Can dentistry survive without furlough?
With the furlough scheme finishing at the end of October, we ask Andy Acton whether he believes dentistry will survive without this support.
When I was asked to write an article under this heading, I thought it would be a short piece as the answer is emphatically, yes!
This is the reality; dentistry is a resilient, innovative, and adaptable profession. For many it isn’t just about survival, it will transform how we deliver dentistry going forward.
If we roll back to the 23 March when the UK was put into lockdown, the future was at best sketchy and at worst unknown.
In an unprecedented move the Chancellor announced the Job Retention Scheme, commonly referred to as furlough. This gave employers a grant to cover 80% of the salary of employees who would have been otherwise laid off. Up to a total of £2,500 per month for each retained employee.
This was for employees who were not working and on ‘furlough leave’. And for many practice owners this was a lifeline.
As a business owner, ensuring your team are looked after is the top priority, but it doesn’t stop there.
Whilst suppliers and landlords were understanding, bills still needed paying. Again, the government stepped in with the Coronavirus Business Interruption Loan Scheme (CBILS). Before quickly following this up with the Coronavirus Bounce Back Loan.
As a green light sector for the banking industry, almost every case was arranged swiftly and hassle free.
These finance packages came with preferential repayment terms. But they weren’t grants, the banks will want their money back over a period of time.
Supporting dental associates
The extent of support for associates didn’t quite match that of practice owners.
The government announced a Self-Employed Income Support Scheme. This allowed self-employed people or members of a partnership to recover money if they have lost income due to the coronavirus.
However, there was a condition that your trading profits must be less than £50,000. And that more than half of your income must come from self-employment.
For most associates, this meant they could not benefit from this scheme. And for many it meant they needed to rely on their own personal savings.
The lack of support for associates led to a marked increase in associates looking to buy dental practices.
Many view practice ownership as the path to long-term security and greater control of their future.
Frank Taylor & Associates increased the number of dentists looking to buy a dental practice to nearly 5,400 – up nearly 400 in just a few months.
On the 28 May via the BBC news ticker announced that dentists could reopen their practices and return to work from 8 June.
Given the work required to reopen dental practices closed for over two months, 11 days’ notice was nothing short of disrespectful to the profession.
It is now over four months since the government gave dental practices permission to reopen. Indications are the profession is responding extremely well.
Practices with NHS contracts continue to receive payments for delivering patient care. And those with patient plans are in receipt of a regular monthly income.
The real success story has been how independent private fees have recovered.
Quarterly management information for the quarter to September 2020 shows most practices are back to pre-COVID trading levels. Anecdotally this is attributed to a combination of longer opening hours, slightly increased fees and a surge in patient demand.
This is also through a period where practices needed to take into account fallow time.
Job Support Scheme
The Job Support Scheme runs for six months from the 1 November. Reported financial recovery is vital for the business health of dentistry.
We don’t know if the government will extend this scheme or not, but it’s prudent to assume not and plan accordingly.
In reality you can only ever cut costs in a business so far and driving up income is the way to thrive rather than survive.
The outlook for dentistry is incredibly positive compared to the wider business landscape. But there is always more that we can do.
Here are some pointers for dental practice owners to build on their recovery or kick-start it:
Pace of work
It is very likely you will see less patients than you did pre-COVID.
Reviewing the hours your practice is open for patients could create additional capacity.
An early start, late finish, or Saturday morning will unlock valuable time to see patients. I appreciate this will mean longer hours, but recovery may not be a comfortable ride.
Efficient use of air filtration systems can help reduce fallow time and bolster productivity.
Engage your team
You are not going to recover and thrive alone. You will get so far and then burn out. Therefore, you will need the help, support and commitment of your team.
You will need to show leadership and empower your team with total support. Regular team meetings will play a big part.
This is planning what you will do each day.
Going forward there are financial gains by structuring your approach to diary management.
Treatment scheduling, triaging patients prior to appointments to minimise downtime in the practice and accepting online payments will all positively impact on the total practice over the course of a day.
Increasing prices will boost profitability.
It is important to consider when you last increased prices and identify treatments that are not so price sensitive.
For example, the prices of a routine examination or hygiene appointment will be more sensitive to change than less routine treatments such as a crown.
Boost your marketing
Recruiting new patients will add revenue and (assuming you run a profitable practice) will add to the bottom-line profit.
For associates it is more about ensuring they build their savings as a safety net should they need it in the future.
As a guide, having a three-month supply of living expenses available in cash is a good start. Review your own personal insurances in case you are unable to work through ill health.
Consider ways that you can enhance the value you bring to the practice you are working at. For example, possibly through the ability to deliver a wider range of services, practice promotional activity or supporting the principal with management assistance.
As government support starts to wind down, it is important to ensure your bank is supportive.
Whilst we know that dentistry is a low risk sector, it is important to have up-to-date financial information to help your bank make quick decisions. Even if you do not envisage needing support in the short term, it is good practice to involve your bank in your business as things can change.
The road to recovery
It would surprised me if a furlough-type support extends beyond April 2021. The financial impact of COVID has been immense and starting to repay this national debt will need to start soon.
The long-term impact on dentistry has already been triggered. Enhanced PPE, new patient flow systems and development of virtual consultations for certain treatments.
The post-COVID practice is more efficient, offers multiple ways for patients to engage and embraces digital technology like never before.
Change is the only constant in life. Whilst COVID is unleashing massive change, I am confident dentistry can cover it.
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