Replacing NHS income when moving to independent dentistry

One of the biggest concerns for dentists looking to make the move away from NHS dentistry is how to replace their contract income. Practice Plan Area Manager, Katrina Rees, outlines some possible ways to achieve this.

23 November, 2023 / professional-focus

When a dentist hands back their NHS contract they have three months until the payments cease. So it’s important that they know how they’re going to replace that income. And the greater the practice’s dependence on the NHS income, the greater the sense of risk and worry.

There are several key considerations for replacing this income, so it’s important that a certain amount of groundwork is done before moving to hand back the contract. The good news for practices is, they don’t have to work everything out themselves as we at Practice Plan will support them with this and do most of the legwork for them.

A full risk assessment

First of all, we will get under the skin of the business to understand it fully so we can carry out a complete risk and viability assessment to ensure that the conversion is a suitable option for the practice. This includes looking at things such as, how long the person converting has either owned the business or worked there? Who is converting – one individual or everyone in the practice? And if it is one dentist, will patients still be able to access NHS treatment at the practice or would they need to find another dentist?

Establishing the answers to these questions helps inform our risk and financial assessments. Once we know more about the business, we then start looking at the patients to assess the potential income for the practice so we can carry out our income replacement calculations. We review things such as how many patients attend the practice? How many of those are fee per item patients?  How many are NHS patients? And of those NHS patients, how many are exempt and how many pay fees? In addition to this, we also need to understand the value of the contract to be replaced.

Having gathered all this information, we can then look at the business pricing structure to ensure it is fit for purpose. We can establish whether it is currently generating the hourly rate the practice needs to be future proof. Do the sums add up? If not, it may be that the current fees need to change to ensure they generate the revenue needed. So, there are several considerations. It’s not something that can just be worked out on the back of an envelope!

The importance of replacing benefits

However, it’s not only about the business. Often when dentists are considering an NHS to private conversion they neglect to consider their pension and the impact leaving the NHS will have on this. This is an extremely important consideration and should not be neglected.

Every individual’s circumstances will be different, so it’s essential to explore this subject fully before making the move. Leaving the NHS will mean foregoing numerous other benefits as well as the pension. However, there are ways to replace them so it’s advisable to seek guidance from a financial expert experienced in this field.

Our friends at Wesleyan Financial Services have a team of Specialist Financial Advisers who have in depth knowledge of NHS pensions and benefits. They are able to offer guidance on how to replace the pension, sickness cover, death in service and other benefits dentists will forfeit by leaving the NHS. If you do choose to hand back your contract, it’s advisable to make sure you put these replacements in place without delay, so you aren’t disadvantaged in the future.

How introducing a membership plan can help

It’s important to remember that every NHS conversion is unique and so the risk assessment and financial calculations are for guidance only. Having said that, it’s useful to have a projection of how things might look.

Introducing a dental membership plan is a good way to help ensure the regular NHS income the dentist has been accustomed to receiving every month is replaced. As part of our assessments, we would calculate how many plan patients would be needed to replace the income received from routine diagnostic appointments. Treatment uptake is treated as a separate amount of money. Our risk and viability assessments also help us to understand how much private and NHS work is currently being carried out at the practice. This information is then used to project how many patients need to sign up to a plan to cover that routine income.

We always explain to dentists that a membership plan is unlikely to replace all their NHS income immediately. That’s not what it’s intended to do. Plan income needs to be sufficient to cover the income from routine and diagnostic work, while the uptake of private treatment plans will provide the rest of the income.

For anyone concerned that patients are not prepared to pay to maintain their oral health, our recent experience has shown that patient attitudes toward paying privately for dentistry have changed since the pandemic. The COVID backlog and shortage of NHS dentists means now more than ever, they are prepared to sign up to a membership plan as a way of ensuring they will be able to gain access to a dentist when they need one. Being able to spread the cost of maintaining their oral health through plan membership also makes the decision to choose private dentistry easier for many too.

That’s why having a membership plan works for both the practice and the patient. Patients have the peace of mind of knowing they are ‘members’ of a particular practice and that they will be able to get an appointment. While practices have the guaranteed monthly income which helps go some way towards replacing their NHS contract revenue while also helping to smooth their cashflow. It’s win-win!

If you’re considering your options away from the NHS and are looking for a provider who will hold your hand through the process while moving at a pace that’s right for you, why not start the conversation with Practice Plan on 01691 684165 or book your one-to-one NHS to private call today.

For more information visit the Practice Plan website.

About Katrina

Katrina is an Area Manager who joined the dental sector in 2018 after 25 years’ of working in sales and people management roles. Practice Plan is the UK’s leading provider of practice-branded patient membership plans, partnering with over 1,800 dental practices and offering a wide range of business support services.

Practice Plan Limited is an introducer appointed representative of Wesleyan Financial Services Limited. Practice Plan Limited (Registered in England and Wales No. 03089948). Registered office: Cambrian Works, Gobowen Road, Oswestry, Shropshire, SY11 1HS Telephone number: 01691 684120. Website:

‘WESLEYAN’ is a trading name of the Wesleyan Group of companies.

Wesleyan Financial Services Ltd (Registered in England and Wales No. 1651212) is authorised and regulated by the Financial Conduct Authority. Registered Office: Colmore Circus, Birmingham, B4 6AR. Telephone: 0345 351 2352. Calls may be recorded to help us provide, monitor and improve our services to you.

Tags: Business / NHS / Practice / Private

Categories: Magazine / Professional Focus

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