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Dentistry (B2B) - UK - August 2015

“The continued strain on NHS finances could lower confidence within the industry that the NHS will be able to offer appropriate remuneration to dental practices. Smaller practices will particularly suffer, especially as compliance costs are likely to rise. This could offer a further incentive for dentists to offer private or cosmetic dental services as a way of guaranteeing more income and revenue.”
– Lewis Cone, Industrial Analyst

This report will explore the following key questions regarding the dentistry market in the UK:

  • What are the key determinants driving the industry?
  • How was the market affected by the recessionary period? Has it managed to recover?
  • How has the provision of dental treatment and other services changed over recent times? Has it favoured private dental provision?
  • How do patients currently rate dental services? Is there room for improvement?
  • What does the future hold for dentistry in the UK?

More people view dentistry as a lifestyle purchase and distinct niches are beginning to emerge as practices want to profitably satisfy the needs of consumers. This is evident when searching for dentistry online, with a large number of dentists rebranding to encourage specific groups of patients. More NHS dental contracts are also expected to be taken up by the corporate dental sector, which will lead to single, smaller practices passing up new contracts as available margins decline and remuneration becomes further integrated with wider access. With the growth of cosmetic dental treatments, more dentists could be tempted to start offering them as standard as a means of guaranteeing income - especially with uncertainty surrounding the future benefits of dentists remaining solely tied to NHS dentistry.

For the purposes of this report, our definition of the UK dentistry market includes the following sectors:

The NHS Primary General Dental Service - This includes revenue from patient fees and revenues from government payments to practices under dental contacts.

The Private Sector - This includes patient fees paid on a per-treatment basis to dentists and revenues from dental plans. The private sector is segmented into primary general dental services - those same treatments available under the NHS.

Private Cosmetic Dental Services - This includes additional treatments where there is no defined patient need.

Hospital, community and personal dental services are excluded from this report. The terms ‘dental care professionals’ and ‘dental specialists’ are used to refer to those qualified employees that support dentists, such as dental technicians, nurses, therapists and hygienists.

The companies profiled in this report include a range of operators in the corporate dental industry (companies operating three or more dental practices) and dental insurance industry. They are selected as being representative of a cross-sample of types of operator rather than necessarily the largest industry participants.

 

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Table of contents

  1. Executive Summary

      • Market size
        • Figure 1: UK Dental Care Expenditure, 2011-15
        • Figure 2: UK Expenditure on Dental Care, by Segment, 2011-15
      • Market trends
        • Market factors
          • Further increases in NHS dental fees weaken value for money
            • Lack of full dental contract reform and government direction on the future of the industry clouds market development
              • Supply of dental workers is mismatched with demand and may lead to oversupply of dental professionals
                • Cosmetic dentistry continues to rise in popularity following the financial crisis
                  • Industry structure
                    • Consumer
                      • Forecast
                        • The value of the dentistry market is forecast to increase by between 2.5% and 3% per year until 2020
                          • Figure 3: Forecast UK Expenditure on Dental Care, 2016-20
                        • Cosmetic treatment expected to gain the most from improving economic conditions
                          • Figure 4: Forecast UK Expenditure on Dental Care, by Segment, 2016-20
                        • What we think
                        • Key Insights

                            • What does the industry expect from the next NHS dental contract set for 2017/2018? What effect will it have on dental provision?
                              • How is the uncertainty surrounding the future of the NHS affecting the industry?
                                • How have dentists reacted to the emergence of the cosmetic sector?
                                  • Is private provision expected to increase?
                                    • Is the industry set for further consolidation?
                                      • How can the industry further develop?
                                      • Introduction

                                          • Definitions
                                            • Methodology
                                              • Abbreviations
                                              • Market Positioning

                                                  • The role of the NHS
                                                    • Dental practices
                                                      • The regulator
                                                        • Market demand
                                                        • UK Economy

                                                          • Key points
                                                            • Overview
                                                              • Figure 5: UK GDP, 2004-15 Q1
                                                              • Figure 6: Quarters after GDP Peak, 1979, 1990 and 2008
                                                            • Inflation
                                                              • Interest rates
                                                                • House prices
                                                                  • Consumer spending
                                                                    • Manufacturing
                                                                      • Business investment
                                                                        • Figure 7: UK GFCF 2003-15
                                                                      • Imports
                                                                        • Exports
                                                                        • Market Factors

