It’s important to communicate the changes from NHS to private to your patients, says Rupert Hoppenbrouwers.
More dentists are considering life outside the NHS. But while private practice can be an attractive destination, it’s important to plan your journey with care.
Statistics reported by the BBC showed that nearly 1,000 dentists left NHS practice in England and Wales over the past year.
Some may be drawn to the private sector by the desire for more clinical freedom or time with patients.
Others may be deterred by NHS targets or re-evaluating their practice following the pandemic.
Whatever the reason, it’s important to get your ducks in a row about how you communicate the changes to patients.
This will ensure your conduct meets GDC standards and will help to keep patients on side during the transition.
Explaining the switch to private to patients
From an ethical standpoint, you should treat patients fairly by giving them advanced notice of your decision.
No patient should find out on arrival at the dentist that NHS care is no longer available and they have to pay for private treatment, when they may feel under pressure to comply.
It also makes commercial sense to retain patients’ goodwill as you begin your new venture.
In the DDU’s experience, agreeing a reasonable notice period with the primary care organisation gives patients enough time to adjust.
It also allows you to complete any NHS-funded courses of treatment before the changeover date.
If possible, give patients the news face to face when they attend for a routine appointment. Explain that this will be their last NHS course of treatment before you convert to private practice.
Most will appreciate the chance to discuss their future dental care in person.
You should then follow up your discussion in writing. Keep a record of who has been told and check this against your patient database.
For those you have spoken to face to face, send a letter confirming the changes at the practice. For patients you haven’t spoken to but might consider regular patients of the practice, send a letter explaining the changes.
Although it may not be possible to reach everyone, this will demonstrate that you have made every effort to keep patients informed, which may help in the event of a complaint.
Stay positive
When explaining your reasons for going private, it’s fine to mention that you want to spend more time with patients or the freedom to offer a wider range of treatments. However, steer clear of any comments that could come across as denigrating the NHS.
If possible, include an outline of your private consultation fees and information about any private treatment payment plans on offer.
You should also provide patients with details of how they can access NHS care if they don’t wish to transfer to private care with you.
For example, give them details of the local NHS primary care organisation or direct them to the NHS Choices website.
Ensure staff are the first to know about your plans for the practice and are ready to answer patients’ questions with consistent messaging.
Staff in a patient-facing role should know what information has been sent to patients and trained to provide accurate and consistent advice when necessary.
Record keeping
If a patient decides to move to another NHS dentist, your practice should retain their dental records and store them securely.
The NHS GDS contract requires you to keep patient records for up to two years after completing a treatment course.
However, remember that claims for clinical negligence can arise many years after treatment, so records should generally be retained for the periods set out in the practice retention policy.
As an absolute minimum, the DDU recommends retaining adult records for 11 years after last entry and children’s records for 11 years after last entry or until they reach age 25 years of age, whichever is longer.
It’s also a good idea to reassure patients that you’ll share information with any dentist they decide to consult. However, you will need their written consent to do so.
Many patients will choose to remain with your practice, not least because they value continuity of care, but it’s still important to record the point at which they ceased to be an NHS patient in their dental record.
It should be clear to you (and anyone else reviewing your records) which treatment plans were completed under the NHS and which were carried out privately.
NHS paper records should not be used once a patient has transferred to totally private care.
Promoting your private practice
To promote your private practice ethically, you should comply with the GDC’s guidance on advertising and the Committee of Advertising Practice (CAP) Code.
This means you need to ensure information is accurate, use clear language that patients are likely to understand, avoid ambiguous statements, and don’t make claims that are likely to create unjustified expectations.
You must remove any NHS branding from your practice signage, website and literature.
Indemnity
The GDC requires dental professionals to have indemnity in place for the work they do.
For DDU members, there’s no need to tell our membership team that your practice is going private, unless you decide to offer additional services such as botulinum toxin injections, dermal fillers, or implants.
In conclusion
When leaving NHS practice, it’s important to consider patients’ interests, to communicate openly and honestly, and to uphold professional standards.
For more information, visit www.theddu.com.
