Smita Mehra talks us through the establishment of the latest practice in her dental group and provides tips on setting up your own squat.

Smita Mehra is the founder of the Neem Tree group of dental practices in London. After qualifying from the University of Birmingham in 1997, she held various associate positions in the Midlands over about three years before moving to London.

She opened her first private squat practice in Wandsworth town in 2004, followed by a second squat practice in Canary Wharf in 2006 and a third squat site in Surrey in 2010, all under the brand of the Neem Tree.

In 2014 she joined forces with Dr Zayba Sheikh, who became her business partner and co-owner of the Neem Tree brand. Zayba set up her own squat practice in Fleet Street and in the summer of 2017, they opened their latest Neem Tree practice together in Notting Hill Gate.

‘It’s very rewarding to build something from nothing and this has been the great appeal of squat practices for me. For my original practice I wanted to create a spa-like facility, with holistic and homeopathic treatments available alongside the dental care. I was aiming for something a bit alternative and quirky, with other affiliated services such as reiki and reflexology offered as a possible alternative to sedation. While the idea has become more common now, 14 years ago it was quite innovative.

‘I have continued this theme throughout the different practices and it remained a strong focus for Zayba and I when we came to set up our latest venture in Notting Hill Gate.’

The latest project

‘As with all my existing practices, this would prove to be quite a project in terms of readying the premises for dental care provision. The building had been vacant for some time and previously operated as a laundrette. The landlord agreed to make good on the building before we moved in to design and install all the necessary dental equipment and rooms. This involved removing an enormous water tank from the basement by breaking through the floor, it was a complete building site – something we were not even able to see as health and safety reasons prevented us from entering the building until it was all done.

‘The structural work took about 10 weeks and then we were able to get in and start designing our cutting-edge practice. After lead-lining the walls we continually referred to CQC and HTM 01-05 guidelines to ensure that everything would be fully compliant.

‘We worked with our interior designer from the very beginning to ensure we made the most of the space available. We paid particular attention to how patients would enter the building and how they would be directed around the practice. We also had to make sure that at least one surgery had full wheelchair access, while also locating the decontamination room and treatment coordinator’s room in the most logical areas. The latter was not something I had done before, but I’d learnt from previous projects how useful it is to plan for this room during the initial phases.

‘We decided to open one surgery first and then open the second once we had demand for it. We also have the space for two additional surgeries in the basement if we ever wish to expand further. With regards to the interior décor, we tried to reflect the same atmosphere created in the other practices within the group. There are a lot of greens and muted colours, with wood finishings and a very natural aesthetic to complement the original Neem Tree brand and to create a calming environment.

‘When it came to equipping the surgery, we worked with Hague Dental. I had collaborated with them several times in the past and we had developed a process that worked well, so I was more than happy to continue this working relationship. The team was very helpful once again, providing all the information and support we needed. They also supplied us with another A-dec 500 dental unit.

‘I have purchased around 10 of these chairs now as I have been so happy with them; they are very robust, high quality, luxurious, slimline and extremely stylish. Plus, they are definitely durable – I believe I had one of the first A-dec 500 units in the UK in 2004 and, although it is very well used, it still looks great!

‘I also always work with Samera – a team of chartered accountants and dental business development experts, who provide strong financial and business support during all such projects and beyond. I think such support is especially important in dentistry, as we dentists don’t always have a lot of experience in this area and Samera helps from the very beginning of the process right through to completion. If you want to buy an existing business, then they also help with all the financial aspects.

‘In addition, as a brand-new practice, we had to establish a new team. I’m delighted that the latest professionals to join the group have integrated so well and there is already good cohesion between everyone!’

Challenges

The CQC is an ongoing challenge that we face as the rules seem to change every time we set up a new practice. For this project, we hadn’t anticipated the strict 10-week lead time for CQC application, rather hoping this was the maximum time it would take.

The difficulty in sending the application is that you need to have a really good idea of how much longer the building work will take before you know when you’ll be ready for inspection. We sent ours off about six weeks prior to being ready, so the additional four-week wait delayed the opening.’

Reflection

‘On reflection, apart from informing CQC at the outset, there is nothing I would do differently for this project. I would advise others to ensure that they have someone who can help them stick to the budget – we all need a voice of reason to make absolutely sure that we are buying what we need and that we don’t go too far off piste!

‘For anyone looking to set up their own squat practice, I think the following points are the most important:

  1. If leasing, confirm that the landlord will make good on the building before you move in
  2. Aim to secure a rent-free period for the building so that work can take place without the need to pay rent at the same time – anything from one to six months may be possible. This becomes even more crucial if the landlord is not making good the building
  3. Don’t rely on just yourself – it is highly recommended to work part-time as an associate and part-time in your own practice to help cash flow! For those expanding an existing group, start small with regards to number of surgeries so you can strengthen your patient base before investing more in additional surgeries.

For more information about A-dec Dental UK, visit www.a-dec.co.uk or call on 0800 2332 85. For further details about Hague Dental Supplies, visit www.haguedental.com or call on 0800 298 5003. For further details about Samera Dental Advisors, visit www.samera.co.uk or call on 0207 100 8788.