Whilst the COVID pandemic has massively impacted dentistry, it has also created new opportunities. Ian Gordon, dental director at Riverdale Healthcare, ADG management team member and North Yorkshire LDC chair, discusses how practices can benefit from this unique situation.

The forced closure of dental practices during lockdown 1.0 placed a huge strain on dental practices across the country. Especially purely private and referral practices, which were left to rely for cash flow on any capitation income they might have.

NHS and mixed practices were impacted by loss of private revenue. But they had the comfort of an NHS finance blanket to maintain a sustainable business.

Now we are in a unique situation.

We have an abundance of patients who have at worse been denied access to NHS care. Or have restricted access due initially to the enforced focus on triage and the triple A approach to delivering clinical ‘care’.

Practices are working through backlogs caused by the April to June 2020 closures of all but 600 UDC sites. As well as dealing with the totally excessive fallow time and the restrictive SOP, which significantly reduces patient flow.

As the new financial year opens, practices face a further increase in targets. These are challenging for all when set against the background of an SOP written for the peak of the pandemic and fallow time which seriously reduces efficiency.

Some private practices have increased their prices and added PPE costs to AGP appointments in a bid to gain some financial compensation for the loss they have experienced and the increased time required for each appointment.

How are Riverdale Healthcare managing the balance?

We have a passionate team of clinicians who genuinely seek the best treatment for our patients. And we are eternally grateful for that.

So, when the chief dental officer closed all practices, their first thought was how can we help?

Our group was delighted to be included in the urgent dental centres in north Yorkshire and the north east. Along with practices in other regions.

As a clinical team, we very quickly pooled our talent, fit-tested teams and implemented a protocol to ensure the safety of everyone.

Some of the team diverted from purely private work to become fit testers. Or use their surgical skills to ensure we could cope with anything coming our way at the UDC. Including on more than one occasion completing the task of removing teeth when patients had ‘tried this for themselves’ at home – such was the impact of enforced closure of most practices at this time.

We invested in air filtration systems to provide the greatest level of assurance to everyone. We wanted to ensure a visit to one of our practices was the safest it could possibly be.

Our urgent dental centres saw many patients that had been unregistered for years. It was those who avoid the dentist at all costs until the inevitable toothache begins and we have to perform reactive dentistry.

Whilst their experience was very different to a usual appointment, these patients gained insight as to how the industry has moved forward.

Our clinicians were able to demonstrate their compassion. Our teams offer their professionalism. And most importantly these patients are happy we can see them. They were grateful that someone could help in such extenuating circumstances.

The NHS versus private debate continues

Whilst our NHS lists are full and people are waiting far longer than ever to be seen, we have identified the opportunity to raise the profile of our private dental offering.

We continue to prioritise urgent patients whether previous patients of the practice or not in line with the requirements set out for Q1 and Q2. This does impact our ability to provide treatment for routine NHS patients.

Whether the patient chooses to join a plan or become an independent patient, there is a large number of patients who are happy just to see a dentist.

We have invested heavily in our teams and our practices during the pandemic. It has been costly, but it is absolutely the right thing to do. Supporting our teams, maintaining their NPE income levels and continuing to pay any abatement charged ourselves as a company. Rather than passing this significant cost onto our teams.

We don’t believe in passing these costs to our patients.

The word ‘private’ from a patient perspective implies expensive. So, whilst we seek to make dentistry accessible to everyone, we are careful not to alienate prospective patients with additional fees for equipment that is necessary for us to carry out treatment.

Fair, honest and transparent

We delivered well in excess of the 45% minimum threshold in Q4. We expect to deliver in excess of 60% in this half year. But even these commitments do not meet the demand there is for treatment.

We believe in being fair, honest and transparent with our patients. We do this by simply advising of all options available to them.

There no longer becomes a discussion of NHS versus private. But simply what’s the best treatment for the patient and what we have a contractual and physical capacity to deliver.

Unless we remove fallow time we cannot increase capacity any further. If the country re-opens fully on 21 June, it is imperative that dental practices can individually risk assess their protocols. This way they can expedite a return to a pre COVID level of PPE. We might then start to see access improve.

As a clinician I cannot wait to dispose of a respirator mask for the last time.

Riverdale is on a mission – what’s yours?

Riverdale Healthcare is growing. If you want to find out more about Riverdale Healthcare and if we are a good fit for each other, speak to Chris Aylward in strict confidence, chris@riverdalehealthcare.com