Our history with the NHS
Moving away from the NHS has been a really difficult decision for us as we’ve been long-time advocates of the original NHS oral health philosophy. Cuckfield Dental Practice started under the NHS way back in 1995, and became an NHS training practice in 1998.
When I first took over here in 1997, our NHS workload was just about manageable. However NHS dentistry – always the poor relation in the Health Service as a whole dating right back to 1948 – was certainly feeling the strain.
To give you an idea, the dentistry we were expected to offer was rudimentary to say the least, and all within 10-minute slots. We’d often be rushing through 50 patients a day like we were on some sort of manic supermarket trolley dash, basically doing little more than drilling, filling and extracting. The whole idea of prevention – which is now right at the heart of our practice’s philosophy – was in its absolute infancy and simply not allowed for in the NHS budget.
Why our costs have hit a tipping point
As the healthcare community began to appreciate the hugely positive effects things like fluoride toothpaste, flossing, interdental brushes, regular hygienist appointments, and dentists simply having more time to educate their patients could have on oral health, it became blindingly obvious that more funding had to be found. But until that happened, it would be up to the dentists themselves to foot the preventative treatment bill. Remarkably that funding still remains elusive!
Even in the most recent significant contract negotiations for NHS dentistry (2006), this critical component for improving the nation’s (thus Cuckfield’s) oral health was basically ignored. Indeed such was the intransigence of the then Government, the British Dental Association (BDA) – one of the least militant bodies around – felt compelled to walk out of the talks. The effect of this was that an NHS dentistry ‘disagreement’ was imposed upon dentists – ‘take it or leave it’ – which was highly unsatisfactory. So much so that two separate cross-party parliamentary committees (in 2009 and again in 2023) both reported the contract to be ‘not fit for purpose’ and unworkable. Successive Governments promised to review the situation, yet none have yet dared to grasp this nettle.
Meanwhile inflation has continued to gallop away for over 20 years. Patients have expected ever more sophisticated and costly treatments with better, more expensive materials. Surgeries have had to constantly enhance and upgrade equipment, and energy bills have rocketed. Yet the money dentists receive from the NHS for each UDA (‘unit of dental activity’) has barely increased at all! Bear in mind that dental practices are all independent businesses which must shoulder all these costs… or risk going under (like we very nearly did after COVID).
Even now the current Labour Government has been making lots of noise about the benefits of getting toothbrushing into schools, yet still there’s no finance for such an initiative. Here at Cuckfield Dental Practice we’ve been doing exactly what they’re talking about for quite a while with our own dedicated Prevention Unit, but educating children about oral healthcare has all been at our own expense.
What we (like many others) have had to do – for years now – is subsidise our NHS work and various preventative initiatives with any profits we make from private treatments. But geese can only lay so many golden eggs! In business terms, we’ve reached our limit, and going pretty much fully private is the only way we can remain in business and continue to serve our patients to the high standards of dentistry we (and they) expect.
Recruitment problems
Another problem we have increasingly had to face as an NHS practice has been being able to effectively recruit – and retain – high quality staff. After all, who wouldn’t want to be able to spend more quality time with their patients, to be better rewarded, to feel less like a stressed out hamster on a wheel and have the latest equipment to use? With so many other practices now offering a more comfortable, relaxed dentistry environment it’s no great surprise to find out that the grass on the private side of the fence really is greener not only for dentists, but for nursing and admin staff too!
The plain fact is that most younger dentists simply don’t want to work for the NHS any more and, given the current lack of awareness and funding we face, I really can’t blame them! As opposed to older generations who were state funded, today’s dental students are having to foot the bill for their education themselves (an expense often exceeding £60k). So, understandably, they don’t feel the same obligation or loyalty towards NHS dentistry as used to be the case.
What it will mean for you
Going private means being able to give you, as patients, the treatment time your teeth and gums deserve. To get to know you better and to empower you to follow a domestic oral health regime that will help prevent cavities, gum disease and the need for unnecessary and potentially costly remedial treatments. Whilst at the same time promoting and protecting your overall physical well-being.
Unfortunately this largely positive change does have its downside – in most cases, you’ll have to pay more than you did under the NHS. I totally get this, which is why we’ll continue to do everything in our power to keep our fees reasonable and affordable.
To help you spread the costs of your dentistry, our practice offers three Care Plan options, each offering combinations of regular examinations and hygienist appointments over the year, along with emergency cover, designed to suit different levels of dental need. Your own dentist will help you choose the one that’s best for you. You don’t have to take out a Care Plan to be registered as one of our patients, however – if you don’t think you’ll need much regular dental treatment, you can always opt to ‘pay as you go’ (here are our current private fees) as and when. Another great benefit of being on a plan, though, is that you get a 20% discount on all additional treatments you might require.
We do aim to keep a limited NHS capacity
We are planning to retain a strictly limited NHS capacity after 2025 (providing the Government doesn’t spring any nasty surprises on us). This will allow us to keep on treating children (to the age of 23) under the NHS, as well as all of our existing patients who remain 100% exempt from paying dental charges.
This restricted NHS allocation could also benefit patients who are still genuinely struggling to pay for their treatment. However we can’t guarantee availability and it would, in any case, probably involve joining a waiting list with a potentially lengthy delay.
Failing this we would do our best to point you in the right direction for your dental needs, and your local primary care trust would also try to help you find a dentist in your area who could treat you as an NHS patient.
Hopefully that’s explained our reasons for easing out of our NHS commitment, a number of benefits you’ll get from Cuckfield being a private practice, and an idea of how much it might cost you. But when’s this transition all going to happen?
When will all this affect you?
Don’t panic – it’s not going to be an overnight change. As a current NHS patient, we’ll discuss your options at your next examination or treatment with effect from May 2025; then you can decide what you’d prefer to do. If that examination indicates that you need some treatment, you will still receive it as an NHS patient.
During the examination, we’ll discuss your ongoing dental options and you can decide what you wish to do: we very much hope you will want to remain as a registered patient with us, whether on a Care Plan or not.
So there it is…
We are aiming to be fully private (with the few exceptions already mentioned) by May 2026. Not a decision I was ever expecting or wanting to have to face, but bills don’t pay themselves and Cuckfield Dental Practice doesn’t want to leave its patients up the proverbial creek without a toothbrush.
Loyalty cuts both ways, and successive Governments have consistently failed to appreciate the increasing costs of providing high quality dentistry on the NHS. It’s not just a case of dentists having a whinge, either – it’s an inescapable fact, as politicians of all hues have publicly stated more than once.
I have had to find a way to continue providing you with excellent, affordable dentistry and, after much soul-searching, I see going private as the most practical and workable means of achieving this aim. It’s not really my ideal solution, but there just isn’t a convincing alternative.
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