                                                                          • Key points
                                                                            • Rising and ageing population underpins demand for dental care
                                                                              • Figure 8: UK Population Estimate and Projection, 2014 and 2019, by Age Group
                                                                              • Figure 9: UK Population Estimate and Projection, 2014 and 2019, by Age Group
                                                                            • Early Signs of Improving Disposable Income
                                                                              • Figure 10: Real Household Disposable Income, 2002-13
                                                                              • Figure 11: UK Households’ Real Disposable Income, 2002-13
                                                                            • NHS Treatment costs rise again
                                                                                • Figure 12: NHS Dental Charges in England, 2011-2015, (£)
                                                                                • Figure 13: NHS Dental Charges in England, 2011-15
                                                                              • Increase in dentists’ NHS activity fails to increase penetration
                                                                                • Figure 14: Dentists with NHS Activity in England, 2009/10-2013/14, (No. of Dentists and % Annual Change)
                                                                                • Figure 15: Number of Dentists with NHS Activity in England, 2009/10-2013/14
                                                                                • Figure 16: Dental Patients Seen in England under the NHS over the previous 24 months, at 30 June, 2011-14
                                                                                • Figure 17: Number of Dental Patients seen in England under the NHS in previous 24 months, 2011-14
                                                                              • Risk of over-supply in dental industry
                                                                                  • Figure 18: Target Number of Dental Students and Actual Intakes in England, 2009/10-2013/14, (Number of Students)
                                                                                  • Figure 19: Target Number of Dental Students and Actual Intakes in England, 2009/10-2013/14
                                                                                • Cosmetic dental demand continues to rise
                                                                                  • Dental insurance offers alternative route to treatment
                                                                                    • BDIA releases dental industry manifesto to provide guidance for the government
                                                                                    • Market Size

                                                                                      • Key points
                                                                                        • Public sector spending control continues to restrict market
                                                                                            • Figure 20: Total UK Dental Care Expenditure, 2011-2015, (£ Billion)
                                                                                            • Figure 21: UK Expenditure on Dental Care, 2011-15
                                                                                          • Other underlying factors
                                                                                          • Market Segmentation

                                                                                            • Key points
                                                                                              • Segment overview
                                                                                                • Figure 22: Total UK Dental Care Expenditure, by Segment, 2011-15
                                                                                                • Figure 23: UK Expenditure on Dental Care, by Segment, 2011-15
                                                                                              • Private treatments
                                                                                                • Corporate dentistry continues to increase market share
                                                                                                  • Cosmetic dentistry market still expanding
                                                                                                      • Figure 24: UK Expenditure on Private Cosmetic Dental Care, 2011-15
                                                                                                      • Figure 25: UK Expenditure on Private Cosmetic Dental Care, 2011-15
                                                                                                    • NHS Dentistry
                                                                                                      • Figure 26: UK Expenditure on NHS Dental Care, by Payment Segment, 2011-15
                                                                                                      • Figure 27: UK Expenditure on NHS Dental Care, by Payment Segment, 2011-15
                                                                                                    • Courses of treatment on the rise
                                                                                                      • Figure 28: Number of Courses of Dental Treatment under NHS, in England, 2010/11-2014/15
                                                                                                      • Figure 29: Number of Courses of Dental Treatment under NHS, in England, 2010/11-2014/15
                                                                                                  • Market Trends

                                                                                                    • Key points
                                                                                                      • Move to prototype stage as NHS dental contract reform continues to stall
                                                                                                        • Direct access barriers still require further break down
                                                                                                          • Workforce transition
                                                                                                            • NHS Activity
                                                                                                              • Practice profits
                                                                                                                • Technology/Innovation developments
                                                                                                                • The Consumer – Last Dental Appointment

