Investing in clinical expertise and practice teams

Rising operating costs continue to reflect investment in the clinical workforce and wider practice operations. As shown, workforce-related expenditure is a major contributor to practice spending, reflecting ongoing recruitment, retention, and wider labour market pressures across the sector.

Several factors have contributed to these pressures, including:

National Minimum Wage and Living Wage increases: Baseline pay expectations have continued to rise across the wider economy. For workers aged 23 and over, the National Living Wage stood at £10.42 in 2023. From April 2024, eligibility for the National Living Wage was expanded to include workers aged 21 and over, alongside an increase in the rate to £11.44. This was followed by a further rise to £12.21 in 2025 and £12.71 from April 2026 (2). These changes continue to feed through into practice payrolls and wider pay structures
Employer National Insurance Contributions (NICs): Following the 2024 Autumn Budget, practices are continuing to manage the increase in employer NICs from 13.8% to 15%, alongside the reduction in the secondary threshold from £9,100 to £5,000 per year, meaning a greater proportion of employee earnings are now subject to employer NICs. The 2025 Autumn Budget confirmed that employer NIC thresholds, specifically the £5,000 secondary threshold, will remain frozen until 2030-1
Recruitment and retention pressures: Dental practices continue to report difficulties recruiting and retaining staff, particularly dental nurses. Our survey data shows that a substantial proportion of practice owners seeking to recruit dental nurses continue to experience difficulties. Given that dentists are unable to provide treatment without the support of a dental nurse, these issues have continued to place upward pressure on wages and wider workforce costs.

These pressures are explored further in the workforce section, which examines trends in pay growth, recruitment challenges, and changing workforce composition across NHS and private provision.

While practice-level operating costs remain elevated, wider macroeconomic conditions are showing signs of stabilisation. These improving conditions are also beginning to support a more favourable environment for practice investment, acquisitions, and long-term business planning across the sector.

Investing in clinical expertise and practice teams

Notes

This is a BDA member exclusive

Not a BDA member?