Dental Contract Reform

Yesterday marked what appeared to be the first attempt to change the way in which NHS dentistry operates in England, since April 2006. The Chief Dental Officer, Sara Hurley has outlined a package of reform, the intention of which is to make it easier for patients to access NHS care and to allow practitioners to allot more time to those of their patients in need of complex dental treatment.


Reform was promised in 2013 and 9 years has passed since then without the mechanism of NHS dentistry being substantially changed. Pilot and prototype contracts have come and gone and perhaps it is only the drastic need for a change to the current system as a result of the pandemic, that has prompted a call to action.


The need for the profession to be supported, for oral health outcomes to be addressed, for NHS dentists to be able to undertake proactive dentistry rather than just reacting to the number of UDAs that they are expected to achieve and to ensure that patients have access to NHS care where it is appropriate are issues that have been in need of attention for some time.


It is perhaps merely a coincidence that these changes have been proposed just as we return to 100% contract activity, this having been slashed as low as 20% in April 2020 and over the course of the last two years, gradually reverted back to pre-pandemic levels.


The events of the last 2 years have not been lost on practitioners and perhaps the CDO is hoping that these proposals, if already far too delayed, might give some comfort to those NHS dentists who were considering moving into the private sector or leaving dentistry completely.


The devil as always, is in the detail and the attached letter from the CDO to the profession outlines the proposals in full.


The intention is to introduce enhanced UDAs to recognise the range of Band 2 treatments; to establish a new minimum UDA value across the whole of the NHS; to enable DCPs to operate using their full skills rather than with the present restrictions; to maximise access to NHS dentistry and to ensure that patients receive the regularity of examinations that their oral health requires.


Implementation is proposed this Autumn. 


We can only wait with baited breath to see if that becomes a reality. Past experience would suggest that promises made do not materialise.


NHS dentistry cannot afford for there to be any more delays and whether the measures provide the "root and branch" change that needs to be delivered remains to be seen.

Principal vs. Associate-Led Dental Practices: A Financial Analysis

20 September 2024
Understanding the Leadership Structure The leadership structure of a dental practice can significantly impact its financial performance. There are two primary models: Principal-led and Associate-led. Principal-led: In this model, the principal dentist owns and operates the practice, assuming full financial and management responsibility. Associate-led: Here, the dentist is a self-employed contractor to the practice, the principal dentist having the responsibility to provide patients and where necessary, to offer assistance and advice. Financial Implications Income Distribution: Principal-led: The principal dentist retains all profits after expenses, potentially leading to higher income but also greater financial risk. Associate-led : Associates receive a percentage of the fees that they generate as income, providing more financial stability but limiting earning potential. Overhead Costs: Principal-led: The principal dentist is responsible for all overhead costs, which can be substantial. Associate-led: The Associate is responsible for a share of the lab expenses that they generate Debt and Risk: Principal-led: The principal dentist is personally liable for any debts or financial obligations incurred by the practice. Associate-led: The associate is not responsible for the practice’s debts and liabilities. Succession Planning: Principal-led: Succession planning can be more complex, as the principal dentist must find a suitable successor or sell the practice. Associate-led: Succession planning can be easier, as associates may have an option to purchase the practice or continue working under new ownership. Financial Considerations When evaluating the financial implications of a Principal vs. Associate-led practice, consider the following factors: Personal financial goals: Are you seeking higher income potential or a more stable income stream? Risk tolerance: How comfortable are you with assuming personal financial risk? Long-term goals: What are your plans for the future of your dental career? Local market trends: Are there any trends that favour one model over the other in your opinion and experience? Conclusion The choice between a Principal-led or Associate-led dental practice sale and purchase depends on your individual circumstances and financial goals. By carefully considering the financial implications of each model, you can make an informed decision that aligns with your professional aspirations and long-term success. Feel free to contact us for more help and advice.

Purchase Completed in York

19 August 2024
Congratulations to Joanne Nurse on the acquisition of a share in Adventurers Day Nursery in York. Joanne now becomes co-owner of the nursery with Helen Nurse. Many thanks to everyone involved in the transaction, especially Amardeep Nangla for his work done on the property side and all those at Barclays Bank who helped facilitate this transaction. All at Jacobs Legal wish Helen and Joanne all the best for the future and much success in the years to come.
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