                                                                                                                  • Key points
                                                                                                                    • Over half of NHS dental patients have had an appointment in the last year
                                                                                                                        • Figure 30: Last Dental Appointment, by Time of Last Appointment and Service Type, April 2015, (% of Respondents)
                                                                                                                        • Figure 31: Last Dental Appointment, by Time of Last Appointment and Service Type, April 2015
                                                                                                                      • The young are most likely to have recently been to a private appointment
                                                                                                                        • Figure 32: Last NHS Dental Appointment, by Time of Last Appointment and by Age and Gender, April 2015, (% of Respondents)
                                                                                                                        • Figure 33: Last NHS Dental Appointment, by Time of Last Appointment and by Age and Gender, April 2015
                                                                                                                        • Figure 34: Last Private Dental Appointment, by Time of Last Appointment and by Age and Gender, April 2015, (% of Respondents)
                                                                                                                        • Figure 35: Last Private Dental Appointment, by Time of Last Appointment and by Age and Gender, April 2015
                                                                                                                    • The Consumer – Reasons behind NHS Dental Visit

                                                                                                                      • Key points
                                                                                                                        • Familiarity and proximity key to NHS visits
                                                                                                                            • Figure 36: NHS Dental Appointment Choice Factors, April 2015, (% of Respondents)
                                                                                                                            • Figure 37: NHS Dental Appointment Choice Factors, April 2015
                                                                                                                          • Cost pressures may be affecting demand for NHS dental services
                                                                                                                            • Figure 38: NHS Dental Appointment Choice Factors, by Time of Last Visit, April 2015
                                                                                                                        • The Consumer – Reasons Behind Private Dental Visit

                                                                                                                          • Key points
                                                                                                                            • High quality of service leads the private way
                                                                                                                                • Figure 39: Private Dental Appointment Choice Factors, April 2015
                                                                                                                                • Figure 40: Private Dental Appointment Choice Factors, April 2015
                                                                                                                                • Figure 41: Private Dental Appointment Choice Factors, by Time of Last Visit, April 2015
                                                                                                                            • The Consumer – Dental Service Satisfaction and Opinion

                                                                                                                              • Key points
                                                                                                                                • Appointment length and treatment explanation satisfy patients
                                                                                                                                    • Figure 42: Dental Service Satisfaction, April 2015
                                                                                                                                    • Figure 43: Dental Service Satisfaction, April 2015
                                                                                                                                  • Familiarity and on-demand use key to consumer thinking
                                                                                                                                      • Figure 44: Dental Service Opinion, April 2015, (% of Respondents)
                                                                                                                                      • Figure 45: Dental Service Opinion, April 2015
                                                                                                                                  • Industry Structure

                                                                                                                                    • Key points
                                                                                                                                      • Boost to dental hygienist and therapist numbers following direct access verdict
                                                                                                                                          • Figure 46: Analysis of GDC-registered Dental Professionals, 2014 and 2015
                                                                                                                                        • Consolidation continues, but at a slower pace
                                                                                                                                            • Figure 47: Analysis of Changes in the Structure of the Dental Practice Sector, 2010-14
                                                                                                                                            • Figure 48: Analysis of the Employment Structure of the Dental Practice Sector, 2010-14
                                                                                                                                            • Figure 49: Analysis of the Financial Structure of the Dental Practice Sector, 2013 and 2014
                                                                                                                                            • Figure 50: Analysis of the Financial Structure of the Dental Practice Sector, 2010-14
                                                                                                                                        • Company Profiles

                                                                                                                                          • BUPA Dental Services

                                                                                                                                                • Figure 51: Financial analysis of BUPA Dental Services, 2009-13
                                                                                                                                              • Company outlook
                                                                                                                                              • Denplan

                                                                                                                                                    • Figure 52: Financial analysis of Denplan, 2009-13
                                                                                                                                                  • Company outlook
                                                                                                                                                  • DPAS

                                                                                                                                                        • Figure 53: Financial analysis of DPAS, 2009-13
                                                                                                                                                      • Company outlook
                                                                                                                                                      • IDH Group

                                                                                                                                                            • Figure 54: Financial analysis of Turnstone Equityco 1, 2012-14
                                                                                                                                                          • Subsidiary companies
                                                                                                                                                            • Figure 55: Financial analysis of Whitecross Dental Care, 2010-14
                                                                                                                                                            • Figure 56: Financial analysis of Petrie Tucker and Partners, 2009-13
                                                                                                                                                            • Figure 57: Financial analysis of Orthoworld 2000, 2010-14
                                                                                                                                                          • Company outlook
                                                                                                                                                          • Oasis Dental Care

