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Business considerations for moving to fully private care

Guidance for practice owners on evaluating a move to fully private care, covering commercial, clinical, and operational considerations, and how to plan a safe transition.

Overview

Most general dental practices rely on a mix of NHS and private income. However, shifting patterns in patient demand, workforce pressures, and contractual requirements mean some practices are reassessing whether a mixed model remains sustainable for them. Deciding to terminate an NHS contract and operate as a fully private practice is a significant strategic choice which requires realistic financial forecasting, careful operational planning, and a clear understanding of the needs and expectations of your local patient base.

The first step is to assess your current position. You should analyse your service mix, appointment utilisation, fee structure, and the contribution that NHS and private streams each make to overheads and profits. Consider the resilience of your practice finances, including cash flow, reserves, and access to investment, alongside the capacity of your team to support change. It is also essential to review your brand positioning and patient communications so that you can explain the rationale for any change clearly and consistently.

You will need to understand what you lose by exiting the NHS contract, including the impact on patient access, the loss of NHS benefits for eligible patients and the operational shifts as you redesign your appointment book. Against this, there may be benefits to a fully private model, such as greater control over clinical time, scope to invest in facilities and technology, and the flexibility to align fees with the true cost of delivery. Your decision should also account for local market conditions, competitor positioning, and the willingness of your existing patients to continue with you on a private basis.

A structured plan helps ensure a safe transition. This includes timelines, legal and contractual steps, pricing and plan design, patient messaging, staff training, and data-driven monitoring to track the effects of change. Our advice outlines the key considerations, highlights common pitfalls, and signposts to further support so that you can proceed with confidence in your decision-making.

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