How did you go about transitioning from NHS to private dentistry?

Initially I spoke to a practice management consultant at the BDA who answered my questions about how to start out, and the regulations and laws around it. Then I contacted a plan provider, and they sent a rep who helps with practice conversions. He told us it would probably take 12 months in total.

We wanted to offer patients different plans according to what suited us, so we chose a provider that tailored plans. The rep for Northern Ireland worked with us to set what the monthly fee should be for our practice, and then we could work out what fees we wanted to charge. We have got two plans the patients can choose between with the name of our practice on, Delicate Dental, and our logo.

Patients

In Northern Ireland, with three months’ notice you can deregister a patient, with no restrictions on who you deregister and who you don’t. Our rep told us that some practices send all the patients letters and then deregister all of them at once, but we decided to do it more gradually.

Use our template letter to deregister patients.

From August 2024 we started to deregister all the adults and kept all the children and students. We didn’t think it was fair to keep some adults and deregister others. When each person came in, they had a checkup and if they needed treatment that would be their last course of NHS treatment. We gave each patient 12 weeks’ notice, and they could have more NHS treatment within that time if required.

Staff

The staff had a training day to learn the best ways to tell patients about the changes and answer their questions. I tell the patients about the new system in the surgery and when the patients get home, they may have more questions, so they email or phone the staff. The training helps staff feel confident in supporting the patients.

With a payment plan the staff explain it to the patients so that the patients feel the value. The receptionists also needed to make a shift into charging the patients more and feeling comfortable doing so. Going over this in the training programme meant that everyone was on the same page and we had easier conversations with the patients.

When we started it was hard to find the words to explain it to the patients, it took me a while to get used to how I was saying it. Over time though, it got easier and faster.

What were the biggest challenges in making the switch?

I know there are people I won’t see again because they don’t have the means to pay, and that’s hard. You can expect a few ups and downs, but you have to believe you’re doing the right thing.

With NHS patients, the fees are set by the government, so you have to put your mind to learning about the new system. At times the team has found the transition challenging because it takes time to settle into what we’re doing. We have two plans that cost different amounts, with different conditions. Then there is quite a lot of training staff go through to be able to answer the patients’ questions. The staff spend more time with people because of the changes and answering their questions, and they have a separate login to sign the new and existing patients up to the private system. Sometimes you don’t know the answer to every question, and you need to check.

Staff go into a portal to get the patients registered, and they need to be trained in how to do that so there is a lot of extra admin, and the training helps them to understand the advantages. Some practices have four plans but we have two because we didn’t want to make it difficult for patients.

When we started in August it took a couple of months to get into the swing of it, then we had a refresher course at the end of February. In between, our rep came in and checked that we were ok.

Managing the challenges

It’s a learning curve and it can be unpredictable. You can have a plan but when you start to communicate with patients, you don’t know how it’s going to go, so practice is key.

The staff get more practice depending on how much reception work they do, so we swap the nurses in at reception. That way, everyone gets up to speed because they have had several days of reception work. At our practice the staff have a lot of exposure to the process, we make sure that everyone is keeping up with it and they are happy. If someone is feeling under confident, they need to do more of it with the practice manager.

Is the patient experience different in private practice compared to the NHS?

In our case, we are in the same building that we built 10 years ago for NHS work, so the surroundings are identical. It was built to a high specification because we wanted a nice working environment. There is a lift, a nice waiting area, and it’s all fully accessible with a good quality A-dec 500 chair. So, because we went above and beyond beforehand it always looked like a private-oriented surgery, but the patients didn’t realise that.

What makes a dental practice seem private is probably a very individual answer. I’ve been in the same town for 20 years, so I remember if patients were going to a wedding or having a grandchild. We have had the same reception team for 20 years and it’s all personalised to the patient. So for me in private practice, I can spend more time with those people and do things to a very high standard. Have that personal relationship and build a connection that you can’t if you see 30 people per day. It’s the luxury of time.

That is important to me because I have always viewed myself as a family dentist and been more about the personal relationship than the fancy surroundings.