Luke Moore, co-founder of Dental Elite looks at the process of deferred consideration and what it means for both parties involved.

If you’re interested in buying or selling a dental practice, you’re likely to have come across the phrase ‘deferred consideration’ at some point – but what does it actually mean? Well, deferred consideration is the term used to describe a common process in practice sales and acquisitions whereby a percentage of the purchase price owed by the buyer is retained until after the transaction is complete. The amount is then only released if the performance of the business is maintained to the agreed level, or whatever other metric has been agreed prior to completion has been achieved. Usually, the funds are held in the buyer’s account.

In recent years this has become a popular part of dental practice deals – especially when independent practices sell to corporates – with buyers seeking to mitigate some of the risk by ensuring that the vendor bears some responsibility for the output of the practice post-sale. For the seller, striking a deferred consideration deal can be a means of securing a sale or negotiating the purchase price at a higher overall consideration, in spite of there being a big unknown risk post-completion such as the continuity of an NHS contract. What’s key to remember is that the structure of the deal can be just as, if not more important than the ultimate sale price – let me explain.

Unlike with a straightforward sale where the money owed is tied to the completion of the sale, a seller continues to have a vested interest in the business long after the transaction ends. It might be that the deal is linked to a turnover target or the business’ post-sale EBITDA (Earnings Before Interest, Tax, Depreciation and Amortisation). In some instances, the vendor might be required to stay on in the practice as a part-time associate or adviser for a set period after the sale. Therefore, both parties need to take care when the deal is being structured to consider the long-term consequences of each option, and whether deferred consideration is the right path to follow.

Of course, in some instances, choices may be limited and compromise is inevitable. For vendors of large private practices or practices with short-term orthodontic contracts, for instance, who would prefer to acquire the full purchase price upon completion, it may be that a deal without deferred consideration is unattainable. In other situations, it can be hard to know whether a deal of £2.4m paid in full at completion is better than accepting £2.5m with deferred consideration of £450,000 over three years – depending on the practice’s performance.

One factor that should always be taken into account is what is deferred consideration linked to. For vendors, it is always advisable to accept a deferred element that is associated with individual turnover rather than the practice’s combined turnover or EBITDA. This is because once the practice is sold any control over associates’ retention and performance, as well as the cost structure of the business is relinquished to the buyer. If a vendor is considering staying on in the practice post-sale, caution should always be taken to ensure that sufficient protocols are in place to protect against illness and underperformance. Especially as some dental corporates impose strict tapering clauses, whereby for every £1 in turnover lost, £1 of the consideration is removed. Bearing in mind that the corporate will not have lost £1 in profit, as they would probably have only paid 45p of the £1 to deliver the treatment in the first place, underperformance could result in considerable losses. They will often also install a collar to the deferred consideration so if performance drops below a certain level then all the consideration is removed and there is no further tapering allowance.

Equally, a seller should be cautious of a scenario where the purchaser is unable to pay the agreed deferred consideration amount if the business fails or they’re unable to borrow any more money from the bank. If the buyer has other directors, they could be made personally liable in the sale agreement if obligations aren’t met. Alternatively, the seller could arrange to personally take charge over assets until the deferred consideration is paid off. There are ways and means of guaranteeing payment so a seller must be sure to hedge this risk.

Other than that, there’s an accounting principal of ‘present net values’ which vendors should give thought to if deferred consideration is on the cards. It’s relatively straightforward – because of unearned returns, there will be less spare cash for investment opportunities and as money in the bank is worth more than receiving a lump sum at a later date (if it’s accruing interest), it can be better to take the purchase price upfront in some situations. Though this will depend on what your expected rate of return is from your invested cash.

You should also consider that deferred consideration is different to that of a generic retention, which some purchasers try to exist on to mitigate against a potential warranty claim or a breach of indemnity. Unless the vendor is emigrating on completion or there is a specific reason to believe that one particular warranty will almost certainly be breached, retentions in dental practice transactions should be heavily resisted. They are, after all, very rare and normally un-commercial as most dentists continue to be of good financial means post-completion.

