Moving away from the NHS is something many dentists spend a lot of time considering. Here, Practice Plan shares the experiences of two principal dentists who introduced private dentistry into their NHS practice in different timeframes. Ann-Marie Bard has just made the move in the past year, whilst Michael Cahill can give a longer-term view after leaving the NHS 19 years ago…
Ann-Marie Bard, Principal Dentist, Cleobury Dental Practice
The move from NHS to private was a personal tug of war for me, but ultimately came from utter frustration at not being able to provide the type of dentistry I wanted to. I’d worked in the NHS for 20 years and my parents had worked in the NHS, so it’s something I really believe in. However, with funding becoming tighter and tighter, and costs increasing, alongside the uncertainty around the contract reform and how difficult the new contracts could be to fulfil, I had to consider whether our practice should have all its eggs in the NHS basket.
I spent around two years thinking about whether or not to make the move to private dentistry. I finally made the decision last year after doing a molar root canal that took two hours, but then feeling worried about the cost to the practice. It was a constant juggling of time, money and the desire to deliver quality clinical dentistry, and something had to change.
‘It was a constant juggling of time, money and the desire to deliver quality clinical dentistry, and something had to change.’
Just as I didn’t want to be completely NHS, neither did I want to jump straight into being wholly private. I decided to move to private whilst the rest of the team remained NHS, which I felt would ease my personal frustration and worries but also give the practice more options for the future.
During my younger associate days I had worked at NHS practices where the principal had converted to private using plan providers, one of which was Practice Plan. I thought it was a very fair system that really benefited the patients, so I contacted them to start the ball rolling. I knew from the start I wanted to have a membership plan due to the guaranteed income and steady cashflow, regardless of absence due to holiday or illness.
The whole process of sending letters to patients prior to their next appointments took around 12 months and, of course, at the start I had concerns around whether it was going to work financially, how patients would react and whether they would move with me. Having those conversations with patients is scary at first but it soon becomes second nature and being open and transparent is appreciated by them.
In that year, we exceeded the target for the number of patients I needed to move private with me – which was a huge relief. It’s still early days but since moving to private I have been able to increase the amount of time I spend with my patients and the type of service I can offer. For example, I now feel I can spend half-an-hour with a new patient – rather than the 15 minutes I felt able to allocate under the NHS; also, a general check-up with x-rays is now 20 minutes rather than 10. I also now offer evening and weekend appointments, but at the same time I’ve been able to cut my clinical hours to allow me to pursue a postgraduate qualification and achieve a better work/life balance.
‘We’re starting to see the benefits just one year down the line, and I fully expect this to get even better as we continue down this journey.’
There’s no doubt it is a big decision, and can feel like a scary step to take at first. However, if you plan well, have a great team behind you and communicate openly with patients, it can really reap rewards. We’re starting to see the benefits just one year down the line, and I fully expect this to get even better as we continue down this journey.
Michael Cahill, Principal Dentist, Cahill Dental Practice
Ann-Marie’s situation sounds very familiar to me, and I’m sure it rings a bell with many other dentists who have worked, or are working, in the NHS. But what I also recognise in her story is not just the frustrations, but also the positive transformation she had after moving private. I made the move almost two decades ago and whilst the specifics of what was happening with the NHS then are different to today’s circumstance, I can recognise and empathise with the emotional experience.
I was in a very similar place. I had become the sole owner of the practice at the same time that a gross fee cut was introduced and it became increasingly hard to provide the dentistry I wanted to and make ends meet. Like Ann-Marie, I struggled with the decision and spent a long time considering what to do for the best, but a decision had to be made and it got to the point where I thought ‘I can’t do this kind of dentistry anymore’. We were losing money every month, having sleepless nights and felt like I was spending all my time at the practice, rather than with my young family at the time.
‘Within two to three months I knew I had made the right decision as I was beginning to feel the benefits.’
Eventually, a decision had to be made and I decided to convert the practice to private with the help of a plan provider as I didn’t want the uncertainty of a pay-as-you-go patient list. Within two to three months I knew I had made the right decision as I was beginning to feel the benefits, much like Ann-Marie.
As the financial pressure dropped, so did my stress levels. I was worrying less about how to pay the bills – and how I was going to get paid – and I began sleeping better. Of course, I’m still running a business so there are some pressures and challenges, but practice life became much less busy and hectic. We were able to spend more time with patients and ensure the number of appointments was manageable, which meant our relationship with patients and their experience was much better.
‘It was such a relief, both professionally and personally, to find another way of working, and I truly now love my job.’
Staff were also much happier as, with more control over the way we managed the practice, we could offer the kind of service we wanted to. It was such a relief, both professionally and personally, to find another way of working, and I truly now love my job. We work hard but we also have a great time whilst at work, I have no doubt that it was the right decision as it had such a big impact on every aspect of the practice and benefited not just myself, but my team and, importantly, our patients.