Strength in numbers

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Barry Lanesman discusses the impact of the pandemic and why he thinks the future of dentistry in the UK is still as bright as ever
How did Dentex tackle lockdown?

Looking back now at when we first went into lockdown, it was such an anxious and uncertain time for our practices and their teams.

The impact was felt across all industries of course, but it was particularly hard for dental teams – as they had to step back from seeing patients, some of whom desperately needed their help – and for private dentists, whose incomes dropped to zero for a couple of months while they still had expenses and outgoings. Concerns about their day-to-day challenges impacted their stress levels, but also how things would look when they started practising again in the future.

Everyone had their own issues. Whether it was from the perspective of clinicians, the wider dental team, or the challenges we faced as a dental corporate, we each had to cope with a different set of problems, difficulties, and traumas.

The success of Dentex’s business model stands or falls by preserving the clinical freedom of each practice and providing them with high-calibre support. We were acutely aware of the number of people who relied on us as an organisation, and that they needed level-headed and coordinated help to cope with a rapidly changing environment. We knew the best thing we could do was ensure our teams were able to get back to work safely, and as soon as possible.

We immediately started to think about how we could help our practices reopen and anticipate what that journey would look like. Throughout the lockdown period, we put a lot of work into developing protocols that would allow our practices to get back to seeing patients quickly and safely. Paramount to the success and wellbeing of our practices was our ability to facilitate open communication. We were quickly able to achieve this both for practices and clinicians virtually within the group, as well as with their patients through developing our own virtual consultation functionality.

From a business perspective, we carried out stress-testing, so we knew how best to manage our cashflow and equity under a variety of scenarios. We wanted to be sure we could take care of our people, we could continue paying them, and we wouldn’t have to let people go.

As a four-year-old business, it was important to manage the sustainability of Dentex and communicate how this was being done throughout the crisis. I know from speaking with our partners that not feeling alone during such a challenging time and being able to ask for support and advice from their peers, as well as the Dentex team, was of huge benefit and comfort.

I was really moved to receive this letter from one of our partners, Dr Magdalena Laskowska: ‘In 25 years of being a dentist, I have never experienced anything like this. The stress of shutting down the surgery, the unknown – a horrendous time for everyone but, in a way, I still felt calm and protected.

‘Over the following weeks, I kept reading posts from other dentists, owners of their own practices, associates; the amount of fear and stress was insurmountable. I felt so sheltered and so privileged to be part of Dentex. I realised more than any other time before how precious the support from the Dentex team is and how incredible is the effort from everyone in order to secure a prompt, safe and stress-free return to work as soon as possible.’

We have such a wealth of knowledge from the Dentex team, but also shared across our clinicians. Our ability to tap into this and to work collaboratively meant that we had most of our practices open in early June and quickly back to revenue levels of last year. We are trying to anticipate how this pandemic could continue to affect our business; we look at it pragmatically, clinically, and with confidence.

You’ve spoken before of the collaborative nature of Dentex: how important was that during the pandemic?

Communication is always essential, but never more so than in a crisis. It was crucial that our dental teams and partners knew what Dentex was planning, that we were secure, and that there was no risk of us failing. We have always been very transparent about our finances and business operations, so this was not a big jump.

As I mentioned, there was a huge focus on collaboration and people rightly had the sense that this was an open partnership within a community that was facing a lot of difficulty. We set up ways for dentists to discuss protocols, share ideas, and support one another. Our culture of transparency helped a great deal: everyone knew what we were doing and why, and we could adapt based on input from the wider group.

Our people felt very solidly that they were not just employees – they were part of a group where they were listened to. I believe that this difference comes from the way that we encourage our people to speak up and share, rather than prescribing what they should do. We support; we do not push or force. For us, this crisis has very much proven that our collaborative model works very effectively.

How did your practices approach the process of reopening?

A couple of our practices had been allowed to open for emergency treatment during lockdown as there were no UDCs in their area and we worked with them to develop protocols, as well as practise and refine working with PPE. By the end of April, we had circulated to practices our first protocols for practising under COVID-19, so they understood what would be involved from a very early stage.

We always knew PPE would be an issue; it was very hard getting commitment from the suppliers, so we slowly built-up stock from a lot of different sources to ensure we could support our practices when they were able to reopen. We were living this on a short-term basis as we didn’t have a large amount, but we did have enough to start, and as things developed it became easier to obtain.

Although many of our practices and their teams felt apprehensive, reopening was relatively painless. When June arrived and the announcement about reopening came, we were ready to do so. That was because we had spent a huge amount of time working on new protocols and were able to hit the ground running. We didn’t expect the announcement would come so quickly, but we’d already started anticipating and talking to our people about it.

Again, I think key to our success is communication, collaboration, and clinical control. We were very proactive in talking to our teams about reopening; they had been involved in the development of our protocols and they had the freedom to interpret and integrate these protocols in a way that suited their practice, team, and patients. We had also started reengaging the almost 450 staff we had on furlough so we had an early sense of who would be willing to come back to work initially.

What’s the picture like now – how are Dentex practices operating?

All of the practices have reopened. It’s not all smooth sailing, we do have the occasional COVID issue that we need to manage; we closed one practice for two weeks based on track and trace advice, and we’ve had one dentist who wasn’t able to come into a practice for two weeks because of a COVID contact. Obviously with the numbers going up, you’d expect such instances to increase a bit, but we are improving how we manage these issues each time.

Overall, the patient numbers are good – the practices are fully booked. There is going to be a percentage of patients who won’t come back in a hurry, but I think with practices operating at a reduced capacity, and a continuing backlog of patients, we’ll continue to see our appointment books being full, and we’re slowly trending upwards in terms of capacity.

 In the event of another national lockdown I don’t expect dental practices to close as dentistry has developed excellent protocols and is a key part of managing one’s overall health. In the long term, I think eventually we will see this as a substantial move in infection control. If you think back to the 80s, issues such as HIV were big steps for healthcare providers at the time. The increased measures took a while to get used to managing financially and practically, but eventually they become second nature. I think we’ll see the same step forward now in terms of understanding air flow and how we control airborne infections. We’ve never really considered air management before, but I think it will become normal; circumstances and technology change, and people’s thought processes move with it. In 10 years’ time, I suspect people will be asking: ‘How was this not thought of before?’

What does the future look like for Dentex?

We started to raise equity of £20 million in June, so very early into the crisis we were looking forward to acquiring, but what has surprised me is the number of great practices coming on board post lockdown – larger practices with excellent practitioners. I think part of this is due to the way we managed through the pandemic. Word has spread and gathered further interest for our offering in the market.

Things are different for us now compared to nine months ago, but I think that is universal. There’s no doubt that we’re in a riskier position – ‘risk’ being the ability to predict future earnings, which are going to be sitting at a percentage of what they were a year ago. We’re all going to have these dips for the next year or two, I think. But if we can work through these ups and downs then I think private dentistry in particular is on a very strong growth trajectory here in the UK.

Philosophically, it’s very hard to predict what the shift between NHS and private work is going to be, but my guess is that private will continue to grow strongly. I really do think that the future of dentistry is very solid; we’ve certainly shown that dental revenues can come back very quickly.

It’s still to be seen how the economy affects private dental revenues but my guess is that it will be fine. There will be a bit of a downturn, but again, move forward a year or two, and I’m confident about private dentistry in the future.

This entry was posted in Private Dentistry in November 2020