Ultimately, every practice transaction is unique, so it is always wise to seek professional, expert advice from a specialist agency that can help you to negotiate the best possible deal. With an unrivalled knowledge of the practice sales and acquisitions market and unwavering commitment to achieving optimal results, Dental Elite can advise you on all aspects of the process right down to the finest details so that no stone is left unturned.

It’s important not to leave anything to chance. To secure a good deal, be sure to surround yourself with appropriate support and expertise.

For more information on Dental Elite visit www.dentalelite.co.uk, email info@dentalelite.co.uk or call 01788 545 900

In August – against all expectation – there was a strong hint that a rise in interest rates could be on the cards. The hint came when three out of the eight people on the Monetary Policy Committee (MPC) who have the responsibility for setting the rate voted for an increase. A three-to-five minority might not sound like much, but no one expected anyone to support a change to the base rate of 0.25%, fixed since 2016.

The MPC meets eight times a year to set an interest rate it judges will enable the inflation target to be met. Whether it happens before the end of the year, or we have to wait until 2018, it would be good idea to think about the potential impact of a future interest rate rise will have on you and your business, in order that you get yourself organised.

If you are on a variable rate mortgage, you will be glad if interest rates stay as they are. But what will you do if rates rise – do you have measures in place? Would it be prudent to switch to a fixed-rate deal now? If you are looking to buy a new property – either residential or business – it is worth considering how a potential rate rise would affect the kind of mortgage that you choose. As a side point of interest, in July the number of people re-mortgaging was the highest since 2009, with customers attracted by low rates.

If you are a saver, the idea of a possible rise in interest rates will be greeted with (cautious) optimism, especially if you have a deposit account or cash ISA. Low rates have meant that many savings products have fallen in popularity. Only a few years ago you may have enjoyed a 1% interest rate on your savings account and now it’s likely to be around half that. According to one report, Cash ISAs saw a whopping £20bn fall in the amount invested in them in just 12 months. Low interest rates certainly make these kinds of products less attractive and we also have to factor in changes to personal savings allowances since 2016 (the first £1,000 of interest that an individual receives from savings is tax-free if they are a basic-rate taxpayer; the threshold is £500 for higher-rate taxpayers). Of course, many of you might be putting your money in other places but easy access Cash ISAs are great products to use to get into a regular savings habit (they are good for younger savers in your family, for example) and it is a shame that they are becoming less popular. On the other hand, the fixed-rate savings bond market – that often pay way above the Bank of England base rate – has remained robust.

This is not a time for rash decisions or fast action. Pundits are predicting interest rates are likely to rise, yet we have seen repeatedly how financial experts have been caught out by unexpected turns of events. The general economic outlook remains uncertain – this is a mantra that bears repeating – and making too many predictions would not be wise. Hardly anyone predicted that inflation would rise again in May, for example. The US central bank did increase short-term interest rates for the second time this year, but that had been well flagged in advance so therefore came as no surprise. Before you do anything, get advice from professionals with an in-depth knowledge of the dental sector. They can help you decide if you need to look at new products – re-mortgage, for example – or if and how you should move you money around to give you more of a buffer should things change.

To find out more, call Lansdell & Rose on 020 7376 9333,
Or visit www.lansdellrose.co.uk

UK Finance. Remortgaging strengthens in July, 12 September, 2017. Link: https://www.ukfinance.org.uk/remortgaging-strengthens-in-july/ (accessed October 2017).
Guardian Money. Popularity of Cash ISAs collapses in space of year, 31 August 2017. Link: https://www.theguardian.com/money/2017/aug/31/popularity-cash-isas-collapses-tax-rule-interest-rates (accessed October 2017).

