From NHS to private: a shared vision for success

StrategyJust over a decade ago, The Priors Dental Practice’s principal Mark Emms and practice manager Lindsey Edwards made the decision to extend their single-handed general NHS practice into a private practice. Josie Hutchings, regional support manager at Practice Plan, caught up with Lindsey to get the inside scoop on this remarkable transformation.

Josie Hutchings (JH): Lindsey, what a journey you’ve all come on in the last 10 years or so. So let’s start at the beginning; how did it all start for you and Mark?

Lindsey Edwards (LE): The Priors Dental Practice started with Mark Emms, the principal and my partner, he’s worked here for 31 years now. About 13 years ago, I was on maternity leave and I could see that Mark had aspirations to expand the practice and I had a strong business background so I could implement his ideas. I was pretty much ready to return to work so I became the practice manager in order to steer the business to achieve his professional dreams.

We had a 10-year vision in 2005 that by 2015 this would be a thriving referral practice, and we’re so delighted and proud to have achieved that. We had this beautiful old Georgian house that was outdated and tired, and the surgery attached to it needed a facelift. It was just the right time for us to start moving everything forward and look to expand into the house.

Business-wise, the end point was to make a centre of excellence where people would know that the fee they were being charged represented great value, because they’d be coming somewhere that was state of the art, with specialists offering an excellent level of care and treatment. As a family we were highly motivated, as we could see it allowing a good work-life balance to come to fruition.

To give you some idea of what the last 10 years have meant in real terms, in 2005 we had seven members of staff and now we’ve got 20; Mark is the principal, then there’s me as practice manager, plus an associate, an endodontist, an orthodontist, two hygienists, one hygienist/therapist, two receptionists, one treatment coordinator, a head nurse, a senior nurse, seven more dental nurses and an apprentice dental nurse.

JH: There’s no doubt you’ve come a long way! Looking back over that period, what challenges come to mind and how did you work to overcome them?

LE: Doing the planning for all of this well in advance – during 2003 and 2004 – was critical to the opening stage in 2005. Financial and resource planning is key; there was no way we could go from a single-surgery practice to one with four surgeries without being meticulous in our calculations to ensure we had more than a fighting chance of success.

After the planning phase, the first challenge was to renovate the building that we were in. Because the premises were in a conservation area, planning permission took some time; in the end we were able to move over in 2005. At the same time, we had our existing practice literally on the side, and that continued to operate during all of the building works. During this time, for about a year, Mark left the practice in my hands, overseeing locum dentists and the nurses, so that he could do a full-time masters in conservative dentistry at the Eastman Dental Hospital.

Then, from HR issues to staffing, pay roll, accommodation of all these people, diaries, planning, increased overheads and stock − everything that comes with moving to a bigger environment – were all a challenge.

At the same time, we added to these challenges by creating a referral service in September 2005, so we now have a full referral service.

We did it by believing in ourselves and our vision – and having a really good, well thought-out plan, well in advance of making the changes. I think the message would be not to underestimate the time that it takes to get it all sorted. We worked tirelessly, seven days a week if needed, because it was such a big move up. It was an ambitious project but we were determined, which saw us through everything.

JH: As you’ve just mentioned, a big part of your vision for the future and the success you’ve achieved was in growing the referral side of the practice. How and why did it come about?

LE: We saw that we could act as a centre of dental excellence; we’ve got the specialists, the equipment, and we’ve made the investment in the building. We knew we could act as a hub in terms of somewhere dentists could consult with Mark, talk about treatment plans, get advice, and, if they were clear what the patient needed, they could send them down on a referral basis and we would work from there.

We’ve fostered very good relationships with the GDPs in the area; we do a ‘Connect Evening’ a couple of times a year, as well as a practice afternoon tea event to get people along to meet us and the staff. Mark gives lectures, which count as verifiable CPD, which is a big draw. Then, every December in the run up to Christmas, I take to the road to say hello to our local referring practices, when it is logistically possible, to make sure they know how much they mean to us, and to tell them about our future plans and how they can benefit.

Our referring dentists know that we’re always going to give a quality service. We also keep the practice advised on the progress of their own patients with quarterly status reports. If they want a more detailed update they can contact our treatment coordinator, and she’ll be able to tell them more.

In addition – and very importantly – our referring dentists know that we’re going to send the patients back to them once we’ve finished that treatment.

JH: To support your vision and business know-how, did you reach out to any external organisations during this time of change?

LE: Yes, we did. Part of our journey involved changing our plan provider. When the practice was mixed we had a full capitation scheme where patients were banded into different categories. In my opinion, unless you’re doing almost constant studies on how time is spent, by whom, and on which patient, you end up having a system that some patients will benefit a lot from while others don’t benefit at all.

