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NHS or private dentistry? What's your future career plan

Blog Author BDA Digital Team

Blog Date 26/07/2018



If you are wondering whether to focus your future career aims on working in the NHS or moving into private practice, here's some information to help you think through your career plan.

Is private dentistry an attractive financial proposition?

All the forecasts from the market analysts have been pointing to an increasing, not diminishing, private sector in dentistry, with some reporting an increase between 2017 and 2020 of 10% in private general dental services, and 15% for private cosmetic work.

This compares to a forecast of 1.5% growth in expenditure on NHS dentistry.

Of course, economic uncertainty is a consideration and some thought needs to be given to local factors such as the closure of a nearby major employer or, as is the case recently in Aberdeen for example, significant investment in new NHS practices.

Many patients appear to be becoming more and more aware of the benefits of private dentistry when it comes to achieving healthy teeth and gums, as well as the incredible things that can be achieved with cosmetic dentistry, the demand for which shows no signs of abating.

However, a percentage of patients will not be able to afford private dentistry and will still need the support of the NHS, to keep their teeth healthy.

As well as those on lower incomes, vulnerable groups such as children in more deprived areas, and adults, with or without learning difficulties, and older people living in care homes. These patients still need treatment, and the NHS should be able to provide for them.


Is there a future for NHS dentistry?

The last 12 to 18 months have seen intensive pressure on the wider NHS and it seems doubtful that NHS dentistry will be prioritised.

Even standing still in terms of its share of the NHS budget seems very unlikely while working harder to slow the backwards slide in income seems very likely.

Although there will always be some exceptions that are able to make a financial success from the NHS, for many we are hearing there appears to be little that gives confidence in the future for NHS dentistry.

The future for private dentistry seems to be bright.

But of course, one must be sensitive to fluctuations in terms of the economy - the crash of 2008 had a greater impact on private dentists, than on those relying on the NHS.

But, it seems enough of the public are becoming aware of the need to look after their oral health and are interested in straighter, whiter teeth that well-skilled dentists can achieve considerable success with the right planning. 


Are dentists working privately happier?

Stress levels for those working in the NHS do appear to be rising – working under the UDA system, increasingly bureaucracy, the pressures of regulation, all appear to be fuelling a low ebb of morale for NHS dentists.

Many young dentists say they are afraid of the GDC and of being sued by their patients. Within the NHS, we've seen breakdowns in communication between dentists and patients, caused by the time pressure of working under the UDA system, leading to GDC investigations.

But it can also be argued that, in respect of the risk of complaints, greater expectations among patients paying privately counteract the increased time available to communicate more effectively and build rapport.

And in terms of benefits, the NHS pension remains very attractive, even if it's not at the generous level it once was.


What will the corporate world look like in five years' time?

The corporate world is also shifting and it's hard to predict exactly what's going to happen, but here's what we know. We've heard that corporates are also having difficulties recruiting associates and this could impact on the viability of their NHS contracts.

Given BUPA were originally pursuing a strategy developing a chain of private practices, their acquisition of Oasis is a fascinating move, as the NHS accounts for a very significant proportion of the turnover of Oasis.

And of course, it is possible that a new NHS dental contract for England will be rolled out from 2020, but at this stage, it's unclear what impact that might have on the corporate model.


Is dentistry still a good career?

Don't let the negativity get you down. There are not many professions in which you can deliver such life transforming benefits to customers that aren't just about damage limitation, but can actually help take them forward in their careers and their personal lives.

Yes, the morale of the profession appears to be at a low ebb, and it's a shame that the NHS appears to be a major contributor to that.

However, many younger dentists today are forging amazing careers, taking on a range of different roles, and developing their skill sets and experience, to help 'future proof' their career paths.

This blog post is summarised from an original article in BDJ in Practice volume 31 issue 5, 'NHS dentists going private, which way will you jump?' by Nigel Jones at Practice Plan and Alan Suggett of Chartered Accountants UNW LLP

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