22 May 2017  •  Options Out Of The NHS  •  7min read By  • Practice Plan

How one practice built a successful mixed dental practice

The partners at Allestree Dental Practice in Derby had been looking at introducing private dentistry in their NHS practice for a number of years. Happily, after meeting Regional Support Manager, Josie Hutchings, from Practice Plan, they learned that they could take that longed-for step toward private dentistry while maintaining the security of their NHS income. Josie spoke with Practice Manager, Angela Ward, to reflect on the practice’s transition.

Josie: Thanks so much for doing this, Angela. Shall we dive right in? So, why did you want to gain some independence from NHS dentistry and what, if anything, worried you about such a change?

Angela: In a nutshell, remaining a fully NHS practice wasn’t going to be a viable financial prospect for us long-term, but we were initially very daunted about the prospect of making a big change to private dentistry. However, after researching the possibilities, we realised that there was another option – a middle ground of mixed practice. We recognised that a mixed offering would provide us with the  financial security from our NHS contract, plus the ability to treat those in need on the NHS, and the opportunity for other patients to get a different kind of care on a private basis and, with the plan in place, the security of a steady private income.

Josie: Clearly, generally speaking, there is the option for private patients to pay as they go. So why did you think a dental plan was important to bring into the practice?

Angela: We wanted to be able to offer the patients a system that would encourage them to attend the practice regularly, thus lending itself to a preventive approach, plus we wanted to help them budget for their dental care. With that in mind, we invited a number of plan provider representatives to come and talk to us about the possibilities, one of which was, of course, you, Josie. What was particularly interesting at that point in our journey was how you were able to give us a clear pathway to make the change, which gave us peace of mind. And seeing evidence of how the processes you implement have worked in other practices alleviated so many of our fears surrounding the idea of change. It gave us the confidence that what we wanted was achievable and that we could take that first step into private dentistry.

Josie: So,  with the guidance and advice you received  you had the chance to form your own ideas of what might work. And then, how did the team feel about the possibility of change?  

Angela: I think communicating why we wanted to make changes was one of the biggest challenges.  Obviously, the practice owners had an idea of what they wanted to do and were the catalysts but, of course, it’s really important to have the whole team on board. We knew that effective communication within the team and education about the benefits were going to be what got the team excited about the challenges ahead. That was something you were able to help us with, Josie, as I’m sure you remember all too well! The team discussions you led about the plan ensured the whole team was able to believe in what we wanted to achieve, and have confidence in its long-term success. The truth is, we have a great team and they are happy to go that extra mile to help patients achieve the best oral health possible.

“We knew that effective communication within the team and education about the benefits were going to be what got the team excited about the challenges ahead.”

Josie: Speaking of patients, how have they reacted to all of this?

Angela: Quite positively, thank goodness! As a team, we discussed how best to communicate our plans to our patients, and decided to speak to each of them on an individual basis. We felt an obligation to do that. That takes time and we are still in the process of doing that. We started in September 2016 and, as you can imagine, we don’t see some patients every 6 months so it’s what you might call a ‘drip’ conversion to private practice.

The practice has been here for over 45 years, and some of those patients have been coming for as long as that. So, it has been a big adjustment for some of them, but we are able to explain the benefits and that makes all the difference to how they feel about the change.

“I’m happy to report we’ve had a good take up of the plan to date and expect more to sign up as we get the chance to let more patients know about the benefits.”

I’m happy to report we’ve had a good take up of the plan to date and expect more to sign up as we get the chance to let more patients know about the benefits. Come back in another 12 months’ time and I think you’ll probably see a whole new practice!

Josie: You have touched the idea that you can still offer patients NHS care if they want, but how do you manage to balance the needs of both NHS and private patients?

Angela: From a purely practical perspective, our two principals are seeing private patients and the two associates are treating NHS patients. So, when a patient comes in for a check-up or because they have a problem, the dentist – irrespective of whether they are a principal or associate –  will explain any treatment that needs to be done, and offer a choice of treatment options. So instead of, for example, an NHS amalgam filling, which is standard NHS fare, the patients do have the option of having a white composite instead, when appropriate in clinical terms.

Josie: It seems like things have fallen into place for you. Based on your experience and knowledge of NHS dentistry, do you think more NHS practices might follow in your footsteps and start to offer private dentistry in this year?

Angela: I think change is inevitable. I think certainly with what’s happening in Britain at the moment, with Brexit – and the health and social care problems, people can see that there isn’t that funding available for the NHS. So yes, I imagine that in the not-too-distant future many practices will operate what you might call a two-tier system, to offer patients the best possible outcomes in line with their situation and preference.

Josie: Looking to the future then, what’s next for Allestree?

Angela: Eventually we will probably convert to a fully private practice, but we’ll do it slowly.  The NHS has its benefits but there are so many rules and regulations, and clawbacks if we don’t reach our UDA quota, that we do feel downtrodden by the system.

“Speak to a specialist about the best way forward, understand your patients, plan your transition, and make sure you have procedures and protocols in place.”

Josie: One final questions, Angela, if I may. If you could offer any advice to a practice that’s thinking of about taking this kind of a step into private dentistry, what would you say to them?

Angela: Speak to a specialist about the best way forward, understand your patients, plan your transition, and make sure you have procedures and protocols in place. When you came in on the first day of our conversion, you said, ‘It’s like clockwork. You’ve got your system in place and it’s working’. There was so much truth and reassurance in that statement; without the processes that you helped us to put in place, we’d be sunk. So, there’s no doubt in my mind that engaging the right dental plan partner is key to success!

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