Hailsham woman, Katie Ensell, has been ordered to pay almost £3,500 by Hastings Magistrates’ Court after pleading guilty to offering illegal tooth whitening treatment through her business, KT’s Cosmetics, formerly Pearly Whites, Eastbourne.

Following the receipt of a complaint in March 2018, the General Dental Council (GDC) launched an investigation and on 18 July 2018, Ms Ensell held herself out to undercover GDC investigators as being prepared to practise dentistry, namely tooth whitening, using the Hollywood Whitening system.

Under the Dentists Act 1984 and following the High Court’s ruling in GDC v Jamous, the legal position in relation to tooth whitening is very clear. The treatment can only be performed by a dentist or a dental therapist, dental hygienist or a clinical dental technician working to the prescription of a dentist.

Katie Spears, Head of In-House Appeals and Criminal Enforcement at the GDC said: “Our primary purpose is to protect the public from harm. Illegal tooth whitening represents a real risk as those who carry it out are neither qualified to assess a patient’s suitability for the treatment, nor are they able to intervene should an emergency arise. When we receive a report of illegal practice, we seek to educate those involved about the dangers and the law in relation to tooth whitening. Where our efforts are ignored, as in the case of Ms Ensell, we will, where appropriate, prosecute in the criminal courts.”

Anyone considering tooth whitening should first check the register of dental professionals on the GDC’s website to ensure the individual offering the treatment is qualified to do so.

BDA Northern Ireland has reacted positively to a major review being undertaken of the Regulation and Quality Improvement Authority (RQIA), and the policy and legislation that underpins healthcare regulation by the Department of Health.

NIDPC Chair Richard Graham, and BDA NI Director, Tristen Kelso recently met with officials from DoH Quality, Regulation, Policy and Legislation Branch as part of a pre-consultation stakeholder meeting.

A DoH discussion paper produced as part of the Review acknowledges the existing, ‘uniform approach to registration and inspection’, developments in regulation policy, as well as existing ‘gaps’ mean a radical overhaul of the policy and legislation underpinning RQIA is necessary.

Richard Graham, NIDPC Chair commented:

“Being classified as ‘independent hospitals,’ and subject to annual inspections despite being considered ‘low risk’ – while we see 3 yearly inspection periods elsewhere – has perpetuated the feeling among GDPs for some time that the inspection regime is overly onerous, and not fit for purpose.

“We welcome the root-and-branch approach as proposed, not least the acceptance of moving to a ‘right-touch’ regulatory regime -and the acknowledgement of the issues associated with dental practices being classified as independent hospitals”.

BDA Northern Ireland has been calling for the 2003 Order to be reviewed for some time. An opportunity to engage with senior DoH officials was secured following representations made to the Permanent Secretary to reduce the frequency of dental inspections.

Following a review of ‘Fees and Frequency Regulations’ in 2017, a move from annual dental practice inspections to inspections every 2 years appears to be in the offing in the short-term, subject to sign-off by the Permanent Secretary. An opportunity to look at having this extended even further will be progressed under this latest review, which recognises the range of regulatory tools in improving quality and reducing risk, including professional regulation, quality assurance/reporting processes and use of data.

BDA NI Director, Tristen Kelso added:

“While this process is still at an early stage, we welcome the opportunity to engage with the Department of Health in shaping the future of regulatory policy, and the subsequent primary legislation that will follow on behalf of the profession. 

“The stated direction of travel by the Department is extremely encouraging. We intend to input fully into this process to ensure regulatory policy is much more closely aligned with the accepted low-risk nature of dental practices, and where the regulatory burden can be reduced by taking cognisance of regulation in the round”.

In Shifting the balance, as part of an increased emphasis on upstream regulation designed to focus more on the prevention of harm to patients, the General Dental Council (GDC) made a commitment to develop a risk-based quality assurance process for dental education. Following a public consultation earlier this year, the regulator is now gradually introducing its proposals over the course of the current year, with full implementation due for completion before the start of the 2019/20 academic year.

The major change for education providers is that the frequency, duration, scope and depth of inspections will be determined by an assessment of risk, based on a range of factors including results drawn from new annual education provider self-assessments. The new risk-based system means that the frequency of visits from the GDC may increase, but it also means the duration of inspection is likely to decrease, to reflect the more focused and targeted nature of inspections.

A further major change is the introduction of thematic reviews which are to run in parallel to the risk-based approach to individual providers.

