With the recent announcement that Bupa will be closing more than 80 of its NHS practices, Matt Everatt discusses what this means for the dental laboratory sector and dental technicians.
Bupa Dental Care has announced its plans to close, sell or merge 85 dental practices in the UK due to the ‘national shortage of dentists and the impact of inflation’.
Although it may be a little too early to say exactly how this may pan out for dental labs, it seems the writing has been on the wall for NHS dentistry for some time.
The ‘NHS priced lab work’ has been debated recently by many dental labs and technicians. It has become unsustainable, with many labs pricing themselves out of the market and moving away from providing budget priced custom-made devices.
‘A sickening blow’
It seems the catalyst to this was during the pandemic. Labs were forced to close, not through any guidance by our peers or governing bodies, but purely because all dental practices were told to close, rendering the services of dental labs redundant.
When NHS dental practices were bailed out, dental labs were dealt a sickening blow by the chief dental officer (CDO).
Labs were told they were merely sub-contractors to the NHS and thus will not be helped out by NHS England. They were left to seek other routes to financing their way out of the pandemic.
This was perhaps the straw that broke the dental techs’ back. For years, dental labs have supported a failing NHS dental service with cheap custom-made dental devices.
The provision of such low-priced services has led to years of driving down quality in order to remain competitively priced. We have also seen it impact technician salaries, cause low morale in the dental technology sector and even lead dentists to sending cases overseas to make ends meet.
NHS shackles
Providing NHS priced work has become a ‘race to the bottom’, inevitably seeing many of these budget NHS servicing labs close their doors during or shortly after the pandemic.
The more agile lab owners changed their model and ditched NHS priced work in favour of providing higher quality and higher value private work.
Over the years, corporate giants in dentistry became the gate keepers to dental laboratories to some degree. They insisted labs were registered with a quality management system (DAMAS) and they set out terms of business including service levels.
Most importantly, many set out payment terms, pricing levels and insisted on labs discounting services to them if they wanted to become an ‘approved lab’.
For many labs, it was a challenge and battle to become an approved lab in the hope the corporate practice would continue to send cases. Many saw this as a poisoned chalice and refused to become an approved lab.
The perfect storm?
More recently, some of those approved labs decided it was time to ditch the NHS pricing shackles and budget range of work, and focus more on quality. Many have said they’ve never looked back.
So, is this the perfect storm? Have dentists decided they no longer wish to work in a bonkers, UDA-driven system and focus more on private dentistry?
Bupa have said recruitment of dentists is one of the reasons they have struggled to provide their NHS dental services, with dentists favouring private practice over NHS dentistry. Many dental technicians have decided NHS dentistry is no longer attractive either.
I read a social media post last night. A dentist sympathetically said he had recently been subsidising NHS patient care. His example was that most labs are now charging more for dentures than the NHS and patient pays him.
He felt he had a duty to provide his patients with a nice denture, so he paid the higher lab fee, essentially paying out of his own pocket. I suspect his experience has become a regular occurrence as more and more labs move away from offering low priced NHS type work.
What does this all mean for technicians and laboratories?
Firstly, I do want to send my condolences to those dentists and nurses who may now need to find employment elsewhere. Having many friends in the dental industry, this will no doubt affect many.
My thoughts also go out to the Bupa-owned dental labs – what happens to them? Hopefully, they will be okay and not affected. After all, they are merely sub-contractors to dental practices.
With my optimistic ‘tin hat’ on, I think, in the medium-to-long term, this is good news for dental labs and technicians. In the short term, there may be some who feel the immediate hit of losing one or two of their big customers.
Hopefully, this will be very short term. The dentists and patients may migrate quickly to another NHS practice or may make the leap to private dentistry.
In general, my hope would be seeing labs focusing on providing higher quality custom-made devices, charging properly for their skills and seeing the wages and profiles of dental technicians raised.
Let’s face it – with the decline in the number of dental technicians, we need to have something to tempt the next generation to want to become dental technicians. Or to encourage those who left to come back into the fold.
A rocky ride
For sure, the Bupa announcement isn’t great news. I do hope the staff in the practices forced to close are looked after and I hope they all find new positions. It does feel like this has been coming for a while.
The UDA system is terribly flawed and my dentist colleagues have tried to bring about change, yet it seems no government or political party ever wants to reform NHS dentistry. Is NHS dentistry simply not sexy enough for politicians? Or is there a darker side to politics that would happily see dentistry ditched as an NHS service? We will see how this story unfolds…
If there was ever a time for the government to open their ears and eyes, seeing one of the biggest corporates struggling to make the NHS model of dentistry work, then now is the time.
It may be a rocky ride for a few labs over the coming weeks not knowing if they will lose clients. Hold tight, we’ve been through worse.
Be agile – can you offer higher quality work to other practices? Try to keep in touch with those clients whom you have worked with in those clinics. See if you can continue working with them when they move to new practices.
In the coming months, my gut feeling will be that it will level out, as dentists and practice teams find new places to work and patients find new practices to get treatment.
For now, I wish all the very best to the practice staff at those Bupa clinics who find they are closing. I hope you are all able to find new positions and continue to provide great patient care, wherever that may be.
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