Improving children’s oral health is central to preventive dentistry. Instruct and support good habits to stop decay in its tracks at an early age and you will reduce the risk of serious dental problems in later life and also help an individual avoid chronic illnesses associated with poor mouth hygiene.

However, with every positive piece of news – the last survey from Public Health England on the dental health of five-year-olds confirmed the downward trend in childhood decay is continuing – we seem to take one step back, or at least get a reason to put any celebration on hold. For example, despite the improvements, in 2017 the Royal College of Surgeons reported a 24% increase in extractions for children aged 0–4 years in the last decade. Tooth decay was also the most common reason for hospital admission in children aged 5–9 in 2014/15 – that’s over 26,000 admissions for a disease that is almost entirely preventable.

In last Child Dental Health (CDH) Survey, 58% of 12-year-olds said their daily life had been affected by their oral health problems, with over a third being embarrassed to smile or laugh due to the poor condition of their teeth. The figures relating to adolescents’ oral health are also damning, with multiple extractions for under-18s in England on the rise. So if an adolescent or teen had poor oral health as a child, they might not have to wait long to see the impact – decay in childhood will severely compromise their oral health as they grow up.

It’s hard not to feel frustrated. After all, this is a 1+1=2 issue; if a patient takes good care of their teeth and gums when they are very young they will decrease their chances of needing invasive procedures in the future, and also be rewarded with a healthy smile to be proud of. The numbers may be going down, but even one child with decay so bad that it requires an intervention is one too many. So what are the missing pieces of the puzzle?

We have to go back to the central tenets of good, preventive dentistry – effective daily cleaning, regular dental appointments and a healthy diet – and look at new ways to support them. Education for families is key. Worryingly, a third of parents said it was “acceptable” for children to have experienced some degree of decay before they reach their teens. Their offspring clearly don’t share this complacency if they are feeling ashamed by their bad teeth (as per the CDH Survey). Engaging with and educating parents and carers will help change attitudes and enable positive, proactive behaviours. When it comes to regular appointments, there may be confusion over the fact that NHS dentistry is free to under-18s. If a family has chosen private dentistry, they may think that when there is no visible problem or pain, regular check-ups are not a priority, but they are.

The latest CHD survey, as with the previous two, found that geographical areas with high levels of deprivation tend to have high levels of childhood decay. Practices in these areas must work with local schools and health/social care institutions to help children in these communities understand why they must visit the dentist regularly. With regards to good food choices; the consumption of sugary food and drink isn’t exclusive to poorer families. The problem of ‘hidden’ sugars in meals that regularly appear on the dinner table (in some shop-bought pasta sauces, for example) is one that the government is trying to tackle with its so-called ‘sugar tax’. All parents know that it is hard, if not impossible, to stop children accessing all sweet treats completely, so balance and learning how to clean properly, to remove optimal debris, is key. Brushing should be supervised, too – good technique will become second nature if children are taught early.

As for that missing puzzle piece, new technology can support clinicians in practicing preventive care, by helping them to detect active demineralisation at an early stage, and therefore possibly prevent caries. CALCIVIS is a new imaging system that can be used with patients from the age of six. The concept is both simple and non-invasive – a recombinant protein which produces light (bioluminescence) as a reaction to the presence of free calcium ions released from actively demineralising tooth surfaces. The dentist can then recommend action to minimise further damage and repair the enamel structure (if necessary) using non-surgical methods.

Ongoing research and analysis into children’s dental heath is appropriate and important. Positive progress has to be balanced with statistics that show there is still much work to be done. Supervised brushing, regular check-ups and a healthy diet that restricts sugar consumption are fundamental, as is parent/carer education. Technology can also support practitioners to detect decay early. Most oral health problems in children are totally avoidable – support preventive care for very young patients and the long-term benefits for all of us will be immeasurable.

