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a blog by Chris Barrow

Serendipity and the NHS Dental Rescue Plan

I left home at 07:45 yesterday morning and after 276 miles of driving (ouch) and two meetings, I arrived at Aston University, Birmingham for 20:30 last night.

As a result, no chance to watch any TV news but I did have the opportunity whilst driving to listen to the emerging news and commentary on the Government's proposed "rescue plan" for NHS dentistry.

The Radio 4 interview with Victoria Atkins, Secretary of State for Health and Social Care, was a very unfortunate start to whatever campaign the authorities might have had to reassure the public that help was at hand. I think "politely savaged" would be a fair way to describe her interview just before 08:00 on the Today programme.

Add to that the "moving the deck chairs"comment from the BDA and "temporary filling - and not a very good one" from the dentist interviewed by Radio 4 - I'm guessing that the TV coverage may not have been much better.

This on top of the queues outside the new Bristol practice that made the headlines on Monday - quite the week.

How easy it would be for me to mouth off here that it's time for every independent, owner-managed practice owner who still has a contract to take this opportunity to jump ship and go fully private.

Which is why there is a strange irony in the fact that, after listening to the Minister make a dog's breakfast of her interview, my first meeting at 08:30 was with a young dentist who bought a 100-year old practice in 2019 (goodwill and freehold) for over £1m and is now managing a list of:

  • 4,000 - 5,000 NHS adult patients;

  • 2,000 NHS children;

  • 900 Plan patients;

  • 100 Fee per item patients.


  • He is finding it difficult to retain associates to deliver the NHS service - they burn out and look for private jobs elsewhere;

  • The hygienist is booked up months in advance;

  • His own diary is rammed with NHS check ups, on top of his plan patients;

  • When he does get patients interested in buying private treatment options (there's an iTero in his surgery), it is weeks and weeks before he can see them.

Is this a classic "pull the trigger, go private, Big Bang or Slow Burn"?

Maybe so - but I'm going to paraphrase what he said to me at the start of our meeting, as we looked out from his first floor surgery across rows of terraced houses:

"This isn't the most affluent postcode around here and I feel a duty of care to continue with some NHS provision to support the local community - I don't want to leave them in the lurch."

I felt humbled by that comment - he has neither an Instagram account, an award on his mantlepiece nor a supercar parked outside.

Paradoxically (and delightfully) after my comments this week on saboteurs, his team (some of whom have been there 20 years) are on the bus - largely I suggest because he is such a nice guy.

The business is profitable but he is reinvesting those profits into an additional surgery, a new surgery for himself, a new staff room for his team and general redecoration, most of it paid for in cash (p.s. he paid cash for his scanner).

In the event, we spent three hours creating an action plan to maintain his NHS activity, whilst allowing him the time to upsell more private treatment (with time to deliver it) - I have no doubt that the growth potential in this business is huge:

  • Therapy-led maintenance;

  • The introduction of implants on-site;

  • A steady increase in plan sign ups:

  • A significant increase in FPI prices;

  • More effective internal marketing;

  • Training TCOs.

Amongst other things.

Perhaps if I hadn't met him, my post this morning would have been ABANDON SHIP!

A very serendipitous meeting for me and a reminder that there are some lovely people out there in dentistry, unsung heroes, Samaritans, trying to do their best with the resources they have and trying to help.

Do you want to hear the icing on this cake?

As our meeting came to a close, he asked me if there was an opportunity to join The Extreme Business 100 community.

A couple of his friends are my clients and had urged him to become a member.

Absolutely - I'm going to enjoy helping and watching him grow over the next few years.

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1 Comment

Beautiful Post Chris. It is humbling to see someone so a part of their community that they want to continue to serve while continuing to build their practices in a more satisfying way. I have clients like this in the US and they have grown enormously in profitability and in patient base while serving both the (USA) Insurnace, fixed fee patients and the fee for service comprehensive care patients. I have been in your mindset re "Jump Ship" before and wonderful dental professionals remind me there are multiple paths. They get to choose. Keep up the great work!! Suzanne

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