I may have mentioned that I love aviation. In fact, after our Christmas meal in December, I told some of my colleagues who mercilessly mocked me for geeking out - that's how much I love it.
One of the more mundane but interesting nuggets is the time it takes for Transatlantic journeys from London to New York and back. London to New York takes roughly 7 hours, and New York to London somewhere in the 6 hour region - a full hour's difference. Headwinds and tailwinds.
At Christie & Co's Business Outlook report event in mid-January, their Global Managing Director Darren Bond provided a timely reminder of some of the headwinds the business market experienced in 2022. January saw the rise and threat of Omicron sweeping through the UK, which affected pretty much every business going. Staffing shortages, late cancellations - you remember. February saw the beginning of the Russian invasion of Ukraine, and the associated rapid price movements of goods. The repercussions were almost instantly felt - and are still being felt today. This threw petrol on the cost-of-living bonfire, putting the general public in a position where things cost more and they had less disposable income - a bad combination whichever way you cut it.
Later on that evening, Robert Peston highlighted the 'unprecedented' political turmoil the UK encountered. Three Prime Ministers, countless changing of frontbench responsibilities, and of course, that mini-budget. He also spoke of the cost of doing business with the EU increasing 'due to Brexit, the resulting increase in paperwork and the impact on freedom of movement'.
For one year, that's a lot. Sometimes it's worth reminding ourselves of just how much the profession had to deal with. All of these impacted dentistry - headwind after headwind, making that particular journey a difficult and long one - and we haven't even mentioned the operational and structural deficiencies that collectively have brought the NHS to its knees.
And still, the Business Outlook reports that its dental team had its 'strongest year of performance on record'. Quite the achievement, in the face of the scale and volume of headwinds. In fact, it's remarkable. Added to this, the report also suggests the dental sector is their most optimistic heading into 2023, another sign of the resilience dentistry has. And yet, the reasons for the optimism for 2023 relies largely upon the continued headwind that is 'NHS dentistry'.
They forecast the high demand for private practices will remain, as private dentistry continues to benefit from growing waiting lists for NHS appointments. They think practices with NHS contracts will be subject to 'more scrutiny' by purchasers and lenders in respect of UDA delivery and practice economics, although demand will continue to be strong for those with higher UDA rates and a good track record of delivery.
They report that corporate operators and other dental groups will continue to seek specialist practices to drive internal referral income while simultaneously reporting further reforms in NHS dentistry are crucial to combat the shift towards private and the loss of dentists in the NHS. To top it all off, Christie & Co expect there to be a rise in practices either rebasing or handing back their NHS contracts as practices convert partly to private/plan - a result of the problems within NHS dentistry.
It feels odd to be praising the resilience of the profession's ability to be financially secure and be optimistic about its future, which is due in large part to the NHS's inability to provide adequate remuneration to its workforce. There's something about that juxtaposition which makes me uncomfortable, no matter how much truth there is to it. What would thriving NHS dentistry look like? How would it change this report - by 360 degrees, perhaps? Dentistry's business outlook for 2023 is optimistic because of the tailwind of 'substandard NHS' driving buyers into the lucrative private market.
Is it going to improve anytime soon, or will the tailwind continue to pick up? Only time will tell, and the BDA pushes for contract reform, but for some, they have decided to seek alternate routes. ◆
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Westgarth, D. Headwinds and tailwinds. BDJ In Pract 36, 4 (2023). https://doi.org/10.1038/s41404-023-1886-0