For more information visit www.CALCIVIS.com
or call 0131 658 5152

Benjamin RM. Oral health: the silent epidemic. Public Health Reports. 2010 Mar; 125 (2): 158.
Public Health England. National Dental Epidemiology Programme for England: oral health survey of five-year-old children 2015: A report on the prevalence and severity of dental decay. Published May 2016. Link: http://www.nwph.net/dentalhealth/survey-results%205(14_15).aspx (accessed October 2017).
Shocking 24% increase in tooth extractions performed on children aged 0-4 in last decade. Royal College of Surgeons, 21 March 2017. Link: https://www.rcseng.ac.uk/news-and-events/media-centre/press-releases/child-tooth-extractions-24-per-cent/ (accessed October 2017).
Public Health England. Launch of the Children’s Oral Health Improvement Programme Board. 26 September, 2016. Link: https://www.gov.uk/government/news/launch-of-the-childrens-oral-health-improvement-programme-board (accessed October 2017).
Child Dental Health Survey 2013. HSCIS, 19 March, 2015. Link: http://content.digital.nhs.uk/catalogue/PUB17137 (accessed October 2017).
LGA – Hospitals spending £35 million on “rotting teeth” in children. 18 April, 2016. Link: https://www.wired-gov.net/wg/news.nsf/articles/LGA+Hospitals+spending+35+million+on+rotting+teeth+in+children+18042016141000?open (accessed October 2017).
Moving oral health higher up the government’s agenda. Dentistry.co.uk, 13 January 2017. Link: http://www.dentistry.co.uk/2017/01/13/moving-oral-health-higher-up-the-governments-agenda/ (accessed October 2017).

What Dental Elite’s mid year goodwill results indicate

Here, Luke Moore dissects Dental Elite’s latest mid year goodwill results.

Our latest mid year goodwill results from September based on all the practices Dental Elite has valued and/or sold in the last financial year, has revealed a number of changes, with significant activity still bubbling away across the board.

The average dental practice transaction value is up, increasing to £1,152,937 since the last goodwill survey. However, this figure is only reflective of the practices that Dental Elite has represented and not the wider market. The average sale value has also gone up 7.67%, supported by big leaps in the multiples obtained not only for practices in general, but also for private practices. We have been reporting a strong demand for private practices for over 18 months now, and if these figures are anything to go by the market is unlikely to slow down any time soon. Moreover, the value of mixed practices has overtaken NHS practices, demonstrating an increasing interest in growing private revenues.

The other notable change to have come out of the results is that the multiples paid of adjusted EBITDA (earnings before interest, taxes, depreciation and amortisation) and adjusted net profits have increased since the financial year-end 2017. In the main, the amounts are greater than the corresponding turnover indicator, which suggests that whilst dental practices are being hit by a softer pound and climbing costs, it is actually the buyers who are feeling the pinch, as they are paying a greater multiple than the owners themselves. This demonstrates that the market is generally becoming increasingly more competitive.

Saying that, there are still some areas throughout the UK where practices are a little less popular with prospective buyers. Compared to the previous goodwill results there has been a slight drop in goodwill values across the South West and in the North East and Yorkshire. This is accompanied by the fact that Dental Elite hasn’t sold any private practices across the North East for the first time ever. While this could be a sign of weakened demand, it is no coincidence that fewer buyers are looking for practices in areas where recruitment is tougher.

The market for private practices in these locations is also a lot tougher unless the turnovers are of a size where they become more attractive to consolidators looking to add to their private practice empires. In the Central Belt and North West on the other hand where recruitment is much easier, we have seen big increases in value as the micro-consolidators expand their patches.

In the Midlands, it must be noted that the results did show an anomaly. This is worth bearing in mind, because while the percentage of turnover for NHS practices is recorded as 111.90% the number is skewed by a partnership sale that took place internally. Had it not been for that unusually low sale price, the overall turnover for NHS practices in the Midlands would have been higher than private and mixed practices. This goes to show that goodwill results should always be taken with a pinch of salt, as an irregularity can distort the numbers.

