Practice Plan regional support manager Amy Hansford suggests some things to consider when planning to become a mixed NHS and private dental practice.
We’ve all been warned about not putting all our eggs in one basket. So, as the recent NHS 10-year plan was somewhat heavy on aspiration but light on detail for dentistry, a number of NHS dental practice owners may want to consider adding private dental services to their list.
To say that many NHS dentists have been feeling the pinch since the changes to the national minimum wage and the employer’s national insurance contributions in April is a bit of an understatement. Bound by the terms of the NHS dental contract, there has been no scope for them to pass on these increases in practice costs to the patient, leaving many struggling financially.
Many have considered handing back their contracts and leaving behind NHS dentistry in favour of a fully private practice. According to the most recent figures published by the GDC in its workforce patterns data report, around 66% of UK dental practices operate a mixed model. So, introducing private dentistry need not be a case of ‘all or nothing’.
Benefits
Adopting a mixed practice model can have many benefits. From a business point of view, it allows practice owners the opportunity to set their own pricing structure for their private treatments, giving the opportunity to increase charges when economic conditions are unfavourable. Having the freedom to increase charges when necessary helps practices to weather the storms of increased costs.
Private dentistry also provides scope to offer a wider range of services to patients while continuing to provide NHS dentistry to those unable or unwilling to pay for private dentistry. In many cases, the income from the private side of the business subsidises the NHS treatments, allowing the practitioner to afford to continue offering NHS services.
A mixed model can help dentists emotionally, as it allows those who feel it’s a matter of conscience to provide NHS care to their patients to continue to do so, to a greater or lesser extent. In our experience guilt is often one of the main reasons practice owners cite as a reason not to hand back their NHS contract.
So, what are the main things to consider when introducing private dentistry into your practice?
Communication
Like everything in life, clear, timely communication will determine the success of your endeavour. Whether that’s with your team or your patients, it’s essential to ensure you communicate clearly what you are doing and why you’re doing it.
Your team needs to be behind the move for it to be a success. That’s why it’s important that they understand what is happening and when. Springing things on them at the last minute is unlikely to help them feel involved and part of the change, especially if they have strong convictions about NHS treatment.
It’s best to make sure your team is informed of what you plan to do and give them an opportunity to ask questions and raise any concerns they may have. After all, you’re asking them to change the way they work and so some of them may feel a little nervous about this. Provide them with the information they need to feel comfortable talking about the changes with patients.
In a practice, it may be the dentist who recommends a treatment plan, but a patient could approach any member of staff with a question about private treatment, so it’s important they’re trained to be able to respond confidently.
The NHS contract arrangements
While you’re introducing private dentistry you will still need to deliver your NHS contract or risk facing clawback. How you go about this will depend on the size of your contract and your plans for the private side of your business.
Could this be a time to enquire about rebasing your contract? Will this be the beginning of a gradual move away from NHS dentistry towards private while you ‘drip feed’ in private patients? How will you divide up clinicians’ time and how will this affect the diary? Do you need to consider bringing in a new associate or can your current contract be fulfilled by a well-established member of your team? These are all things that need to be considered.
How easy will it be for your current NHS patients to get an appointment in the future? Handled properly, having fewer NHS slots could be an opportunity to help encourage patients to remain with the practice as a private patient.
Introducing a membership plan
Many practices choose to introduce a membership plan when they begin to offer private dentistry. Having a membership plan provides a regular predictable income for the practice, which helps with cash flow.
For patients, as well as allowing them to budget for and spread the cost of maintaining their oral health, it helps engender a sense of being a member of the practice, increasing their loyalty. It also gives them the confidence that they will be able to get an appointment regularly and that their smile will receive the attention it needs.
As part of an NHS conversion, a membership plan provider such as Practice Plan, will carry out an assessment of your business. This will help inform both your pricing structure and the number of patients needed to make the move viable.
This process serves to give some peace of mind about the move as practice owners are often pleasantly surprised at how many patients they can afford to lose to make a full or partial conversion work for them. However, at Practice Plan we will never push anyone into a conversion if it’s not right for them. Over the years, as access to NHS dental treatments has become more difficult, the likely success of a move away from NHS dentistry has become greater. However, even now, if the numbers didn’t add up, we would be honest and advise against such a move.
Have a transparent pricing structure
There’s no doubt about it; private fees are generally higher than NHS patient charges. So, it’s important to be transparent about your prices. Publish them on your website and perhaps have a leaflet available for when patients come into the practice. If you set out the difference in cost between NHS charges and your private fees, they may see the difference isn’t as vast as they at first thought.
If a patient is dentally fit, then plan membership is usually more cost-efficient than pay-as-you-go pricing. You may also want to offer a discount on treatment to plan members, which will save them even more money should they need it.
If you’re introducing new treatments that aren’t available on the NHS, then it’s important to set out the costs clearly. There’s nothing more damaging to a patient’s trust in their dentist than for them to be presented with a treatment plan and then charged for lots of ‘hidden extras’.
Managing NHS versus private patient expectations
Many dentists making the move from NHS to private dentistry are concerned that their patients will expect a lot more when they make the move. This is probably true. By and large, the standard of dentistry will be the same, but the patients’ experiences will be different.
You may want to have separate lounges for your NHS and private patients to give them a feeling of getting value for money. The private lounge may have comfortable sofas and complimentary drinks, while the NHS one could be furnished with ordinary chairs and a water fountain.
Although the standard of dentistry for both may be largely similar, private dentistry removes the time pressures an NHS contract imposes so dentists can spend longer with each patient. They can take the time to get to know their patients better and to understand how they might want to improve their smile as well as keeping their teeth and gums healthy. There’s time to offer a personalised service without the feel of there being a revolving door on the surgery.
Running a mixed practice can provide benefits to both the practice and patients. It can be the best of both worlds, as long as the ground is prepared properly.
If you’d like to find out more about introducing a plan, and how Practice Plan can help you, visit practiceplan.co.uk/nhs.
This article is sponsored by Practice Plan.
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