Overall, we looked at the value for our patients and, for us, you always need to give more value than you charge in price, and we felt we couldn’t do that with our original provider. Looking at all of the options, our choice was to partner with Practice Plan, as it allowed us to set up our own practice-branded dental plan that covered routine dental appointments (check-ups and hygienist visits); we’ve also got a couple of levels above that for people who need extra help. They are all within a very manageable monthly direct debit price for our patients and that allows us to control the overhead that is spent on each patient and we can keep track of our income.

As a team that wanted to expand our services and treatments, money – though essential to keeping the business running – was not our only focus. We also wanted to continue to offer excellent customer service, market ourselves effectively and grow our identity, have access to ongoing business support and training, to name just a few of the goals our plan encompassed.

Our research into various plan providers led us to believe that you, Josie, and your team would always be available to help us, as well as offering multiple services throughout our partnership, including business advice, tools and services to help the practice grow. Your claims and our belief in them have borne out, which has been such a big support.

Basically, we still have complete control but without a lot of the hassle we might otherwise have encountered. For example, it’s not up to us to chase missed payments or to worry about data protection in terms of patients’ bank details. That’s all been taken off our hands by your team, which is a huge weight off our shoulders.

JH: How did you feel about making the switch from one plan provider to another?

LE: Our patients were used to seeing the branding of our original plan provider and we were worried to some extent that it might lead patients to follow it and move to another practice. To a degree you can never predict what the public are going to do.

However, we also had a very strong belief in the service that we were offering and the consistency of Mark’s abilities and presence in the county that we’re in. He’d built up a really good reputation, so he was sure of himself in terms of his own abilities. Mark had been able to explain his vision to me and I implemented it.

JH: While we’re on this topic, what can you tell me about how you were able to ensure your patients and staff felt as confident as you and
Mark did?

LE: The staff were a bit worried, as they all understood the old plan membership scheme and it’s all they’d ever known. However, once Mark and I explained why the banding wasn’t really working for us and how we thought a different scheme would benefit the patients, they were completely on board.

For our patients, we sent out a letter based on a template provided by Practice Plan that had been altered to be bespoke to our practice. We simply explained to patients why the change had come about, what our vision was for the practice and that they were invited to find out more about the scheme. We also sent out leaflets with the letters to communicate the structure of the scheme and how that was going to work for their benefit.

As you know, creating our own ‘look’ was really important to us, and with your help we had already begun that process of increasing our branding among our patients. They had warmed to that, and I think it was a strong motivator for patients to sign up to the new plan.

That said, we did have patient queries because some people were confused that the price had gone down for them. It took a while to explain that we were only charging them for what they were actually going to have (two check-ups and two hygienist visits on the basic plan). Once they understood it, it sparked a whole new conversation that we were giving really good value for money, and that increased people’s love of the system and the fact that they could transparently see what they were being charged for.

JH: So, just a quick final question for you – what does the future hold for The Priors Dental Practice?

LE: The idea is to grow patient numbers on our plan; patients often like to see all of the services you offer and if we chat to them about our plan offering, we have found that’s frequently something that they like to take up. We are also looking to increase our referral side of the practice. We still have about 20% growth left in our practice so we’re looking to augment the services we offer.

The thing about making changes is that once you’ve undergone a big transformation such as ours – and achieved your vision – it gives you the confidence to carry on! Dentistry has undergone many changes since we began back in 2005, so we’re constantly looking at ways to transform and evolve, ultimately to provide a service for our patients that we can all be proud of. This won’t stop and, now we have the freedom to do the dentistry we want to, we will continue to find ways to make our patients smile. And with that vision firmly established in our minds, we won’t let anything stand in our way!

Practice Plan is a specialist provider of practice-branded dental plans. It has a wealth of business and plan support services, including expert marketing support, and a proven reputation for supporting practices to develop and maintain a profitable and sustainable business. So, whether you’re considering your options away from the NHS, looking to introduce a plan into an established practice, or considering switching from another plan provider, Practice Plan can offer you expert advice. Call 01691 684165 or visit for more information.

Lindsey Edwards holds a diploma in dental practice management along with a BA (Hons) in languages. She joined The Priors Dental Practice as the practice manager in 2002, and now oversees the management and organisation of the practice, including the financial and marketing aspects of the business. She is also responsible for the referral side of the business from other dental practices within the area. Being passionate about patient care and customer service, Lindsey ensures that excellent standards are met and maintained throughout the practice in both clinical and non-clinical aspects.

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