The dental profession, practice finances and the impact of Covid-19
The arrival of Covid-19 and its related consequences has challenged the future existence of dentistry throughout the UK – it is as simple as that.
For those not involved in the dental world, it is easy to overlook the fact that each practice is also a commercial business operation. The potential impact for a dental surgery is the same as for any other business when instructions are given to close the doors.
Early offers of financial support across all industry sectors were forthcoming from the UK Government and this was supplemented by a Scottish Government (SG) specific financial support package for NHS practitioners. The initial SG offering spread disharmony amongst the profession and following multiple representations, a revised package was subsequently issued.
Earlier mention was made of UK funding packages which includes the Job Retention Scheme (JRS) or furlough. There is much current debate about the interaction between the NHS financial package and JRS funding and the cross-over between both sources. SG have belatedly outlined their stance whereby they do not expect any ‘NHS staff’ to be furloughed within a mixed practice but do not specify how to determine the split between NHS and private staff. In the absence of clear guidance, NHS practitioners and their advisers are then left to best interpret the split of staff and I foresee trouble ahead here. The SG guidance is to prevent double funding which will be policed by way of possible future audit of financial claims. There will undoubtedly be some NHS practitioners at risk of a potential fraud accusation if their claims are aggressively excessive. UK Government have been silent on the matter to date.
The SG package was limited to NHS practitioners and silent on any support offering for private practitioners. Separate representations are now being made to SG by the private sector for financial support, with emphasis being placed on the consequences of private sector patients being forced back into an already strained NHS system should their current private practitioner be forced to close the doors – it will be interesting to see how much sympathy SG offers this line of argument.
The UK Government also announced a separate funding support package for the self-employed – unfortunately, the annual earnings cap is £50,000 above which a claim cannot be made. This effectively removes the possibility of a claim by the, perhaps vast, majority of the profession.
So where are we at this point in time. NHS practitioners have a specific funding package in place until the end of June and private practitioners, now, have no current specific Government funding. What happens, however, after the end of June? Which then turns thoughts from the here and now to the future and upon first sight, the future appears bleak. With some form of social distancing now likely to last for many months, it is hard to envisage how any dental practice will operate during this period. How will patients be managed? How will each individual surgery be cleansed between patients? What level of PPE will become mandatory? What types of treatment will be allowed?
Every aspect of the new dental world suggests potentially significant falling levels of income and undoubted increasing costs – a perfect storm. Each practitioner, whether NHS or private, needs to prepare a business forward SURVIVAL plan which needs to remain flexible in the full expectation that the journey ahead will have a few twists and turns.
Roy Hogg is a Partner at Campbell Dallas LLP and Chair of NASDAL Scotland.
See here for UK NASDAL ‘state of play’ report.