Altogether, our mid year goodwill results have revealed a number of interesting trends that will play a huge part in practice sales and acquisitions. For further insight or for details on how these changes could affect you, call the team at Dental Elite.

For more information on Dental Elite visit www.dentalelite.co.uk, email info@dentalelite.co.uk or call 01788 545 900

Keep them coming!

In the 24-month period up to the end of June 2017, 22.2 million adults were seen by a NHS dentist in England; that’s just over half of the adult population. But what about the rest of them? Well, in a separate survey where respondents were asked their views on NHS dentistry, 38 per cent gave ‘private dentistry’ as the main reason for not trying to obtain an appointment.

Private or NHS, that’s still quite a lot of adults missing from the statistics. As for children, although the under 18s get free dental care, the 2016-17 figures for England revealed that only 58 per cent saw an NHS dentist during this period.

Rather than endless number crunching, we really need to ask why people still don’t get to the dentist as often as they should. The question is relevant whether your schedules are full to capacity, or if you have been seeing your numbers dwindle every year. New patients are only part of the answer too, as loyal ones aren’t immune to cancelling and/or vanishing altogether.

Cost is of course a factor if they pay for treatment. Perceived need ties in with this – a patient may bring their children for a check up every six months because it is free, but only book an appointment for themselves when they have a problem that needs fixing. Paying for a dentist to regularly check that all is well is often far down the list of financial priorities.

Anxiety will is another reason why people avoid going to the dentist. In the last Adult Dental Health Survey, 36 per cent reported ‘moderate’ anxiety at the thought of going to the dentist; 12 per cent said their fear was ‘extreme’. Travel issues/access can also be a cause of poor or lapsed attendance. As can being unable to get an appointment at a time that suits, with a preferred clinician.

Taken together, these factors create a mountain to climb, but small changes can make a big difference. Are your charges clear and do patients know exactly what they are entitled to? Do you have protocols in place to deal with dental anxiety and do you advertise these well enough? How well do you spread the message that prevention and regular appointments are paramount to general well being, alongside a good daily cleaning routine?

Is your booking system convenient and fully patient-focused? The answer for many practices has been to implement online booking. Online booking that can be done anywhere, on a computer, smartphone or tablet, speaks loudly to the busy commuter, or the on-the-go mother who does not have any desire to be held in a telephone queue while tending to her young children. Online booking also allows patients to switch an appointment easily, without having to cancel and possibly go elsewhere.

Online booking will also give your practice numerous benefits. You need only upload slots you wish to fill, thus retaining full control of what and how many appointments are booked. The reception team will get more time to deal with people actually in the practice and those who prefer to call. This is an important point; online booking should run alongside an informed, professional and efficient front desk to give patients a choice about how they engage with you. Depending on their specific needs, patients can either book quickly and easily online or know that if they call they will be able to discuss their matter with someone who is knowledgeable and polite. One size does not fit all and a successful, forward-thinking practice must consider the different kinds of patients they treat and how to support and engage successfully with all of them.

Investing in online booking means looking for a system that can improve both attendance and patient satisfaction. The CS R4+ Engage from Carestream Dental is a brand-new tool designed to do just that and more. Combining the power of cloud-based online booking with SMS text messaging and encouraging satisfied customers to provide testimonials, it utilises the latest technology and marries it with good, ‘old-fashioned’ values like convenience and high standards of customer service.

We want more people to go to the dentist more often, not just when they are in pain. Making it easier to access and book your services is an important step in the right direction. Having a choice of booking online will make more patients come to you and then return. If you can offer convenience, support and efficiency, alongside excellent care, your patients will become your biggest promoters.

For more information, contact Carestream Dental on 0800 169 9692 or
visit www.carestreamdental.co.uk
For the latest news and updates, follow us on Twitter @CarestreamDentl
and Facebook

NHS Dental Statistics for England – 2016-17. NHS Digital, 31 August 2017. Link: https://digital.nhs.uk/catalogue/PUB30069 (accessed November 2017).

