Dental Earnings and Expenses Estimates 2017/18

The results within this publication relate to full-time and part-time self-employed primary care Principal and Associate dentists with registered NHS/Health Service activity during 2017/18. Dentists in different countries worked under different dental contracts:

England & Wales

• General Dental Services (GDS)
• Personal Dental Services (PDS)
• Mixed GDS/PDS or mixed GDS/PDS/Trust-led Dental Services (TDS))

Northern Ireland

• General Dental Services (GDS)

Scotland

• GDS and a registered Dental Surgeon (DS) number

This report considers only self-employed primary care dentists who performed at least one NHS Unit of Dental Activity (UDA) and/or one NHS Unit of Orthodontic Activity (UOA). This is the equivalent of one Item of Service and/or one Orthodontic Item of Service, in Northern Ireland and one Course of Treatment and/or one Course of Orthodontic Treatment in Scotland.

• Dentists with no self-employment income
• Dentists who performed only private dentistry

Also excluded from the England & Wales dataset:

• Provider Only dentists (who undertake no dental activity).
• Dentists working solely under a TDS contract.

These sections of the report look at the 2017/18 NHS/Health Service and private dental earnings and expenses of self-employed primary care dentists by the percentage of time spent on NHS/Health Service activity as opposed to private dentistry. Dentists’ responses to the Dental Working Patterns Survey provide the percentages of time spent on NHS/Health Service dentistry within this report.

As “percentage of time spent on NHS/Health Service dentistry” is derived from the individual survey responses of dentists a number of factors should be acknowledged:

• The measure “percentage of time spent on NHS/Health Service dentistry” relates to the activity of the individual dentists rather than the practice(s) in which they work.
• The percentage of time spent on NHS/Health Service dentistry is not related to the total weekly hours devoted to dentistry, i.e. a dentist who undertakes a percentage of NHS/Health Service work may do so on either a part-time or full-time basis.
• Some dentists have NHS/Health Service income (employed or self-employed) from outside their practice, such as from working in dental schools, and therefore the measure of “percentage of time spent on NHS/Health Service dentistry” may not be solely restricted to self-employed work within a dental practice.

Average levels are expressed as ‘≤25%’ (less than 25 per cent of dentists’ time is spent on NHS/Health Service dentistry); ‘>25<75%’ (where more than 25 and less than 75 per cent of dentists’ time is spent on NHS/Health Service dentistry); or ‘≥75%’ (where 75 per cent or more of dentists’ time is spent on NHS/Health Service dentistry).

The report provides a detailed breakdown of the allowable expenses results. For each expense category, results are shown in monetary terms and as a percentage of the total expenses.

• Office and general business expenses include general administrative costs as well as legal and professional costs.
• Interest expenses include almost all types of interest; however, this category excludes a small amount of interest for businesses (which in this report are self-employed primary care dentists) where turnover is less than £85,000 for the year, which is included in the Other category.
• The Other category includes a variety of expenses, including laboratory costs, materials costs, advertising and business entertainment costs, bad debts, alternative finance payments, interest (for businesses where annual turnover is less than £85,000), and expenses for those businesses where a more detailed breakdown is not available.

Costs incurred by self-employed primary care Principal dentists for using Associate dentists to deliver some NHS/Health Services work on their contract may be included in different expense categories, depending on the person completing the Self Assessment tax form. It is thought that such costs of Associate dentists are likely to be included in the Other category on most Principal dentists’ tax forms, but in some cases these costs could be included in the Employee category.

The expenses figures may also be affected by the way in which reimbursement for specific overheads are recorded on a dentist’s Self Assessment tax return.

A number of factors make comparisons between the 2016/17 and 2017/18 results difficult, including changes to the dental population, changes in dental type as well as the sample used to produce this report.

Analyses for subgroups with low population counts must be treated with caution, as changes in the sample size can have very noticeable effects on the averages.

Furthermore, when examining the detailed expenses breakdown for Associate dentists, it is important to note that some Associate dentists may not have any expenditure in one or more of the expense categories which will affect the average value for expenses in these categories.

Further detailed information on some of the elements of dental expenses in England & Wales – laboratory costs, materials costs, non-clinical staff wages and other non-staffing overheads – has been provided by the National Association of Specialist Dental Accountants and Lawyers and Morris & Co. Specialist Dental Accountants, and is included in Annex A.

Analyses by working patterns are based on results from the Dental Working Patterns Survey, 2016/17 and 2017/18, and provide detailed analysis on average earnings and expenses from NHS/Health Service and private dentistry by weekly working hours and percentage of time spent on NHS/Health Service dentistry. The Dental Working Patterns Survey is a biennial survey of self-employed primary care dentists who conducted some NHS/Health Service activity during the survey period. The survey is commissioned by the Dental Working Group and administered on its behalf by NHS Digital.

As with the results in the rest of the report, the findings relate only to those dentists who:

• performed at least one NHS Unit of Dental Activity and/or one NHS Unit of Orthodontic Activity in England & Wales
• were registered with the Northern Ireland Health and Social Care Business Services Organisation (BSO) to provide Health Service dentistry in Northern Ireland

or were identified by NHS National Services Scotland: Information Services Division (ISD) as having an arrangement with an NHS Board to provide General Dental Services (GDS)

The earnings and expenses estimates in this report do not consider, nor contain data on, dentists who performed only private dentistry in 2017/18. The results cover earnings and expenses from both NHS/Health Service and private dentistry, and non-dental income is excluded from the analyses.

Estimates in this section are based only on the sample of dentists who responded to the survey and may be subject to more uncertainty, if based on small numbers, compared to those which do not rely on the use of survey data.

Results based on the survey data were weighted using the same methodology as the rest of this report (rather than those used in Dental Working Hours, 2016/17 and 2017/18), which means that average values for the “All Dentists” category presented in these sections – comprised of the “All responders” and “No survey” categories – are the same as the average values for the “All Dentists” category throughout the rest of the report. Further information about the survey is available in Dental Working Hours, 2016/17 and 2017/18

Earnings and expenses estimates, where presented by the average number of weekly hours worked on NHS/Health Service or private dentistry, include both clinical and administrative work. It is important to note, however, that some survey respondents may have included time spent in employed dental work, such as time spent working in dental schools, rather than solely self-employed activity. As a result, the measure of weekly working hours may not be restricted to self-employed work in a dental practice.

The measure of weekly working hours is expressed in three bands for dentists in Northern Ireland and Scotland: less than 35 hours, 35 hours to 45 hours, and over 45 hours.

This year additional weekly working hours bands have been included within the England and Wales section of the report. These additional bands provide results in smaller increments and allow more meaningful analyses to be presented. Due to a significantly higher number of Associate dentists, there are more bands available for them in comparison to Principal Dentists.

In England and Wales, the weekly working hours are as follows:

• Principal dentists: less than 30 hours, 30 hours to less than 35 hours, 35 hours to less than 40 hours, 40 hours to less than 45 hours, 45 hours and over
• Associate Dentists: less than 20 hours, 20 hours to less than 25 hours, 25 hours to less than 30 hours, 30 hours to less than 35 hours, 35 hours to less than 40 hours, 40 hours to less than 45 hours, 45 hours and over