If...questions and answers
If practice costs continue to outpace NHS income...1
...how can you ever hope to get ahead?
Over 90% of dentists surveyed1, who spent the majority of their clinical time treating NHS patients, said that if practice costs continually outpaced NHS fee income, practice profits would be reduced. Nearly two thirds of these dentists cited the reduction as significant. The last ten years has seen a 35% reduction in average earnings*, whilst looking ahead, the Doctors’ and Dentists’ Remuneration Body is recommending a below inflation pay uplift of just 1% for next year. This, coupled with the uncertainty that Brexit brings, only adds to the growing financial pressures facing NHS dentists.
1. Denplan NHS Survey, February 2017
* BDA analysis of Dental Earnings and Expenses 2014/15 Published Sept 2016
If working under the NHS means your morale is now notably low...2
...how will staying in the system give you a professional high?
A recent NHS Digital paper2 showed that the more NHS work dentists carried out, the lower their morale. This was backed up by another survey**, conducted this year, in which 83% of respondents said there was a direct correlation between morale and working hours.
2. The Dental Working Hours, Motivation Analysis 2014/15 and 2015/16 Report.
** Source: Denplan NHS Survey, February 2017, (341 respondents).
If every working day is spent chasing time-constraining NHS targets...3
...does the ensuing risk of litigation stop you sleeping at night?
Over 70% of dentists with a largely, or purely, NHS patient base, cited fear of formal complaints or litigation as a major cause of stress3. Time-constraining NHS targets are the root cause of this stress. By impacting on the amount of time practitioners have to discuss options, obtain consent and write up records, so the potential for complaints increases. And in these uncertain times, the possibility of ever-tighter targets looms large.
3. Source: Denplan NHS Survey, February 2017. Base: 148 respondents with largely or purely NHS patient base
If Associates are no longer classed as self-employed...4
...is your practice ready?
Proposed changes to the NHS contract may result in practice owners having to pay sessional fees to Associates in place of unit of work arrangements, making the relationship look much more like that of an employer and employee.
As an employer, you would be responsible for paying Associate salaries and employer contributions for their National Insurance and pensions, as well as providing holiday and sick pay.
4. A17 Advice Sheet Associate Contracts, BDA, April 2011
If every five years meant retendering for your NHS contract…5
…how would that affect your long-term plan?
Building a successful, sustainable dental practice is a long-term business, an investment in capital and effort that pays back over time.
While, in an uncertain world, no one can predict the future with absolute confidence, the possibility of regular contract reviews makes it challenging to commit to any long-term plan.
5. A better deal, HM Treasury, November 2015. (Section 2.16) Reforming the NHS dental contract in England, p14
If experience no longer matters...6
...how much could the introduction of tiered treatment cramp your style?
If tiered treatment becomes standard practice as a result of NHS contract reform nearly two thirds of dentists are likely to leave the NHS***. The challenge would be how to validate dentists who are competent through experience but not necessarily equipped with formal qualifications.
Potentially it’s a great leveller, preventing many NHS dentists from undertaking more complex work without further training, assessment and almost inevitably, cost.
6. Dental Contract Reform Pilots, Notes to support Care Pathway Approach, Department of Health, pre-publication copy.
*** Denplan NHS Survey, May 2016
If composite becomes the restorative material of choice...7
...what choice will you have when it comes to filling your private practice?
For 66%**** of NHS dentists, the ability to offer composite fillings on posterior teeth for cosmetic reasons outside the NHS contract, is fundamental to maintaining the profitability of their practice.
No longer on the curriculum of leading European dental schools, the long-term viability of amalgam as the NHS material of choice remains uncertain. Fortunately, the choice for dentists wanting to secure their future is more black and white.
7. Dental Contract Reform Pilots, Notes to support Care Pathway Approach, Department of Health, pre-publication copy.
**** Denplan NHS Survey, May 2016
If UDA under-performance inevitably led to clawback and re-basing of contracts…8
…how would a change in your base-line impact your bottom line?
Last year more than 62% of NHS practice principals found meeting their NHS targets demanding†.
This year, or next year, missing UDA targets by a few hundred units could have significant consequences: most serious, a re-basing of NHS contracts, at best, a clawback, although how much remains impossible to predict, dependent on the approach of local area teams.
8. The Dental Assurance Framework
† Source: BDA Surveys of Practice Owners 2015 Base: Practice owners
Denplan has always helped dentists navigate major contract reform.
If the NHS dental budget fell over the next five years...9
...how would that impact the value of your NHS dental contract?
If all things were equal, in real terms, you might expect to feel a squeeze to your business. And dentistry will be competing against other essential services, such as community pharmacy, public health and the armed forces for a bigger share of a smaller pie.
So even when you have all the figures, the extent of the impact on NHS dentists still remains anybody’s guess. At Simplyhealth Professionals, we help minimise the guesswork, helping thousands of dentists to stay in front, prepared for the unexpected, supported with a steady, regular income stream, resilient through efficiency and growth.
9. A budget paper approved by the Board of NHS England in December showed that, ‘other directly commissioned’ services, which include dentistry, would see funding reduced by 3.4% from 2016 to 2021.
With our extensive experience and best-in-class support services we have been there to help thousands of dentists stay in front.
Don’t fall behind. Let us help you stay in front.
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