GP Patient Survey Dental Statistics; January to March 2017, England. NHS England, 6 July 2017. Link: https://www.england.nhs.uk/statistics/2017/07/06/gpps_dent_y111864861/ (accessed November 2017).
NHS Dental Statistics for England – 2016-17.

Adult Dental Health Survey, 2009. Heath & Social Care Information Centre, 24 March 2011. Link: http://content.digital.nhs.uk/pubs/dentalsurveyfullreport09 (accessed November 2017).

It was reported recently that common oral health problems are costing the economy more than £105 million each year in sick days, with around one in 20 UK employees thought to have taken time off in the last year alone. While the profession has been alert for some time as to the external factors at play in regards to patients’ oral health, it’s been an eye opener for many in that the issue is still a long way from being brought under control.

The growing sugar consumption is one such problem that continues to plague the profession, with no end in sight. Indeed, despite widespread efforts from the government, avid campaigning from a number of high profile dental bodies and attempts from global food companies to reduce sugar content in popular food products, intake remains well above the recommended sugar allowance. A review of consumption from nationally representative dietary surveys across the world suggests that sugars as a percentage of energy ranges between 20 per cent and 38.4 per cent in infants, 17 per cent to 34.8 per cent in children, 15.4 to 29.6 per cent in adolescents and 13.5 to 24.6 per cent in adults. The data presented similar results for adults 60 years and above, with total sugars ranging from 13.3 to 23.2 per cent. The message simply isn’t getting through – and it’s showing.

It doesn’t help that every which way we turn there’s some sort of sweet treat there waiting to tempt us, from cakes and biscuits being passed under our noses in the workplace to chocolate and fizzy drinks on display in our local supermarket. Even those with high self-control are likely to crack from the pressure of temptation.

The same goes for alcohol. Despite a notable decline in consumption, there is still a booze culture in the UK that threatens to reverse all the hard work that has been going on behind the scenes. Dental caries and periodontal disease are two of the main culprits for toothache and oral discomfort, and it’s no coincidence that excessive drinking has been linked to both these conditions. Throw in the effects of tobacco on oral health (the prevalence of smoking in adults aged 18 and above is 15.5 per cent) and it’s almost no wonder that employees are taking time off to deal with or rectify oral illness.

Of course attendance remains one of the largest issues, with data suggesting that just 61 per cent of adults go for a check up on a regular basis and more than a quarter of adults only visit their dentist when they have a problem. Patients’ busy schedules have a lot to do with this, as many find it difficult to fit an appointment around their work and family commitments – especially if slots are only available from nine to five, Monday to Friday. It’s ironic really that in trying not to miss work, patients will invariably end up having to take time off anyway to attend an emergency appointment. After all, adults who do not attend check ups are both more likely to have a poorer dental status and suffer from acute symptoms of dental disease.

Unfortunately, attendance has also been heavily affected in recent years by accessibility. Indeed, it’s been an ongoing issue that patients are struggling to find an NHS dental provider taking on new patients, and where there are opportunities to register, appointment availability is often limited. With the additional barrier of affordability, more and more patients are slipping through the net, with oral problems going undetected.

But what can be done? The harsh reality of it is that there’s no easy solution to rectify this growing issue. By standing together, however, and continuing to work closely with the government and influential bodies, the profession can prevent this problem from becoming any worse. The needless pain of patients that are resorting to going off sick simply cannot be allowed to continue any longer, and with your ongoing support and hard work the profession can put an end to this suffering.

As well as encouraging regular dental checks, raising awareness and urging patients to adopt a thorough oral hygiene routine will be essential moving forward. You’ll also need to recommend products that are affordable yet effective, such as Curaprox CS toothbrushes and CPS interdental brushes, informing patients of the benefits that using specially designed adjuncts can have on their oral health.

As long as you help to improve just one patient’s quality of life, you will have made all the difference.

