Why the mixed model is spreading
The mixed dental practice model is becoming the default response to an uncomfortable maths problem for a growing number of NHS practice owners: NHS contract values are fixed, while the costs of running a practice are not. Writing for Dentistry.co.uk, Amy Hansford of plan provider Practice Plan points to the increases in the national minimum wage and the rise in employer's National Insurance contributions introduced in April last year as pressures that owners bound by the NHS contract cannot pass on to patients. Private income, by contrast, is a lever the owner still controls.
Hansford's answer is the mixed model — adding private dentistry alongside NHS provision rather than handing the contract back entirely. She cites the GDC's Workforce Patterns data, reporting that around 66% of UK practices already operate this way. That figure is worth checking against the GDC's own published report rather than taking from trade coverage, but if broadly right it makes an important point: going mixed is not a radical step. It is the sector norm.
So this is not an "ignore it" story. The underlying cost pressure is real and structural, and for many owners doing nothing simply means watching margins erode by default. But before treating the article as a how-to, three things are worth holding in mind: it is advisory content from a party whose commercial model depends on conversions happening, it contains no hard financial figures, and it frames as a tidy "best of both worlds" a change that, for a meaningful group of patients, means losing affordable access to their dentist.
What the source gets right
The operational checklist is sensible. Communication with the team comes first — staff who hold strong views about NHS provision, and who aren't consulted early, are a retention risk at exactly the point you need continuity. Front-of-house and nursing staff will be asked about private treatment costs by whoever is nearest, so they need genuine training, not just a script. All of that is sound practice management.
The contract mechanics matter more than the article's brisk treatment suggests. You must keep delivering your NHS contract while you introduce private work, or risk clawback — so reallocating clinician time between UDA delivery and private slots is a compliance exposure during any transition, not merely a scheduling puzzle. Hansford floats rebasing the contract as an option worth exploring; that is a conversation to have with your commissioner and your accountant, not a box to tick.
On fees, the guidance is genuinely useful: publish your prices, set out the difference between NHS charges and private fees plainly, and avoid presenting patients with a plan and then loading it with "hidden extras." Transparency here is both a trust asset and a compliance safeguard.
Where the numbers actually live
What the article does not give you is a business case. There is no capital outlay, no fee percentage, no payback period anywhere in it. As a general rule, membership plan providers charge a percentage of plan revenue — the source does not disclose what that is — and you should also budget separately for any fit-out spend, staff training time, and possible recruitment if an associate is needed to backfill UDA delivery while a senior clinician's diary shifts toward private work.
Hansford describes the provider's feasibility assessment, which tells you how many patients you can afford to lose and still stay viable. That is useful information. It is also, plainly, a sales-qualification tool as much as due diligence, and it should be sense-checked by your own accountant before you commit to anything. The reassurance that a provider "would never push anyone into a conversion if the numbers didn't add up" is a marketing line from an interested party, not an independent audit — there is no evidence in the source, and none generally available, about how often such providers actually turn clients away. Get your own numbers.
The part the sales pitch leaves out
Here is the tension the article resolves too neatly. If the feasibility numbers "work" — if you can afford to lose a certain proportion of NHS patients — it is worth asking why they work. In much of the country, NHS dental access is so constrained that patients have few realistic alternatives. A conversion that succeeds because patients pay up rather than lose their dentist is not straightforward validation of the model; in part it reflects a captive market. That is a less comfortable reading than "best of both worlds," and it is the honest one.
The clinical dimension deserves the same candour. The source states the standard of dentistry will be "largely similar" across NHS and private streams — a reasonable working assumption where the same clinician delivers both, but it is an unevidenced generalisation, not a measured claim, and it glosses over time. More chair time genuinely changes what can be assessed, discussed and planned. So the honest, defensible patient-facing message is about time and continuity — "more time with your dentist," "guaranteed appointment availability" — which are operational facts, not clinical claims. What must never be implied is that private care is clinically superior or safer: that risks breaching CAP Code rules on misleading and unsubstantiated superiority claims, and could invite a GDC complaint under the standard that marketing be accurate and not misleading.
This is also where treatment-planning integrity comes in. As practices introduce private-only treatments and lean on the wider team to discuss cost, the GDC's requirement that recommendations remain needs-led rather than revenue-led does not relax. Any conversion process should build in a clear internal check that clinical advice is not being shaped by conversion targets.
And there is the access question the article treats as background. If you thin out NHS capacity to create private slots, patients who don't convert and can't find an NHS appointment elsewhere may lapse from recall — a continuity-of-care and patient-safety issue, not just a reputational one. Repeated practice-by-practice at national scale, this playbook has an aggregate consequence: the shrinking of NHS dental capacity. That is a policy-level concern, and there is a real argument that the mixed model working so well as an individual coping mechanism reduces the political pressure to fix the underlying contract — good for the individual owner, arguably weakening for the profession's collective negotiating position. The article does not engage with this at all. A balanced reader should.
The "separate lounge" idea — comfortable sofas and complimentary drinks for private patients, ordinary chairs and a water fountain for NHS ones — illustrates the problem in miniature. It should certainly never be advertised, as it could read as differential care standards. But even unadvertised, a visible two-tier in-practice experience is something staff and patients notice and talk about. Reputational risk here exists independently of marketing compliance.
The sensible path is neither wholesale, rushed conversion nor doing nothing. It is a phased, modelled approach: get an independent feasibility view alongside — not instead of — any provider's assessment; map the diary rebuild against your UDA obligations before you move a single slot; train the whole team, not just the clinicians; and publish transparent fees from day one.
But model the human side too. Decide in advance what you will tell NHS patients who cannot convert, give them fair notice, and never let "your NHS slot may not be available much longer" become a plan-sales trigger — that tips into pressure-selling. Watch the load on whichever clinicians remain doing UDA-heavy work, because concentrating NHS delivery on fewer people worsens the burnout pattern already well documented in NHS dentistry.
One further watch-item the source ignores entirely: the possibility that commissioners tighten scrutiny of practices that sharply rebase or shrink NHS delivery. There is no sign of that in this piece, but it is a live regulatory tail risk worth factoring into a decision you expect to live with for years.
Going mixed can be the right move — often it is the only rational response to a contract that no longer covers its costs. Just don't mistake a plan provider's checklist for a business case, and don't let the marketing language convince you that a decision which withdraws affordable care from some of your patients is a win for everyone. It is a genuine trade-off. Make it with your eyes open.