Manjula Das, Head of Education Policy and Quality Assurance at the GDC, said:

“The introduction of thematic reviews is designed to enable us to look at not only education programmes in individual institutions, but also at wider issues across the dental education sector. We heard compelling views about what the first theme should be. This led us to select new dentists’ ‘preparedness for practice’ as the area of investigation for our first thematic review – research is currently underway, and we will report on this at the end of 2019. This research will provide a robust evidence base to identify whether improvements are needed and, if so, what those might be, to ensure new graduates are fit and safe to practise.

“This is an interesting time for quality assurance in dental education and we are looking forward to working closely with our partners as we implement and learn from this new approach, which will inform our future developments in this important area.”

The GDC’s response to views submitted during the consultation phase and further details of the changes can be found in Education processes: consultation outcome report.

Leah Turner, Practice Sales Director of Dental Elite considers independent buyers’ purchasing habits…

Practice acquisitions: How has the independent buyer changed?

As you know, the dental practice sales and acquisitions market is constantly evolving, which can affect everything from dentists’ ability to buy and sell, to the practice asking price. But it’s not just trends that change; so do the buyers. Independent buyers in particular have changed somewhat over the years, in that the overall knowledge of buyers on the purchasing process and market trends has improved drastically.

Whereas before dentists might have been unsure about what buying a practice entailed, it is now the case that more dentists are aware of what is involved; especially in regards to how to model a practice themselves and how aspects of the transaction – such as the valuation – theoretically work. This is due, in part, to the amount of information that is now available via different mediums and an increase in being business savvy. But there’s also an element of necessity, as expectations from banks are far greater than a decade ago. Buyers have to not only be able to prove that their chosen practice is viable, but that they’re capable of running and growing a business. It’s no longer enough to just have the clinical skills.

We’ve also noticed that an increasing amount of dentists are less reliant on advisers; at least in regard to identifying whether a practice is a good business venture or not. This is a good thing, as it means that buyers are less likely to make bad investment decisions – not necessarily from a financial perspective, as banks don’t tend to lend against a failing or non-profitable business – but in regard to time and effort. This means that dentists are able to search more efficiently and find a more suitable practice fit for their needs.

In regard to the plans that buyers have, there’s been a real resurgence over the last few years in private practice acquisitions. Of course, there’s still strong interest in NHS practices and we are continuing to see dentists follow the pattern of: qualify, complete foundation training, and work for a couple of years as an associate before buying their first practice. A number of these dentists invariably go on to acquire additional practices and build what is essentially a small group, most likely with the intention of reducing their presence in the practice over the course of time.

But alongside this, there has been a notable rise in the number of dentists looking to enter into private practice, who tend to go down the route of further education after working for several years as an associate. This has grown from the fact that because there are more and more dentists offering specialist treatments due to greater postgraduate training opportunities, not all specialists are able to feasibly offer their services as associates. These dentists are therefore seeking alternative options – that is, buying a private practice that they can work in and grow themselves.

Due to the time it takes to secure the right qualifications and financial wherewithal, these buyers tend to be a bit older. This is also the case where goodwill values are higher, though you do see younger buyers if they have the support of family money. Where the buyer is younger or more entrepreneurial, we have seen a growing interest in buying under new structures that means they don’t own 100% of the practice. Not only can this be beneficial for the buyer in terms of easing some of the financial burden and providing business and clinical support, but it can also be extremely advantageous to the existing principal looking to decrease their involvement in the practice.

In light of all this, it is important to remember that trends (including those pertaining to lending) can change very quickly, meaning that the current pool of independent buyers could well be different in the future to what it is now. The market too can evolve rapidly, which can make it extremely difficult to navigate through the transaction – regardless of prior knowledge and understanding. Indeed, no matter how clued up you are, there are certain aspects of the process that are best dealt with by a specialist sales and acquisitions agency like Dental Elite. Plus, going at it alone, you can’t guarantee that what you’re getting is the best deal in the long-term. As for the vendor, staying up to date with current market trends and having an awareness of what the buyer pool looks like is essential to ensuring a successful sale. Only by seeking professional help can one hope to stay ahead of the game.

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

Manchester-renowned dentist, ANDY MICHALCEWICZ has been in the dentistry industry for more than four decades. Here he talks to The Probe about his journey to finding the perfect location for his new practice, using the power of persuasion to secure the premises and how careful planning went in to refurbishing Ash Villa.

