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| Dentists The NHS provision of dentistry is made through the General Dental Services (GDS). Dentists working in the GDS are remunerated primarily on an item of service basis (i.e. fees for work undertaken) together with some capitation payments. The dental profession has maintained for many years that their Target Average Gross Income (TAGI), out of which they must cover practice expenses as well as their personal remuneration, is inadequate. Despite the introduction of a new contract in 1990 and subsequent amendments to the system, more and more dentists have moved into private practice. During the late 1990s and early 2000s the government reaffirmed its commitment to NHS dentistry and made funding available to improve access to NHS dental services. However, the increases to the NHS fee scale considered by the professional bodies to be essential to the continuing provision of NHS dentistry have not been made. There are approximately 22,000 NHS general dental practitioners in Great Britain, many of whom are sole practitioners. There would, however, appear to be a trend towards larger practices. Demand for the dental practitioner's services remains strong, but uncertainty surrounding the future direction NHS dentistry will take still exists. Practitioners maintain that NHS remuneration is inadequate to provide the quality of service they would like. Many have moved into private practice. Dentists practising in the UK are regulated by the General Dental Council (GDC), with which they must register. Dentists working in the NHS are self-employed contractors responsible for running their own businesses. They may work alone, in partnership or alongside an associate. Practice staff may include receptionists, dental nurses, dental hygienists and technicians. Some dentists also offer private treatment. Despite the shift towards private practice, income from NHS sources generally accounts for the greatest part of practice income. Item of service fees account for between 75% and 80% of NHS gross fees. Gross fee income may fluctuate for a number of reasons, including changes to the NHS remuneration system, a change in practice size or working patterns, a move towards private practice or an increase in local competition. Output tends to decline as the practitioner ages. According to the Department of Health, average earnings for female dentists are approximately 68% of the male average. Dental practices must keep comprehensive details of both NHS and private patients. Many practices have installed computers and specialist software to assist with this. Approximately 26% of NHS patients are exempt or eligible for remission of charges. Those patients who do have to pay normally do so at the conclusion of a course of treatment. The patient charge is currently 80% of the fee, up to a maximum of £360 (£345 in Wales). Dental practices generally put out the construction of dental appliances to specialist dental laboratories. The dental lab sector is intensely competitive and practices are likely to be offered generous terms. Dental equipment and practice sundries may be obtained from specialist suppliers and/or local dental wholesalers. Performance in the dental practice sector may be assessed in terms of the relationship between practice expenses and gross fee income, and the relationship between lab fees/dental consumables and gross fee income. Practice expenses generally average around 54% of gross fees, while lab fees/dental consumables account for some 19% of gross fees. The relationship between expenses and fee income can vary for a number of reasons, including changes to the NHS remuneration system, a move towards private practice, a change in the number of hours worked or an increase in practice expenses not reflected in an increase in the fee scale.
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For further information or to become a part of our winning team contact us at: Hadrian House, Front Street, Chester Le Street, Co. Durham, DH3 3DB Te: (0191) 388 3377 Fax: (0191) 387 1745 Email: straughans@straughans.co.uk Straughans Limited (trading as Straughans) is a limited liability company registered in England and Wales under No 0354727. Registered office: Hadrian House, Front Street, Chester le Street, Co Durham, DH3 3BB | ||
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