‘Staggering’ increase in the cost of compliance

New research from the National Association of Specialist Dental Accountants and Lawyers (NASDAL) highlights the rise in the overall cost of compliance.

The research found the advent of the Care Quality Commission (CQC) and HTM01-05 had increased dentists’ costs by a factor of seven.

Nick Ledingham, chairman of NASDAL and a partner in specialist dental accountants Morris and Co, said: ‘The increase is staggering.

‘In the last 10 years, dentists working in the NHS have witnessed a change in the policies of NHS commissioners.

‘So at the same time as having to spend ever more on their business, they are more unsure over the future and whether they will retain their contract.’

In 2004, the essential requirements for setting up in practice was a one-off registration fee to the General Dental Council (GDC), an annual retention fee and registration with the Information Commissioner’s Office (ICO).

But in 2014, it has been estimated that it costs a single-handed practitioner £11,200 on an annual basis to meet the requirements of the CQC and HTM01-05 alone.

Combined with the various mandatory registration fees and indemnity, the figure goes up to £15,011, an overall percentage increase in the cost of compliance of 845%, compared to inflation over the same period of 37%.

One young dentist, who became a practice-owner four years ago, spoke anonymously saying: ‘When I hear what it used to be like to set up in practice, I feel very envious.

‘A lot of young dentists are put off by the amount of admin taking you away from patients, and so they don’t want to own a practice.

‘I was inspected by the CQC in 2012 and now the file I prepared is just sitting gathering dust.

‘A lot of its requirements were irrelevant or time-wasting.’

Simon Thackeray, source for the figures, a CQC adviser and a full-time practitioner, says the estimated annual costs includes the time dental nurses spend on decontamination and maintaining records, the time Simon spends on admin and staff training, but excludes autoclave accreditation and servicing, and excludes membership of the British Dental Association and The Confederation of Dental Employers.

According to Ian Simpson of Humphrey and Co, the records show that expenses and overheads for a single-handed dentist have gone up to £91,350 in the year 2012/13 compared to £69,991 in 2002/03, an increase from 37.6% of fee income to 40.0%.

Alan Suggett, a member of NASDAL’s technical committee and a partner in UNW LLP, said: ‘Not only has it never been so costly to operate a dental practice, the cost of complying with rules and regulations has increased disproportionately.’

Nick Ledingham concluded: ‘While there has been a certain amount of guesswork in the costs of staff and training in an average practice, we tried to be conservative throughout this investigation.

‘We hope that by demonstrating the burden of costs faced by practice-owners, the GDC will think very hard before it implements its proposed 64% increase in the ARF.’

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