For more information please call 01480 862084, email info@curaprox.co.uk or visit www.curaprox.co.uk

The Oral Health Foundation: ‘Charity urges workplaces to tackle poor oral health as sick days cost UK economy £105m’. Published 15 May 2017. Accessed online 17 August 2017 at https://www.dentalhealth.org/news/details/961
Newens KJ, Walton J. A review of sugar consumption from nationally representative dietary surveys across the world. Journal of Human Nutrition and Dietetics. 2016; 29 (2): 225-240. Accessed online 18 August 2017 at http://onlinelibrary.wiley.com/doi/10.1111/jhn.12338/full
NHS Digital: ‘Statistics on Smoking, England – 2017. Published 15 June 2017. Accessed online 21 August 2017 at http://www.content.digital.nhs.uk/catalogue/PUB24228
National Smile Month: ‘Facts and Figures’. Accessed online 21 August 2017 at http://www.nationalsmilemonth.org/facts-figures/
Montero J, Albaladejo A, Zalba JI. Influence of the usual motivation for dental attendance on dental status and oral health-related quality of life. Med Oral Patol Oral Cir Bucal. 2014; 19 (3): 225-231. Accessed online 21 August 2017 at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4048109/

Tax year planning for many ranks as one of those tiresome yet necessary tasks that must be completed no matter what – much like taking out the bin or cleaning the house. Without it, investments can wither, profits become stifled and tax contributions far exceed what they would do than if you’d planned efficiently. Luckily, it’s never too late for tax planning, and what better time to start than the beginning of the tax year.

There are a great many aspects to take into consideration, but by getting on top of your finances early rather than waiting until Q4 and beyond to execute your strategy, you’ve got a more realistic chance of achieving your goals and avoiding a huge tax bill – not to mention that it’s far less stressful. Checking your allowances and options in advance will also help you to maximise any potential benefits available to you, ensuring optimal return with minimal losses.

An Independent Financial Adviser (IFA) can help evaluate your position and assess the best way to approach the tax year, ensuring that you start as you mean to go on. Together, you then have time to watch your strategy unfold, as well as the space to make any necessary adjustments along the way. After all, the perfect portfolio and financial plan isn’t realised overnight; it takes continual nurturing and modifications to get it just right.

To achieve the best results and make your tax bill as efficient as possible for the tax year 2017/18, it might be worth considering the following: are your current investments effective? Are you taking advantage of new financial products? Are you on top of your tax bill? Are you utilising all the tax relief options available to you? Are your financial records up to date? And are you making the most of savings vehicles?

In terms of your investment portfolio, now is a great time to review your current investments as well as consider future assets that might be worthy additions. Diversification, as much as the assets that you choose, is integral to the balance and success of your portfolio, so take care to establish the potential risk versus reward of each individual investment and how they all work in tandem in relation to the bigger picture goal. Any cash assets, bonds, shares, equity funds and property that you have will need to be reviewed, taking into account any current market trends or relevant reforms that may have an impact on your investments’ performance over the course of the tax year.

With your cash savings, your private pension is always a good place to start. Like last year, the Annual Allowance (AA) will be £40,000 for 2017/18, so if you’ve got some extra cash that you’d like to put to good use or invest in a tax-efficient manner then it might be worth focusing on your private pension for this tax year. Of course, if your total savings pension (PIP) exceeds your AA it is possible to reduce the excess by carrying forward any unused AA from the previous three years, as long as you utilise your current PIP first. As it stands for 2017/18 the carry forward amounts are £40,000 for 2014/15, £40,000 for 2015/16 and £40,000 for 2016/17 – permitting that taper provisions do not apply. Don’t forget, however, that the rules around accessing a Money Purchase Pension Arrangement (MPPA) as a way of avoiding tax on current earnings have been tightened, limiting the extent to which pension savings can be recycled. Instead of £10,000, your MPPA is now just £4,000.

