NHS contracts and considering your options

NHS contractsJosie Hutchings contemplates the progression of the new NHS contracts and the options a dental practitioner could consider in the future.

Following the recent debate about the General Dental Practitioners contract in England at the General Dental Practice Committee (GDPC), the case for reform has now been termed as ‘irresistible’. However, the prototype contracts are due to begin testing in 2015 and a date for implementation is still to be settled upon.

Rather than reassure NHS practitioners about the future, this uncertainty is testing the hardiest of them, and it is understandable that I am experiencing a growing number of dentists who are losing patience with the pace of the contract reform and are giving serious thought to their options to leave NHS dentistry and join the ranks of the private sector. But is this always the right move, and if it is, how do you go about it in a way that will maximise your success?


Arguably, the most important place to start is by looking at your motives for wanting to change. Many dentists will have spent years working hard for their NHS patients and making the decision to walk away is unlikely to be easy, however painful the powers that be are making life in the NHS. 

Defining what you want out of your practising life is not just a question of money. However, there are other issues such as professional satisfaction and quality of care to consider. But it’s also important to think about the way you want to balance other aspects of your life.

Only once you’re clear on where it is you want to end up, is it possible to start charting a course to get you there.

Achieving your outcome

The next step is to assess the likelihood of you achieving your desired outcome. This means considering patient demand for the type of practice you want to have and estimating the level of support you will receive from your existing patients. The latter will be a factor of the length of time you have spent treating them, but may also be impacted by environmental factors such as the proportion of your patients on income support and local NHS availability.

Often, the favoured approach is to go through a financial analysis and risk assessment with a plan provider, who can draw on the lessons learnt from hundreds of practice conversions to help you gauge the level of risk attached to your circumstances. Sometimes that risk is just too great and remaining as you are may be the action that is right for you. Most of the time, however, the risks are manageable and the only thing holding you back is likely to be your confidence.

For many dentists, the self-belief needed to make a success of a conversion comes with the certain knowledge that the change is being undertaken for the right reasons. For others, that conviction needs to be underpinned with the reassurance of a well-thought-through plan of engaging the practice team and communicating effectively with patients.


Never underestimate the importance of having the whole practice team on board. While some practices have survived a conversion characterised by negativity from some or all of the team, this shouldn’t be about just surviving. It should be about a positive move to a better future for all parties and time invested in exploring the team’s fears and concerns will be time well spent.

Good teamwork at the time of the change is vital, as effective communication with your patients is not just about a well-crafted letter. It’s about how reassured they feel when they check the possible options with your team. A consistent and positive response from whoever they grab will do wonders for giving them confidence to stay with the practice.

Of course, the written sources of information play their part in securing the loyalty of the patients, and again it is wise to seek advice from those with experience of developing conversion letters, plan brochures and practice marketing material. Even the most positive of practice teams may find the loyalty of the patients tested by poor quality leaflets that can be viewed as symbolic of wider issues in the practice.

None of this is rocket science or new thinking as practices converting today are still following broadly the same approach as in 1990. Of course, there are different contractual arrangements to consider, but the essential components of ‘beginning with the end in mind’, as Stephen Covey puts it, and thorough planning are still the same. 

And the similarities don’t end there, as the completion of the first year in the private sector will almost certainly prompt the familiar refrain: ‘I wish I’d done it sooner!’

Josie is part of the NHS change support team for Practice Plan. As a regional support manager with 21 years’ experience, she has guided many dentists through the 2006 NHS contract and continues to do so today. Contact her for further advice and support on changesupport@practiceplan.co.uk or visit www.practiceplan.co.uk/nhs.

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