The impact of the dental landscape on patient mindsets

Gaby Bissett speaks to Zoe Close, head of sales at the Practice Plan Group, who considers the state of the current dental landscape and the impact it is having on practices and patients.

What does the current dental landscape look like?

I’ve been working in dentistry since the age of 16 so I’ve been in dentistry for 35 plus years now. There’s quite a sad landscape, if I’m honest. There’s a lot of optimism out there, but also a lot of sadness because there’s a balancing act of practices making difficult calls and decisions about where they fit within dentistry.

We’re finding that the landscape is quite changeable. People are either waiting for what’s coming next after a very turbulent three years working with NHS practices. There’s a lot of activity at the moment.

As a business, we are doing lots of NHS conversions to private, or we’re doing partial conversions where people are rebasing their NHS contracts, or at least trying to do a bit of both.

We’re just trying to navigate that difficult phase for practices at the moment. There’s a lot of uncertainty, and many associates are questioning how viable it is to work within the NHS, as are the owners. It’s really moving quickly, and there are a lot of stories out there. At the moment, I would say, we’re constantly watching and waiting to see what happens next.

What impact is this having on patient mindsets?

It’s an odd one because I do think that people’s mindsets have changed pre-COVID-19. I know we always go back to that term, but it really is true. But it’s not just about COVID-19 and what happened to people’s access to dental practices during that time.

At the moment, practices are faced with doing the right thing for the patient, and patients are a little bit more accepting that it’s quite difficult for them to get that right all the time.

There is a problem with access – there’s always been a problem with access, I think, generally with the NHS. But there is more now because of the conversions. Patients’ mindsets are almost accepting their fate, a lot of them. Obviously, some can’t afford to accept that fate, and there is a place for people who are really going to need access to that NHS care for a long time to come.

It wasn’t that long ago that I was managing NHS contracts and I think doing quite a good job of it. I think we had a good balance of keeping the patients happy and comfortable and the ability to get in when they needed to be seen, while looking at alternatives for us as a group as well. But I do think that’s changed.

I do think as a business owner, they’ve had to make quicker decisions. But then the mindsets of patients… I do feel that there’s an open door. Patients aren’t accepting of the current situation, and there are a lot of very unhappy people.

But I would say that patients are a little bit more understanding that it is difficult. They know the wait is going to be a lot longer to be seen on the NHS if practices are doing some kind of conversion or working more independently away from the NHS. Patients are more open-minded to that and accept that things may change.

Can a practice negotiate contracts?

That’s the big question.

There are variations depending on the area you live in, where you practise, and your postcode. We’ve seen many people able to approach the local area team and negotiations have been conducted quickly. It has just been a conversation, followed by a signed document, and that’s gone forward.

So that’s been brilliant because they’ve been able to move into the private sector at the pace they want while keeping the NHS contract for the patients in need of that service. That’s been really good to see.

However, of late, we have had some areas that have been more rigid, requiring you to do the full amount of the contract and deliver all of that or not at all. It’s quite scary because it takes that decision out of your hands, and you have to act quickly.

I would say that I feel at the moment that the integrated care boards (ICBs) are listening, and they understand the pressures we’re all under. They recognise their responsibility to address access and getting people seen.

They also understand that it may not be financially viable to sustain just working with that contract alone. So I would say it’s definitely an option. It is happening, and there are people managing to do that. But not all practices are getting that opportunity. Some are choosing to go fully private. There’s definitely a possibility that you can do the both still.

Do you have some examples of successful conversions?

Success, how do you measure it? That’s a significant question, regardless of the line of work. With a conversion, success means patients accepting and enough patients signing over to the practice privately to continue providing the desired standard of care.

There’s an interesting case of a guy who bought a couple of practices just before COVID-19. Soon after, he faced a practice where hardly any associates wanted to stay and a substantial NHS contract to fulfil.

His conversion was driven by the associates’ shortage and the recruitment crisis. He decided that going private would allow him to recruit more people into the practice and alleviate the recruitment issues.

Financially viable

Without the conversion, he feared he’d have no business left. So he went ahead with the conversion, mailing around 17,000 patients, and ultimately getting about 7,000 patients on the plan. It turned his business around completely, and he found success in that situation.

There are other significant conversions happening as well. We’re managing to sign patients up to the plan very quickly because people’s mindsets are quite open to that. The successful thing is getting the practices to a place where they’re comfortable and financially viable, doing the dentistry they want. Ultimately, their patients are happy to have a secure place for treatment.

The downside is that some people can’t afford private dentistry. It’s not in their priority list or feasible for them. That’s the only negative aspect of what we do here.

Ideally, there’ll be a place for everyone.

If you’re considering your options away from NHS dentistry, whether that’s a full or partial conversion, why not start the conversation with Practice Plan on 01691 684165, or book your one-to-one NHS to private call today:

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