In an uncertain post-pandemic landscape, how can dentists thrive?
Associate Director and healthcare finance expert
UK dentists have had to cope with challenging sector dynamics recently. The exigent demands of the pandemic and its aftermath - especially in the private sector - years of stagnant state funding and an NHS dental contract that, arguably, is not fit for purpose. Then overlay the government clawbacks associated with underperforming against post-pandemic NHS targets, which are by many seen as unrealistic. It’s no wonder then that almost half of dentists have reduced their NHS commitments almost half of dentists have reduced their NHS commitments and thousands have cut ties altogether, in favour of private practice, according to the British Dental Association (BDA).
Whether dentists are moving into the competitive private market, staying with the NHS or seeking a better balance between the two, running a successful dentistry business today comes with a host of challenges. In this article, we signpost a few key factors dentists should consider when planning for growth and success in 2023.
NHS dentistry is at crisis point
The impact of the pandemic on dentists was in some ways unique. Whilst many businesses struggled to build back up post lockdowns, the dental sector was hit by a wave of pent-up demand. Closures and restrictions resulted in a year’s worth of lost appointments, but post-pandemic, demand persists and with additional challenges. Many practices are trying to mitigate the impacts of years of NHS underfunding, whilst managing the rigors of post-pandemic service requirements.
26.4 million courses of NHS dental treatment were delivered in the UK in 2021-22, the BDA says. That’s just two-thirds (67%) of the 39.4 million delivered, on average, in each of the five years before the pandemic. Over a year's worth of NHS dental appointments have been lost since the first Covid lockdown, and the BDA estimates the resulting backlog “will take years to clear.”
Can NHS England reforms to the dental contract halt the NHS exodus or fix the crisis in patient access?
To make things even harder, since 1 April 2022, dentists have been compelled by NHS targets to hit 100% of their pre-pandemic activity, and will see NHS revenue clawed back if they fail to deliver their requisite Units of Dental Activity (UDAs). Yet despite this pressure, the BDA says there have been no gains in the volume of NHS dentistry delivered.
Patient access to NHS dentists is worse than ever.
A December 2020 report from national watchdog Healthwatch first revealed the damage done to NHS dentistry by the pandemic. It reported a 452% rise in complaints during the first Covid peak in summer 2020, and its survey of 1,300 people found that 73% struggled to access NHS dental care. Its update in December 2021 revealed this figure had gone up to 80%, because NHS services had not returned to pre-pandemic levels. With the crisis becoming front-page news, a comprehensive BBC investigation in 2022 contacted nearly 7,000 NHS dental practices across the UK and found that 90% were not accepting new adult NHS patients.
Can dental contract reforms halt the NHS exodus?
In July 2022, NHS England announced the first significant change to its dental contract in 16 years, including a minimum UDA value of £23 for the first time. However, this effort to reverse the decline in NHS dentists has been widely labelled ‘too little, too late’ by voices across the sector. The BDA says these “minor tweaks” are not enough to prevent the exodus of dentists from the NHS, or to fix the crisis in patient access, because they come with no additional funding and don’t fundamentally overhaul the contract’s “failed target-based model.”
A brighter future?
The UK Parliament’s Health and Social Care Committee recently launched a new inquiry into access to NHS dentistry. The BDA welcomed the inquiry but warned that it may be the “last best hope to save the service.” It says that government ambitions to improve patient access and retain NHS dentists will fail unless there is new investment after a decade of “savage cuts.” Allowing for high inflation, it would take an extra £0.5bn each year just to match the spending levels of recent budgets, but an extra £1.5bn a year would be needed to restore NHS dentistry in England to 2010 levels.
How can dentists set themselves up for success in 2023?
To succeed in this uncertain post-pandemic landscape, dentists must have the freedom to invest in successful commercial businesses, to build the capacity to tackle the backlog of procedures and take on new patients. As the sector evolves with a greater focus on the business itself, there has never been a better time for dental practices to expand their services and build thriving businesses, whether they’ve just started out, are looking to grow by acquisitions or simply want to keep up with current demands. But all of this takes a substantial investment, which requires working capital.
Going forward, the working capital requirements of dentists will be bigger than ever before, as practices are going to need more of everything to tackle the pent-up demand for treatment. Whether a practice decides to focus on NHS patients, private practice or a combination of the two, a flexible and ready supply of working capital should be at the top of its list of priorities.
Moving into private treatment means surgeries will need to spend more on marketing, facilities and training to keep up with rivals in a highly competitive market. Practices have to consider investments such as expanding their patients’ services, updating their reception facilities or investing in technology, automation and staff, as well as considering acquisitions to grow their businesses.
For NHS dentists, the challenge is how to service their NHS patients efficiently and meet challenging targets, while simultaneously operating successfully at a commercial level, often by combining private with NHS treatments. With NHS funding in short supply and a history of years of structural challenges, dental practices must prioritise operating as successful businesses first, or they won’t be able to care for patients at all. Whatever the future holds, the one thing dentists cannot afford to do is stand still.
Choosing the right finance partner is crucial.
Traditional finance simply isn’t suited to scaling a modern dentistry business. A specialist partner like TradeBridge, who understands how dental practices work, can help dentists to seize opportunities and adapt to challenges on the horizon.
With years of experience in the dental sector, we’ve designed a finance facility specifically for dental practices that uses real-time trading data and other information to make a faster, more accurate risk assessment that reflects the true strength of a business. That means we can offer a flexible, revolving line of credit of up to three times a dental practice’s monthly income, with no restrictions on its use, no fixed repayments, immediate online access and the freedom to only draw down (and pay for) what the practice needs.
At TradeBridge, we speak to all kinds of dentists every day and we hear a common theme - at a time of seismic change, it’s wise to prepare for an uncertain future, whatever your goals. Choosing flexible finance gives you the working capital to be confident. Whether you want to seize the day and grow your business aggressively through acquisitions, start a new practice or simply invest to keep up with patient demand in an increasingly competitive market, the future is bright for those who are ready for it.
A specialist finance partner who understands how dental practices work, can help dentists to seize opportunities and adapt to challenges on the horizon.