but also enjoy significant freedom. As general practitioners, we are not tied up to any institution, and are free to put in place a system that allows us to provide excellent care and look after our teams.

Hernán Morillo BDS (Wales)  CertMedEd MJDF RCS (Eng) 

To find out more about Sycamore House Dental Practice visit: www.sycamoredental.com