Getting the right mix

shutterstock_177618035‘Going private’ or remaining in the NHS can be a difficult enough decision in itself, but what if you need a foot in both camps? Nigel Jones explores developing a patient membership plan base in a mixed practice.

Some dental practitioners envisage a future that remains almost entirely within the NHS, regardless of contractual changes. Others have a vision for a professional life that is mostly, or even entirely, independent of the NHS but retains some of the security of both patient attendance and finances through the development of a base of membership plan patients.

The quickest way to develop such a base is at the point of ‘going private’, but despite dissatisfaction with the level of care NHS dentists feel they can provide patients, as well as concerns for their personal well-being as they struggle to do their best for the patients, taking that step can feel a step too far.

The reasons can be many and varied but ultimately often focus on patient welfare, over concerns that too many patients will be lost in the transition. This gives rise to a secondary worry – that patient losses will affect the new private practice’s ability to be a viable and sustainable business. Fortunately, a viability assessment, such as one offered by the patient membership plan providers, can often help provide the reassurance and the expertise to form an action plan towards a successful future.

However, what happens if the viability assessment suggests ‘going private’ is not the right course of action? What if you remain unconvinced by the facts and figures? What if you are happy but your partners or associates are less confident?

A staged move

In many situations, time is an important fact to consider as it usually takes repeated visits to build up the level of patient loyalty needed to survive the test of going private. Within a practice, different practitioners have been seeing their list of patients for differing periods of time. So it is not uncommon to find a practice staging its move away from the NHS with the most well-established dentists leading the way, supported by a well-informed and confident team, followed, usually over a period of years rather than months, by others.

If opting for a staged moved, then one other consideration is the composition of the patient base of those practitioners who seek to go private further down the line. For those who are first to take the step, the aim is usually to earn the same income but to spend more time per patient through seeing fewer patients. That can mean other dentists have their patient lists swelled by those who migrate from the pioneers within the practice. This is not a problem, so long as it is a factor when assessing other dentists’ loyal patient counts.

Challenging circumstances

So, what about the situation where there are no dentists in the practice who have the circumstances or the will to convert from the NHS? Developing a membership plan base in such circumstances is not impossible but can certainly be challenging. Practices that have successfully developed a membership plan base in this scenario have tended to focus on offering preferential appointment times exclusively for private patients, such as early morning, late evening or even weekends. In some cases it can be possible to run an appointment book, which offers different length appointment times for private patients compared to NHS patients. A few practices have gone to the lengths of creating separate waiting rooms for private and NHS patients, although most lack the space to accommodate such an approach. Still, others have differentiated between NHS and private care on the basis of the range of treatment options available, particularly those considered cosmetic. However, the reality is that managing the operational challenges such approaches create, and remaining within the terms of the NHS contract, means the introduction of a membership plan as an NHS dentist will only lead to limited success.

For dentists with an established private ‘pay-as-you-go’ list, developing a membership plan base hinges on the ability of the patient to discern the additional benefits of being a member of the practice compared to their current arrangements. Old habits die hard, so compelling reasons communicated in a credible way by the whole team will be required to move a substantial number of private pay-as-you-go patients on to a plan. Sometimes those compelling reasons are financial; sometimes they are about a belief that the regular attendance encouraged by membership means a plan is the best way of packing a preventive approach for the patient.

Developing a significant membership plan base should be highly advantageous for both patients and dentists and the approach adopted to achieve this goal will vary from situation to situation. However, the first step should be to approach a plan provider who has the experience and support services to help explore what is possible and most appropriate for your individual circumstances.

If you would like to get some honest, impartial and free advice on the viability of your practice making the move to gain independence from NHS to private care, please get in touch with Practice Plan on 01691 684120 or visit

Get the most out of your membership by subscribing to Dentistry CPD
  • Access 600+ hours of verified CPD courses
  • Includes all GDC recommended topics
  • Powerful CPD tracking tools included
Register for webinar
Add to calendar