How to design your care and services when moving out of the NHS using a dental plan!

Dental plans provide a great service, they are very patient-friendly, and I highly recommend my dental clients to explore them when moving to private care.  You can choose comprehensive plans that cover all treatment required or a plan that provides examinations, emergency care and hygiene care.  In this post, I’m mainly discussing the latter and you will discover why that is. 

Changing a system

Moving a patient from NHS to a dental plan requires tremendous effort and energy.  It is often a difficult decision for dentists to make because although there are challenges/restrictions within the NHS contract it has provided you with a platform to serve your patients and one which many of your patient’s value and expect.

You need to break this news to your patients which can also be a daunting task.  Your team may feel hesitant because of how some patients may react, plus you have to manage the patients and how they will handle the news.  Changing a system affects everyone BUT you are doing it for a reason and so you need to be clear on what the future looks like or you could come into further problems along the way!

When you stop your NHS contract and transition these patients to a private plan, there are two major points that you should spend time considering relating to your exams and hygiene appointments.

1. What type of service do you want to provide? What types of dental treatments do you want to do more of? What are you moving away from? What direction are you moving towards?
2. The plan should be designed around the direction you are moving towards and enable you to deliver the care you want to provide.  Avoid benchmarking your plan on your existing way of working. 

Let’s begin with you and how you want to work

It’s very important that you spend a lot of time thinking about the care you want to provide because often it is the ‘more time’ benefit that features in a dentists’ mind.  Giving an extra five or ten minutes in an exam or hygiene appointment will feel good to give the patient ‘more time’ and gives you ‘more time’ but the reality is an extra five or ten minutes doesn’t automatically design a higher level of care;  it usually allows more chat time and for the patients are less rushed. 

I need you to delete ‘more time’ from your narrative, and instead consider the elements involved in an examination.

• What is carried out, what additional tools and technologies do you want to include?
• What time is required to do so?
• How do you wish to plan your dentistry, are you working linear and fixing a problem at a time or do you want to work more comprehensively?

Next, look at a hygiene appointment; speaking as a dental hygienist, the NHS system has crippled the value of hygiene and preventive dentistry and does not serve the patient in supporting them moving towards health.  

Unfortunately, many patients are programmed to expect this low value ‘cleaning’ appointment and moving them requires careful planning and effort.  You need to break down the elements involved in assessing, carrying out the treatment and supporting the patient in making the improvements they require to make between your visits.  The biggest problem of how hygiene appointments have been traditionally structured is that most time is given to the ‘doing’ element and not the ‘being’, and what I mean by ‘being’ is being at service and supporting your patient move towards health which is more about building relationships, education, behavioural coaching and less about ‘scaling’ teeth.  The goal always should be centred around moving patients towards health instead of ‘cleaning teeth’.

Make sure your plan is a major upgrade from the NHS and that you can present its true value to your patients.

One of the biggest mistakes that dental practices make when selecting the plan categories is that they design it around a fast pace NHS style of dentistry and perhaps add five or ten minutes onto an exam or hygiene appointment.  Is this better? Yes, but is it enough for the care you want to provide?

The quick ‘check-up’ and ‘scale and polish’ undervalues your expertise as clinicians: we unknowingly have placed a low value on ourselves by using these terms and working within the tight constraints of short appointments.  The biggest challenge you face in converting patients is related to what they have been programmed to expect. 

If you want to work differently and deliver a higher level of care and service please, please, please do not design your dental plan only on more time, nor only on what you think your patients will accept.

This is your opportunity to design a plan based on individual needs instead of fitting people into a system and here are my recommendations on what to consider and some simple ways you can build value in the service and in how your patients perceive the service.

1. Consider optimum care, what is involved and what time is required? What should the fee for the exam be?
2. Separate patient types – history of periodontal disease or not
3. Consider individual patient needs and categorise accordingly
4. Consider hygiene led caries prevention programme – which patients require this? what’s included?
5. Think about diagnostic tools and testing kits that differentiate the service and help to build value in a monetary sense
6. Change the names of appointments to be descriptive, representing their value and help to build value to the patient – train your patients to not expect a ‘clean’ or ‘scale and polish’
7. Added value items such as a discount off whitening and treatments, facial aesthetics
8. Be clear on what is included and what isn’t
9. Make sure periodontal treatments are charged separately and not conducted in maintenance appointments
10. Consider a reporting system of the patients’ oral health where the patient leaves with a clear indication of what is healthy, what isn’t, what are the options to move them towards health, what is their role in moving themselves towards health, what products do they need to support them doing so.
11. Make sure you build on this reporting system visit after visit and that you keep engaging with the patient and supporting them in always moving towards health

If you don’t want to work differently and just want out of the NHS, work with your plan provider to help you on how you communicate the conversion to your patient.  Perhaps the comprehensive cover would suit as it’s an easier sell to your patient.  “everything covered for £xx”. This can work for practices that want to stay working as they are but upsell treatments excluded from the plan such as orthodontics or facial aesthetics.  It does restrict you in the future if at any time you want to change your system so please be mindful of that.

So, once you have everything in place, it’s now time to deliver this new service to your patient

You have patients signed up to your new dental plan and now it is your time to deliver this higher level of care your goal is for them to leave that appointment thinking WOW what a difference and be motivated about some aspect of their oral health or just in how you made them feel.  Your hygienist has to do the same. 

Get in the way of telling your patient what you are about to examine, what you have observed, what you recommend, or educate them about a likely future need and keep them informed on where they are in achieving optimum health.

Do not ever compromise in what you deliver or recommend in the appointment or in the outcomes you want to achieve for your patient.  The patient does not dictate the content of their appointment although they do have a choice in what treatments they proceed with. 

Your patients could still be adjusting to how their dentistry is charged so if you do have any challenges with patients not accepting treatment be very supportive and always be on the patient’s side.  Never dilute your message and always make sure you present the benefits of them proceeding with your recommendations and the consequences if they don’t. 

With regards to the care in the hygiene room, make sure your hygienist doesn’t use any extra allocated time on the gum therapy ‘doing’ element of the appointment, and instead, they should be spending more time assessing, monitoring and communicating with the patient where they are concerning achieving optimum health.  Through time the goal is to programme the patients to expect their health status update, and ultimately take more responsibility for the determinants of their oral health which is a win-win regardless.

Why make all this effort?

Patients that take more responsibility and interest in their oral health are often more interested in elective and optimum dental care.  Having an optimum examination appointment and an excellent hygiene department with a clear structure will help you to deliver the best service, be profitable and help to fuel the dentistry that you want to do. 

Designing this plan well, in the beginning, will help to future proof your flexibility in how you work and in how you move your business forward.

Have you set up a dental plan and still have challenges?

Are you thinking of setting one up and need more support?

If you want to find out more click on the image below 

 Let us know, we will very likely be able to support you!