To me, with changes afoot in NHS dentistry across the UK, it seems likely that some dentists, even those committed to the NHS, might need to spread their wings into private dentistry to make the practice a viable business.
It’s the same for us at Inglewood House Dental Practice, where we currently provide a mixed offering. We aim to treat every patient with the respect and attention they deserve, ensuring we provide an exceptional quality of dental care and personal service, so that every patient is delighted with their unique smile. The combination of NHS and private dentistry allows us to meet this philosophy, as well as offering us the opportunity to make a reasonable profit.
We aim to deliver the best dentistry possible, irrespective of the form it takes. To this end, dental care is available on the NHS. Then we add to that by offering one-off private work that will complement the routine treatment that patients are having on the NHS. In addition, patients can opt for private dental care either on a plan or pay-as-you-go.
When my family bought Inglewood 10 years ago it was already a mixed practice; however, the membership plan the previous owners had put together didn’t suit us at all. Having worked with Practice Plan at other practices, we immediately converted the private patients to the normal adult care plan they offered and worked from there. At the time there was never any question of opting out of the NHS completely; we do firmly believe in the ideology of the NHS and we want to be part of it. In addition, it does offer the security of a baseline income, which we needed.
Conscious that we weren’t communicating the benefits of what private dentistry could offer, we put in a brand new facility upstairs for private patients, taking them away from the busy reception area. With the dentists focusing on private dentistry on the first floor, it was just natural to send those patients to the waiting room upstairs, which had comfy leather seats and drinks machines.
We also devised private surgery time. Our NHS contract is 10am to 4pm, so the early part of the day and late afternoon, which are always the most popular, are kept for private patients and plan members. We will see children after school and we see emergencies whenever, irrespective of whether they’re private or NHS. But, on the whole, we don’t book in routine work for those early and late sessions.
Offering private and NHS dentistry can be confusing for patients, so we employed a treatment co-ordinator to help with our communication. We’ve found that having one point of contact allows for a consistent message to be delivered by someone who is familiar with the types of questions patients tend to ask and the issues that generally worry them.
Our treatment co-ordinator is there to talk through the options for NHS and private treatment, how much they are and the benefits. Every time someone new comes to the practice they will be booked in to see her to have their choices explained; we want everyone to be able to make an informed decision in a comfortable environment.
Mixed treatment plans can be the result of patients asking for something in particular or may be chosen once the treatment co-ordinator has run through the options. Someone might be having an NHS crown, for example, and mention they’d like whiter teeth. If it’s clinically appropriate, we make that part of the treatment plan, so the dentist will perform the whitening procedure privately first, to make sure we can colour-match the crown to the shade of their teeth. We ensure the patient is aware part of their treatment plan is on the NHS and there will be a supplementary charge for the private work. For us, it’s a seamless process nowadays.
One of the main barriers we experience with some patients when we talk about private treatment or joining our plan is the idea that they’ve paid into the NHS and therefore NHS dentistry is their entitlement. This can often be overcome by how you discuss things and the terminology you use. Certainly, some people will switch off straight away because they don’t want to lose what they perceive as their right to NHS dentistry. But for others it’s not such a great financial leap. Yes, if someone’s having a lot of treatment, then the NHS can work very well for the patient, but there are others who don’t see a lot for their money. Patients need to know that it’s not as clear-cut as paying for what you’ve had. I think whether patients benefit dramatically from NHS subsidised treatment depends on their oral health.
The customer surveys we run have revealed that, overall, our patients like that we offer a variety of treatment options. They’ve got a greater choice, but they don’t have to take us up on them; it’s the best of both worlds.
In addition, if we didn’t offer private work, patients might go elsewhere for one-off treatments like whitening, or just not have it done because the dentist they have confidence in doesn’t offer it. Our patients can get it all from one provider, and stay with the team they trust.
And it goes beyond what patients can easily see are the benefits. For example, some of the equipment we have just wouldn’t be in the practice if we were purely NHS. We have a Cerec 3D that, of course, is great for our private patients. However, there’s also a potential benefit for our NHS patients. Taking just one example, it offers an opportunity for NHS patients who are nervous and for whom, therefore, the added expense actually offers great value because they can get everything done in one appointment.
Also we’ve grown the practice, largely as a result of our private treatments, which has allowed us to run more surgeries and provide all of our patients with greater access to care. If we stayed just within the NHS, we would never have been able to do that.
It’s only through private dentistry we can see ourselves growing. In the early years, our revenue was fairly evenly split between NHS and private dentistry. However, recently we’ve worked hard to promote one-off private treatments, so although our plan membership has not changed dramatically, our ratio now is about 60% private and 40% NHS.
Looking back, I think we made the right decisions for our patients and ourselves. I think the trick is to ask yourself how many of your patients have gone elsewhere for a treatment you don’t provide. We see a lot of patients for one-off treatments because their own dentist doesn’t offer it. We don’t try to convert those patients, but dentists do need to consider they’re not only losing that one income but, potentially, they could lose that patient forever when they walk into another practice. Can you afford that?
The help of an honest expert can’t be underestimated! We have Shelley Clegg from Practice Plan as our regional support manger and she has been invaluable. She offers great advice and is very honest with us about what is and isn’t likely to work. Finding yourself someone like her is very beneficial.
We’re in a good place but we do routinely revisit the prospect of a full conversion. We are a pilot practice for the NHS contract and would like to be selected for the prototypes. Hopefully we’ll be able to help shape the future of NHS dentistry to a suitable outcome. But if that doesn’t work out and at the end of this trial we feel it’s not for us, we’d consider going fully private. However, for now, we’ll continue to meet the varying needs of our patients with a greater focus on growing our plan members.
When you consider we’ve grown during the recession thanks to our private offering, that says something.
For more information on Practice Plan please visit www.practiceplan.co.uk.