Sir, in his article (BDJ 2008; 205: 475–476) Peter Swiss looked at the historical development of Denplan. As a user of this capitation scheme over the last 15 years I should like to offer my personal comments as a practice principal on its benefits.

I did a practice conversion in January 2000 of a mixed NHS/private practice in the reasonably affluent south east of England to Denplan. This changed my attitude to my profession. For the first time in 28 years I knew how much I was going to earn the next month without the vagaries of patients not turning up and the fee per item system. I could now budget, plan ahead and attend postgraduate courses without losing fee income. I knew how much I could invest in my practice and could adjust yearly my monthly fees to cover future expenses and inflation. Denplan collects the patients' payments. I had the help of Denplan support staff who provided information, business plans and an arbitration service for any disputes. I had my own key client consultant who visited me regularly to update me on developments, courses and give advice. By my yearly accreditation to Denplan Excel I met all my clinical governance requirements. The Denplan Excel Oral Health Score and Preventive Programme Agreement make our patients dentally aware and interested and encourages them to want to keep on coming in order to increase or maintain their oral health. Copies of both these forms contribute to good record keeping and help identify any oral deterioration. Denplan in our practice provides a framework for patients to improve the aesthetics and function of their mouth, should they wish, via additional cosmetic treatment and implants. Patients have the reassurance of world wide emergency treatment and accidental injury cover.

Some of the criteria I would suggest for a successful (both for patients and practice) Denplan practice are carefully placing patients in the appropriate fee category and being flexible in moving them up or down according to any long term changes in their treatment needs. Having sufficient patients to prime the pumps and taking the long term view of both the practice's future and one's patients' needs are important.

Eight years later, I am independent of the health service and our practice is expanding and improving. I am doing a clinical master's degree and despite the recession, I have confidence for the future. I am enjoying general practice even more than when I started 36 years ago.