Practice Plan regional support manager Selina Alexander reviews the state of dentistry in Scotland.
How is NHS dentistry in Scotland faring? From what I see from visiting practices and reading the news, it’s less healthy than it used to be. The change to the Statement of Dental Remuneration (SDR) which came into effect in November 2023, has been casting a long shadow. It was given a mixed reception at the time.
Since then, the general feeling I have come across is that it was good enough for dentists who wanted to remain in the NHS, but insufficient for those who were looking for an excuse to leave to be persuaded otherwise.
While it seems to have improved matters for some, the jury still seems to be out on whether it’s enough to save NHS dentistry in Scotland. According to polling published by the BDA in summer 2024, although two thirds of those who responded believed the new model was an improvement on the old one, 88% of them felt, as they put it, this could not be the ‘final destination’ for NHS dentistry.
Less frequent examinations
From a patient’s point of view one of the biggest changes that also came into effect in November 2023 was the move from six-monthly examinations to 12, 18 or 24 months recalls. Dentists have told me that quite a few of their patients who have been used to seeing their dentist twice a year have been unhappy about the longer recall period and have chosen to pay privately to maintain their six-monthly visits.
This is an observation Christie & Co’s head of dental, Joel Mannix, feels will continue to be the case when I spoke to him recently. ‘Typically in Scotland, people are used to seeing their dentist twice a year and, as the NHS isn’t going to be able to pay for two checkups for each patient, they’ll need to pay for the extra one themselves.’
Private more popular
This is clearly something that will hit many people in their pocket. However, it’s an ill wind that blows no good, as the adage goes, as the change to the recall rates has seen a boost to private and plan income for practices. It will probably also mean that the NHS is spending less on examinations too. So, it’s good for some but leaves the patients picking up the bill.
That’s if they can get an appointment with a dentist! Like people south of the border, patients in six Scottish council areas are now living in so-called dental deserts according to BBC research published last October. So, clearly the change to the SDR has not done enough to tempt dentists to carry out NHS work in the more sparsely populated areas.
This is something Joel finds disappointing. ‘We get to sell some great businesses in fantastic rural locations that could be perfect for the right buyer but dentists sometimes don’t necessarily look at those lifestyle businesses, which is a shame. They can bring amazing opportunities both from a professional and a personal perspective and also offer flexibility if someone wants to run the practice as NHS or private, the world is their oyster.’
Greater confidence
There are some bright spots, though. After a tricky couple of years, Joel told me the practice sales market has been improving. Completed sales of practices were up by 114% last year compared with the year before, something he attributes to a number of factors.
‘A lot of it is to do with greater market confidence,’ he told me. ‘The mini-budget in September 2022 caused chaos for a while, with interest rates and inflation being high in 2023 as a result. At the time, people were also waiting to see what happened with the SDR. All this affected people’s confidence in the market. Since then, as inflation has normalised somewhat and as dentists in Scotland feel more supported by the NHS, we’ve seen confidence return north of the border which was evident through the spike in transactional activity in Scotland last year.’
He sees this confidence growing as the year progresses as lenders show themselves to be willing to do business in Scotland. ‘Given its needs-driven nature, dentistry is seen by many lenders as a green-light sector. This has been the case for many years, and we expect it to continue in 2025 and beyond,’ he explains. ‘We’re seeing a few new lenders looking at dental specifically, as well, which reiterates the overall confidence in the Scottish market.’
Strong market in Scotland
It’s not only the banks that are keen do business in Scotland. ‘Anecdotally speaking, we’re also seeing appetite from English-based corporates who want to expand into Scotland which illustrates the strength of the market and the desirability of Scottish contracts and its UDA system – where, in England, there is a contract limit, in Scotland, you can operate 24/7, 365 days a year. The sky is the limit, so it really comes down to how many patients you can see and how many dentists you have to deliver those services.’
So, as I see it, the picture for Scottish NHS dentistry is mixed. The revised SDR has worked for some, but not for others and is viewed by most as a stop gap until a better funding solution comes along. However, it has not improved patient access which has plummeted in some areas causing dental deserts. Perhaps the potential incursion by English corporates will help alleviate that situation. That remains to be seen.
This year, Practice Plan celebrates 30 years of welcoming practices into the family, helping them to grow profitable and sustainable businesses through the introduction of practice-branded membership plans. If you’re considering your options away from the NHS and are looking for a plan provider who will hold your hand through the process at a pace that’s right for you, you can start the conversation with Practice Plan today by calling 01691 684165 or to book your one-to-one NHS to private conversation at a date and time that suits you, just visit practiceplan.co.uk/nhsvirtual.
If you’d like to find out more about introducing a plan, and how we can help you, visit practiceplan.co.uk/nhs.
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This article is sponsored by Practice Plan.
