In the ever-evolving dental sector, practice principals are increasingly seeking our expertise to navigate the transition from NHS to private practices. This shift is primarily driven by two critical challenges: the insufficiency of contract funds to cover operating costs and the difficulty in recruiting reliable associates to meet UDA targets. The stark reality of these challenges was perfectly illustrated by a client who, in response to an inquiry from their Integrated Care Board (ICB) about how they could be of assistance, humorously remarked that nothing short of the ICB becoming a qualified dentist within a week would be of help, given their year-long unsuccessful recruitment drive. This anecdote sheds light on the pervasive issue of staffing, affecting not just dentists but also nursing and front-of-house teams.

Crafting an irresistible workplace: Beyond financial incentives

The transition to a private practice model is often seen as a panacea, promising financial freedom and the autonomy to offer more personalised care. While these are undeniably significant benefits, they alone do not suffice to make a practice the employer of choice. At the heart of attracting and retaining the finest talent lies the cultivation of a workplace culture and leadership ethos that resonate deeply with your team.

Leadership: The pulse of your practice

True leadership goes beyond mere management; it's about inspiring a shared vision, fostering professional growth, and creating a supportive environment. This approach not only boosts job satisfaction but also instils a deep-seated commitment to the practice's success. The reality is when we first explore what a principal working in the NHS system really wants from private practice, they simply have not had the head space to consider this beyond ‘I will try and achieve my UDA target and avoid clawback'. If the principal does not have a compelling vision, then how can they gain commitment from their team? That is not to assume that private practice owners are immune to this - we have helped realign private practices so that they have a foundation for accelerating growth.

Cultivating a positive workplace culture

A practice thrives when its culture is inclusive, respectful, and purpose-driven, making every team member, from dental nurses to hygienists, feel valued and integral to patient care and practice goals. Recognising achievements, providing constructive feedback, and supporting a healthy work-life balance are essential elements of such an environment. If time and funds are not available inevitably workplace culture will suffer. The future of NHS dentistry we know is unlikely to provide a better funded system - if you caught Rachel Reeves' statement on behalf of the Labour Party, she spoke about funding emergency dental appointments not dental care. Any differing view seems to me optimism over experience as we see young dentists looking for a career pathway in private practice.

Empowering your team through engagement

Empowerment and engagement are key to maintaining a vibrant workplace culture. By valuing every team member's input and fostering open dialogue, practices can create a sense of collective ownership vital for collaborative problem-solving and shared success. Implementing a robust communication policy, backed by empowered managers, paves the way for this level of engagement. We find however, that when presented to NHS principals a proper communication policy seems so beyond their reach in an environment staffed so minimally and often run by a practice manager (PM) who has not had any proper support and training. Recently I found that an NHS practice has made the PM redundant to save costs and even though they are working five clinical days as partners they think they will be able to run the practice and keep it both well-regulated and well run. Within one week the team reported to the old PM how chaotic it was and how everyone was now looking for employment elsewhere - and let's face it, we all know that good dental nurses are in high demand and they really will not have a problem finding alternative employment.

Aligning vision and mission: the magnet for talent

A clearly articulated vision and mission not only enhance job satisfaction but also attract professionals who share the practice's ethos. This alignment is crucial for both NHS and private practices aiming to become employers of choice. However, many principals working in the NHS are so bogged down by daily targets and operational pressures, that they struggle to envisage a broader mission. Our role post-conversion is to facilitate this realignment, making it easier for practices to transition and achieve their true potential.

The financial and cultural advantages of private practice

While private practice offers a lucrative and patient-centric platform, its true value as an employer of choice lies in the strong foundational values, exceptional leadership, and positive culture it can sustain. It's essential to recognise that transitioning to private practice is a means to an end, not an end in itself. We find that generally dentists take courses that are to improve their clinical skills rather than to enhance their soft skills and business acumen. Once in the private sector, there is finally time and funds to access both which are critical to make a success of your practice. As more practices turn to private arrangements, patients will be comparing not NHS with private, but private with private and mediocrity will be punished. We set out a programme for post-conversion that considers rebranding now that the comfort blanket of the NHS is no longer theirs - this is not just a logo - we consider all 18 elements that make up branding and facilitate organisational branding for our clients, whereas a marketing agency will simply offer the external messaging. Private practice offers the opportunity to take advantage of organisational branding benefits - but clearly you have to be prepared to embrace that. Owning a private practice does not offer this, you have to want to do this. Working on your mission will mean achieving your goals, whatever winning looks like to you.

The real costs of staff turnover

Staff turnover poses a significant financial burden, particularly for NHS practices relying on less experienced staff. Our analysis reveals the comprehensive costs associated with replacing a dental nurse or receptionist, emphasising the importance of investing in staff retention strategies. Again, how does one manage this in the NHS system? Few in our experience do so. Let's try and quantify this here. This example makes assumptions but clearly demonstrates the impact of high staff turnover.

  • Annual salary of a dental nurse or receptionist: Assuming £20,000 to £25,000. Recruitment costs: 20% of annual salary = £4,000 to £5,000

  • Training and onboarding: Assuming 2 weeks of reduced productivity and direct training costs = £1,000 to £2,000

  • Lost productivity: Assuming it takes 3 months to find and train a replacement, with an additional 3 months for the new hire to reach full productivity. This could equate to around 50% of the position's salary during the 6-month period = £5,000 to £6,250

  • Impact on team morale and workload: Hard to quantify without specific data, but could include costs related to increased turnover, overtime pay, and reduced patient satisfaction.

Based on these assumptions, the total cost of losing a dental nurse or receptionist could range from approximately £10,000 to £13,250 or more, considering the specific circumstances and excluding less tangible factors such as the impact on patient satisfaction and team morale, which could further increase costs. As an ex-owner of a private practice myself, I know all too well that they are not immune to a high staff turnover having faced a very disruptive senior team member resulting in an alarmingly high impact on a business, taking away the focus from our business plans. We sought help and rectified it, benefiting from the best team we ever had, but at a very high cost I would have preferred to avoid.

Overcoming NHS recruitment challenges through strategic branding

As part of our transition programme, we employ strategic branding to redefine the practice's purpose, vision, and mission, enhancing its appeal to top talent. This approach has proven effective in transforming recruitment processes, attracting high- calibre candidates, and fostering a workplace that professionals are eager to be a part of. One notable example involved a client who had struggled to find a trustworthy competent associate. Once they converted to private practice, we were able to use the brand strategy to attract a high number of excellent candidates, ultimately leading to the creation of addition roles to accommodate the quality of applicants.

The journey from NHS to private practice, and ultimately becoming an employer of choice, requires dedication, strategic planning, and a willingness to invest in change. As a former private practice owner and qualified branding strategist, I understand the nuances of this transition.

In conclusion, while the transition from NHS to private practice presents its own set of challenges, the real success lies in a practice's ability to attract, develop, and retain the best talent. The NHS mixed model is fragile with each generation of new dentists refusing to accept the UDA system with ambitions for purely private practice. This is combined with poor funding as well as the closer monitoring of your private dental activity if you hold an NHS contract. I therefore must conclude that private practice is far more likely to attract and retain talent than a practice holding an NHS contract. â—†

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