Where are we with NHS reform? We know the final contract will pay practices according to both UDA activity and a fee determined by the number of patients they serve. We don’t know how. We know it could arrive in 2020. But realistically it must be later given Brexit and the government’s other health priorities (let’s face it, dentistry is its least sexy portfolio).
So not a great horse to harness your cart to if you’re looking for long term business security. A cynic might observe that the government seems to be trying to snuff out NHS dentistry altogether, and it’s a fact that life in the NHS is being made intolerable for all but the big groups and corporates.
Just to make life that bit harder the NHS operates different policies for Northern Ireland, Wales, Scotland and England, but there are common elements in the direction of travel. Here’s why the future looks bleak for all you owners of mixed and total NHS dental practices out there.
- You’re in hock to a capricious and often brutal administration. A quarter of NHS practices are financially crippled by clawback, a cashflow dirty bomb detonated after the end of the financial year when businesses thought they’d already paid overheads
- You’re at the sharp end of souring public relations as news gets out that within five years NHS patients at a third of surgeries will be paying more than their treatment costs (and patients assume you’re making more money)
- While UDA contracts keep getting harder to perform, especially in areas with the most contracts, you’re vulnerable to taking on patients who need work that isn’t remunerated
- Toxic levels of patient dissatisfaction continue because you face recruitment issues and staff shortages
- There’s a skills gap that’s acknowledged by many experienced dentists, so it’s an unhealthy environment for your clinical career
- There’s an unprecedented volume of fitness to practice cases — will you be next?
- The increasingly onerous regulatory environment means you’re scared to claim for things you’re entitled to
The only certainty about contract reform came from Sara Hurley, the chief dental officer for England, who announced the end of lifetime contracts — they will all become time-limited to bring them in line with other government contracts. So even less security.
If you need a hand transitioning out of the unhappy public sector and into the lucrative private one, get in touch.
Zac
