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