A warmer, friendlier dentist you could not wish to meet. With almost 41 years in dentistry under his belt, Andy Michalcewicz is perhaps one of the longest qualified, still practising, dentists in the Manchester area. With his career continuing to flourish, Andy reminisces about how he landed in dentistry, a chance meeting with an old friend that led to his first practice purchase and the latest chapter in the development of the practice.

“I made the decision to go into dentistry when I was 8 or 9 years old. After a few bad experiences with the dentist I thought to myself, “I could do a better job.” I gained the results I required at school and found I was good with my hands through a love of model building and playing musical instruments. Encouraged by my mother, who was the senior theatre nursing officer at Wythenshawe Hospital and responsible for running 20+ operating theatres, I studied dentistry at Sheffield University and after completing my training, became an Associate at a practice in Stockport.

“I used to meet a dentist friend for a pint every Wednesday. One week, while we were chatting, another old friend arrived by chance, someone I hadn’t seen for over 15 years. It was a fabulous reunion and we had a great evening catching up on everyone’s news. During the course of the evening my friend happened to mention that his future father-in-law, also a dentist, was in the process of selling his dental practice. Since this dentist and practice had an excellent reputation, I was intrigued.

“The sale was almost complete but my friend’s future father-in-law wasn’t happy with the T&C’s and it didn’t seem certain that the sale would come to a satisfactory conclusion. It was probably an ‘off the cuff’ remark at the time but I asked my friend to get his father-in-law to call me if the sale fell through. It was a few weeks later when I got a surprise call to say the sale was off and was I interested. To cut a long story short, I became the proud owner on 1st April 1981.”

Andy’s new practice was an end terrace building, on Washday Road, Sale, next to Mecca Bingo. His business thrived there for 19 years before Andy took the decision to relocate a mile away to a larger property. He explains, “We just could not accommodate our growing patient base so I started to look around for suitable new premises and found a detached residential property that seemed perfect for conversion to a dental practice. The downside was that it was already being pursued by a physiotherapy business, but the sale was proceeding slowly. With some persuasion, I managed to get the owner to agree they would sell to whoever could be ready to exchange contracts first. Needless to say, we were successful and opened Ash Villa in January 2000.”

The new property gave Andy’s practice the room it needed to expand. Moving all the equipment from the Washway Road property, they kitted out two surgeries, and in 2003, opened a third surgery upstairs in the former front bedroom.

Fast forward 14 years to 2017 and prompted by the departure of his long serving hygienist, Andy started to think about bringing the third surgery up to date. With Brooke, the new therapist/hygienist on board, he set about planning a modern new room they could share.

The starting place for their planning was the Belmont showroom at Salford Quays. Andy explains, “I had been tempted to install a Belmont chair 15 years ago but at the time was persuaded to install another brand. This time I decided I would take another look, as many of my dentist colleagues and service engineers recommended them highly.

“At the showroom Mark Harris patiently took us through all the options. We settled on the compact Compass electric model with two micro-motors and the 5-to-1 speed increasing hand piece, as I really like the control and torque. Both Brooke and I felt the delivery system would work well and the ergonomic design makes it easy for the patient to access extremely comfortably. I particularly liked the LED operating light too.

“We contacted Simon Pearce at McKillops for help with the refurbishment work. Simon came over to the practice and one evening, together with Brooke, we planned out the room layout plus a new decontamination room under the stairs and made our wish list for the kit and equipment we wanted.”

Starting work in April the refurbishment project took just three weeks to complete, which included rewiring the first-floor electrics and all the plastering, plumbing, flooring, decorating and installation of the new equipment, cabinetry and chair.

The service delivered by McKillops impressed Andy, “They’ve been a fantastic bunch of people to work with. Clearly Simon has lots of experience and is able to anticipate potential problems and work them out. Throughout, he liaised closely with Julie, my Practice Manager, to ensure dates were co-ordinated and she is extremely complimentary about the professionalism of the whole team.

“Due to Simon’s careful planning we were able to keep the practice open with very little disruption to the patients, which as everyone knows, is vital in the dental world. I’m really thrilled with how it has turned out and the patients love it too.”

Andy has absolutely no regrets. “The plan now is to celebrate the official opening of the new room with all my great team and, of course, the McKillop team. I’m sure they’ll be a ribbon cutting and a glass or two of fizz for all too.”