Johnny Minford discusses why the 2023 autumn statement could be a cause for concern for practice principals and owners.
It is true that dental practices are seeing their income squeezed in this time of slowed economic growth and higher interest rates. This equally affects the members of the team, particularly those employed, who perhaps do not have the opportunity through circumstance to work more, harder or longer to make up their household income.
Concerned staff are more likely to have an increased sensitivity to their own family situation, and possibly be pushed to seek what is sometimes a short-term monetary gain elsewhere – rightly or wrongly. From the practice perspective this nevertheless adds to the stress of staff shortages.
The autumn statement from the Chancellor announced two matters which affect the team. Both may be seen as good for the individuals, but one may cause their principals a sleepless night or two.
‘Major’ national living wage increase
Firstly, the reduction in employee National Insurance by 2% immediately puts some extra take home pay in the employees’ pockets, with no cost to the practice owner as the employer. This will be very welcome. However, it may not stop someone thinking about changing their job, as all and every job will have an increased take-home rate, so every job remains comparable. Whether or not they switch will be related to other aspects of their employment.
The other announcement was an increase in the national living wage. This will affect the principal as there will likely be roles in the practice which are at this minimum wage level, which will directly increase the cost of employment. Additionally, there is always a knock-on effect on the rest of the team as wage hierarchy will have to be maintained at least at some level.
Given that around 20% of the total gross income on average is spent on salaried employees, this is a major increase, and it will need to be shouldered either by the principal or the patients. Many on the patient list will also be struggling, and the price lists to them may be quite inelastic, and increasing them may have a fall-out on the practice. If it is an NHS practice, without the ability to increase the treatment rates, the increasing cost will inevitably will fall on the principal.
Again this increase in minimum wage effects all jobs in all industries, so it will not stop an employee leaving for another job elsewhere, and giving an extra headache to a principal who finds themself with gaps in the team and not enough chairside time to generate the extra gross required.
Retainment challenges
Retaining staff in the team is a different problem from affording the extra costs, and comes down, as it has for generations, to job satisfaction as well as pay and conditions. The professional nursing bodies continue to talk about their members searching for appreciation and the ability for career progression as being at least as important. As nursing is more and more promoted as a career rather than simply a job, this is something which will be attractive to those entering that profession, and those considering changing jobs.
With practice income held back, many practices will find it difficult to respond to the strain on their employees’ personal financial situations. This is often unspoken, and in the vacuum of avoided conversation, employees are much more likely to search for another job or leave the profession all together.
In insecure times there is never a better time to demand consideration of the efficiency of the team performance, open conversations across the team and reassess its shape, involving especially the vulnerable employees and those who make the practice vulnerable.
This last is the crucial element; you may have all the care in the world for your team, looking after them and their personal development but if they are not told, they’ll never know. And you as the practice owner will be worse off.
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