A calmer way of working – Manor Square’s move from NHS to private practice

A calmer way of working – Manor Square’s move from NHS to private practice

Leaving the NHS could not have been further from dentist, Paul Ellul’s mind this time three years ago. As a training practice with a large NHS contract, all was well for his practice, Manor Square Dental, until the twin misfortunes of COVID and the cost-of-living crisis struck. “Things started to go awry over the last year and a half,” Paul explains. “Financially, things weren’t adding up. And so, it got to a point where we had to make some really tough decisions. It wasn’t what I wanted to do. I never thought I would be leaving the NHS, but financially and for the business, we would not be here now if we didn’t.”

Tough decision

As an NHS dentist of 26 years’ standing, this was not a decision Paul made lightly. However, as well as the immediate future of the practice he also had its long-term prospects to secure as well. “We had a number of younger dentists and we wanted to build up a young team moving on,” Paul explains. “There are a few  of us over the next five years who will be retiring. We wanted to be able to prepare for the transition. However, the younger dentists were struggling to meet targets. Although they’re fantastic dentists, they could not do the number of UDAs that the older dentists were doing, and they didn’t want to work like that. And so, to be able to move forward and to grow, there was only one option and it wasn’t happening within the NHS contract.”

Paul had introduced a membership plan with DPAS in 2006 and had viewed it as a safety net in case his NHS contract proved unviable. Faced with spiralling costs and no chance of increasing his fees to compensate, it was now time to leave the NHS and encourage as many patients as possible to sign up for the plan to secure the future of the practice.

Backlash

Despite support from their Regional Support Manager, Deborah Bell, Paul and the team were not expecting the backlash they experienced. As well as angry social media posts, Paul was also contacted by politicians. “The biggest shock was the MPs who clearly had no idea about how dentistry was being run,” Paul says. “They blamed us for the state of dentistry. We had contact with about six or seven councillors and MPs, the majority of which were pretty good. They wanted to genuinely find out what was happening, what they could do. But that wasn’t the case for everyone. And it was quite eye-opening to appreciate how little they realised how we were working in the community.”

However, after a relatively short period of time things settled down, and Paul and his team were able to concentrate on bedding in the plan successfully. Within the first few weeks, they had achieved roughly 90% of their target, which pleased Paul. “The figures are still coming in,” he says. “We haven’t even gone through everyone’s recalls yet. So it’s going to be 18 months before we really find out the true figure. And after the initial shock of someone losing their NHS place with us and then moving away, we have already had some people starting to come back. That wave of leaving the practice is starting to change. And so, the numbers are encouraging at the moment.”

Slower pace welcomed

Life in private practice is proving much more comfortable for the team. “The dentists are definitely finding it easier, not having the quick turnaround on every single patient. Things are now calmer and that has made a huge difference to the atmosphere for the staff and for the practitioners working with us. That’s the biggest change I’ve noticed. I’ve even had some of the associates come in and say, ‘thanks for taking the plunge and actually going private.’ And that’s quite touching because they said they didn’t know how to make that jump themselves. They may have wanted to, as they realised that things were getting harder and harder, but it’s stepping into the unknown and it takes a lot to say, right, finally, let’s make that decision.”

The team is also enjoying being able to provide a wider range of treatment options to their patients. “There’s some relief that, right we’ve made that decision now this is what we can offer. We can give you a number of different options. It’s up to you to choose. I think that’s taken a lot of the pressure off the team.”

As has the more relaxed pace at which they’re now able to work. “The number of patients you had to see just to exist put so much pressure on everyone,” Paul continued. “We’re now seeing half the number of patients. We can take the time to talk to those people and that is a very different way of working. You don’t appreciate how important it is until you’re in it, until you realise how hard pushed you were before and the level of anxiety you were working in. Life is much easier for us all now.”