The next generation

Aspiring dentists in Scotland will benefit from modern, first-class teaching facilities – but what kind of profession will they be entering?

14 February, 2022 / editorial
 Will Peakin  

Commenting on the news that the value of NHS practices fell significantly in 2021, Alan Suggett, specialist dental accountant and partner in UNW LLP, said: “These results may come as a surprise to some, coming as they do in the uncertainty of a worldwide pandemic.” 

At first, I thought he may have missed  out a word; that is, “not” – as in “…may not come as a  surprise…”. With NHS practitioner burnout building pre pandemic, and lockdown prompting many to consider their  future, surely it would not come as a surprise that there  would subsequently be a glut of NHS practices coming on to  the market – thus forcing asking prices down. 

But no, Mr Suggett’s logic was that an NHS contract ought  to provide certainty in an uncertain world. Well, perhaps,  in a previous world. To be fair, he did acknowledge that it  “could be the beginning of a trend as dentists turn their back  on NHS practices due to uncertainty around their value in  years to come”. A colleague, Johnny Minford, of Minford  Specialist Dental Accountants, added: “Anecdotally, I’m  seeing a lot less interest in buying primarily NHS practices  because the uncertainty of required achievement has  increased negative attitudes and pulled down prices.” 

What of Scotland's new model of care? Hello? Anyone?

I understand that corporates, and even fledgling  independent groups looking to grow, regard an NHS contract  as an important recurring revenue stream. But there are  several reasons why it is equally understandable that  practitioners – and in turn – the market for NHS practices  are turning their backs on our National Health Service.  Principal among these is the failure by governments –  

Scottish and UK – to come up with a new model of care  and an accompanying system of funding. 

As we report in the News section, NHS England  has abandoned the testing of new ways of providing  care with an increased emphasis on preventing  dental disease. Around 100 practices that were  taking part in the Dental Prototype Agreement  Scheme have been told that from 31 March they  will revert to the historic, target-based, model of  care. And what of Scotland’s new model of care?  Hello? Anyone? We’re still waiting. 

Meanwhile, consumer trends are fuelling a  demand for orthodontics (the so-called Zoom boom) and private dentistry (paid for from savings made by not being able to go on holiday and, to a  lesser extent, not having to commute to work). As Christie &  Co notes in its annual report Business Outlook 2022: Adjust,  Adapt, Advance: “Noticeable trends include the migration  of patients from the NHS to the private sector and a general  increase in the typical spend of patients, particularly on  cosmetic and aesthetic dental treatments.” 

Its report notes that reduced activity in the NHS sector,  because of the restrictions brought about by the pandemic,  has freed up capacity in some practices for private dentistry  to be introduced. Practice owners are looking at a more  balanced income mix and are actively considering reducing  their NHS commitments, when activity returns to 100 per  cent, to retain their new private income. 

Free NHS dental care at the point of use remains a central  policy of the Scottish Government. A recent BDA survey,  however, showed that Government plans to revert to pre COVID models of care risk sparking a flight of dentists from  the NHS, with potentially devastating consequences for  patient access. New data has already revealed decreases in  attendance and ever-widening inequalities. 

In this issue, we report on Dundee Dental Hospital and  School’s recent £2m refurbishment, which has seen the  school benefit from 53 new dental chairs and the installation  of innovative pods which allow dental treatment to be  delivered in a COVID-safe way. The refurbishment is a  significant investment for patients and, importantly say the  team behind the project, Dundee is now able to provide the  next generation of dentists with modern, first-class teaching  facilities. 

The question is, what kind of profession will this next  generation be entering?

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