A major new report from Patient Plan Direct (PPD) is shedding light on one of the biggest pressures currently facing UK dentistry, as practices across the profession reassess sustainability, workload, recruitment and patient access in the wake of April’s contract revisions and ongoing debate around the long-term viability of NHS dentistry.
Drawing on first-hand experiences, clinician perspectives and data from practices across the nation, The State of NHS Conversion 2026 examines the financial, operational and personal factors shaping NHS to private conversion, helping to build a clearer picture of what the transition can look like in practice and why increasing numbers of practices are exploring alternative models of care.
What the data shows
Among the report’s headline conclusions, PPD’s long-term conversion data suggests practices often require a much smaller proportion of their NHS patient base than many expect to support a viable private model, with around 40% patient retention frequently sufficient depending on practice structure and patient demographics.
PPD’s findings also show that 70% of conversions currently take place as full-practice transitions, while 30% follow a phased or clinician-led approach, with almost a third of phased conversions later progressing to full conversion within two years.
Conversion timelines are continuing to shorten, with practices PPD has supported through conversion now reaching target plan patient numbers in an average of seven weeks, compared with 11 weeks three years ago.
Taken together, the findings suggest a profession under growing pressure to rethink what good dentistry, sustainable practice ownership and professional fulfilment could realistically look like in 2026 and beyond.
Simon Reynolds, Managing Director of PPD, said: ‘There has been a huge amount of discussion around NHS dentistry over recent years, but far less visibility around what conversion from NHS to private looks like in practice and how those decisions are being made.
‘What this report shows is that there is no single model or route forward. Every practice is different, but there are clear trends emerging around sustainability, patient behaviour and the factors shaping long-term decision making.
‘Our aim was to create something grounded in real experience and real outcomes that helps practices better understand the realities of conversion, rather than relying on speculation or assumptions alone.’
Voices from practice
The report includes perspectives from practice owners who have already completed the transition away from NHS dentistry, including Dr Jim Sykes, Principal Dentist at Hexham Dental Clinic.
Dr Sykes said: ‘I felt like the NHS model was draining the quality and enjoyment out of dentistry. The only way to improve seemed to be to work faster, and eventually it became impossible to provide the level of care I wanted for my patients.
‘Moving away from the NHS gave me the time to focus properly on quality, patient conversations and the type of dentistry I had trained to do. It has completely changed how I feel about the profession again.’
The findings further suggest this shift is not limited to independent practices, with larger dental service organisations (DSOs) and other multi-practice operators increasingly reassessing long-term viability, workforce pressures and operational flexibility across multiple sites.
Todays Dental Group, which recently completed conversions across five practices in Wales, is among the organisations contributing to that growing conversation.
Lisa McKinnon, Chief Operating Officer, said: ‘As a group, we’ve seen first-hand how significantly the NHS conversation has shifted in recent years, particularly around sustainability, workforce pressures and long-term planning.
‘What’s important is having the right support, structure and communication in place throughout the process. Our experience working with PPD across multiple practice conversions has shown how valuable that preparation and ongoing support can be for both teams and patients.’
The bigger picture
Overall, the findings suggest NHS to private conversion is becoming an increasingly mainstream consideration for NHS practices reassessing long-term feasibility, clinical freedom and the future direction of their business.
For practices currently weighing up what comes next, the full report brings together practical insight, real-life perspectives and data-led findings to help support more informed decision making. It can be downloaded at: https://patientplandirect.com/report