The new tax year is also a good chance to review Independent Savings Accounts (ISAs). As there isn’t the option of carrying over unused Allowance, the £20,000 AA must be used by 5th April 2018 or you lose it. For maximum return, it can pay to invest as much as you can as early as you can, though it is always best to discuss this with your IFA in case it conflicts with your other financial plans. It may well be that for 2017/18 other assets take a priority if the market looks to be performing better in that area.

In the meantime, be sure to make a start on your accounts preparation and stay on top of your bookkeeping, if you’re self-employed. With the whole tax year ahead of you, better to take advantage of the time you’ve got then leave everything to the last minute.

For effective tax planning in 2017/18, make sure that you get in touch with your IFA sooner rather than later. You have it in your power to be tax efficient and handle your money wisely so that you make the most of it, don’t squander that chance.

For more information please call 0845 345 5060, email info@money4dentists.com or visit www.money4dentists.com

I started with MyDentist in November 2011 as a volunteer at the St Ives practice when I was at sixth form, working in reception to assist the orthodontist who used to work quite long hours. At the time I was studying to go into medicine so I wanted to gain some experience working across various fields – including dentistry. After just one month I quit sixth form and began training as a dental nurse; and I haven’t looked back.

Since qualifying in 2014, I’ve completed many additional qualifications across a number of areas, including specialist orthodontic nursing, advanced impression taking, intraoral photography, radiography, fluoride application, PAR scoring, IOTN assessment, basic sedation and implant nursing. I’ve always taken a very keen interest in all aspects of dental treatment and learning new skills, so whenever there’s been the opportunity to take a course I’ve always jumped at the chance. Granted, it’s not an option that every dental nurse is fortunate enough to experience, but if you work for a company where it is possible to master a broad range of skills, it is good to make the most of it.

The speed at which I completed each course was merely down to my competitive nature and the fact I enjoy a challenge – even against myself.
Naturally, it has helped the practice too, as these skills allow me to take on some of the dentists’ work freeing them up to see more patients and make more money in a shorter period of time. It’s effectively what made me an attractive candidate when MyDentist set up their referral implant clinic at the Warboys site, along with my experience working as a TCO.

Now, with all these additional skills and extended scope of practice, I am able to help my practice deliver a much more efficient service to patients. They can be seen quickly by me for consultations and record appointments or by the dentist for more complex treatments. For example, if a dentist saw 20 patients a day, due to sheer demand, the waiting list would be a year a half. However, as I am qualified to take on some of the tasks the dentist would normally do, I can also see 20 patients a day, reducing the waiting list to just six months. It’s here that an effective implementation of skills mix reaps the rewards.

The other notable benefit for patients is choice. When practitioners are under extreme pressure there’s not always a chance to explore as many treatment options as they’d like. Yet, if the dental nurse is able to share the workload they then have more time to spend with patients, meaning better choice and greater patient satisfaction. Even the NHS can profit from use of skills mix, as less waiting time and a smaller waiting list means less cost.
As for my role as a TCO, having worked in both private and NHS practices, I can safely say that treatment coordinating is much more useful to visiting NHS patients, as it gives them the option of choosing private treatment, which may not otherwise have been available to them. Again, this helps to ease the strain for National Health England. Unlike nursing, however, I don’t think the role is fully appreciated or maximised within dentistry – especially in independent practices – though hopefully in time we’ll begin to see TCOs used more and more. An increasing amount of nurses are gaining the qualifications needed to carry out this role it’s just a matter of the skills actually being used; and it’s in that area that more work needs to be done.

Companies like MyDentist are definitely ahead of the curve with this, with professional development and additional qualifications all part and parcel of working as a dental nurse. This just needs to be implemented on a bigger scale and filtered down on a practical level so that skills are being maximised to the fullest potential.

There’s no denying there is a lot of promise, it’s up to the profession to ensure that time and skill management is a priority moving forward. Only then can we ensure that the highest standard of care is being delivered to patients.

For more information about the ADG visit www.dentalgroups.co.uk