The 900 redundancies at Boots head office announced in January include staff who provide support services to the 56 Boots Dentalcare practices. At the time of going to press, it seemed likely that as many as 20 head office staff who work directly for the dental practices will opt for voluntary redundancy.

While this is few in relation to the overall job losses in Nottingham, where the head office team is being cut by 50 per cent, it is likely to have a considerable impact on the dental practices. One of the features of Boots practices which made them attractive to both staff and patients was the investment in standards and training for all the team.

Additionally, hygienists working for the high street chain are now being asked if they would like to work on a self-employed basis and the numbers of nurses across all the practices are being reduced.

Chris Potts, the dentist who inspired Boots to move into high street dental provision, said the staff cuts were not just about saving money but reducing complexity at head office. There would in future be more emphasis on decision-making at practice level.

‘We value professionals complementary to dentistry and the proposals should not be seen as a U-turn. It's about doing things differently.’

Meanwhile, Sue Skinner, chairman of the British Dental Hygienists Association, said that while many hygienists were self-employed by choice, in some areas of the country the Inland Revenue was insisting that they should work on an employed basis.

She added: ‘The BDHA wants whatever is in the best interest of members but we are not a trade union and therefore cannot negotiate on their behalf.’