                                                                                                                                                                • Figure 58: Financial analysis of Duke Street Capital Oasis Holdings, 2010-14
                                                                                                                                                                • Figure 59: Financial analysis of Oasis Dental Care, 2010-14
                                                                                                                                                                • Figure 60: Financial analysis of Oasis Dental Care (Central), 2010-14
                                                                                                                                                                • Figure 61: Financial analysis of Oasis Dental Care (Southern), 2010-14
                                                                                                                                                              • Company outlook
                                                                                                                                                              • Practice Plan

                                                                                                                                                                    • Figure 62: Financial analysis of Practice Plan, 2010-14
                                                                                                                                                                  • Company outlook
                                                                                                                                                                  • Rodericks

                                                                                                                                                                      • Figure 63: Financial analysis of Rodericks, 2010-14
                                                                                                                                                                    • Company outlook
                                                                                                                                                                    • Simplyhealth Access

                                                                                                                                                                          • Figure 64: Financial analysis of Simplyhealth Access, 2009-13
                                                                                                                                                                        • Company outlook
                                                                                                                                                                        • Southern Dental

                                                                                                                                                                              • Figure 65: Financial analysis of Southern Dental, 2010-14
                                                                                                                                                                            • Company outlook
                                                                                                                                                                            • Western Provident Association

                                                                                                                                                                                  • Figure 66: Financial analysis of Western Provident Association, 2009-13
                                                                                                                                                                                • Company outlook
                                                                                                                                                                                  • Figure 67: Profiled Companies’ Turnover, 2010-13
                                                                                                                                                                              • Forecast

                                                                                                                                                                                • Key points
                                                                                                                                                                                  • Market Size
                                                                                                                                                                                      • Figure 68: Forecast UK Expenditure on Dental Care, 2016-20
                                                                                                                                                                                      • Figure 69: Forecast UK Expenditure on Dental Care, 2016-20
                                                                                                                                                                                    • Market segmentation
                                                                                                                                                                                      • Figure 70: Forecast UK Expenditure on Dental Care, by Segment, 2016-20
                                                                                                                                                                                      • Figure 71: Forecast UK Expenditure on Dental Care, by Segment, 2016-20
                                                                                                                                                                                    • NHS spending to stall until 2019
                                                                                                                                                                                        • Figure 72: Forecast UK Expenditure on NHS Dental Care, 2016-20
                                                                                                                                                                                      • Private GDS care competition to intensify
                                                                                                                                                                                          • Figure 73: Forecast UK Expenditure on Private GDS Dental Care, 2016-20
                                                                                                                                                                                        • Cosmetic sector surge continues
                                                                                                                                                                                            • Figure 74: Forecast UK Expenditure on Private Cosmetic Dental Care, 2016-20
                                                                                                                                                                                        • Further Sources and Contacts

                                                                                                                                                                                          • Trade associations
                                                                                                                                                                                            • Association of Dental Administrators and Management
                                                                                                                                                                                              • The Association of Dental Anaesthetists
                                                                                                                                                                                                • Association of Dental Groups
                                                                                                                                                                                                  • Association of Dental Implantology
                                                                                                                                                                                                    • British Association of Dental Nurses
                                                                                                                                                                                                      • British Association of Dental Therapists
                                                                                                                                                                                                        • British Association of Prosthetists and Orthotists
                                                                                                                                                                                                          • British Dental Association
                                                                                                                                                                                                            • British Dental Industry Association
                                                                                                                                                                                                              • British Endodontic Society
                                                                                                                                                                                                                • British Orthodontic Society
                                                                                                                                                                                                                  • British Society of Dental Hygiene & Therapy
                                                                                                                                                                                                                    • British Society for Dental Research
                                                                                                                                                                                                                      • British Society for Disability and Oral Health
                                                                                                                                                                                                                        • British Society of Paediatric Dentistry
                                                                                                                                                                                                                          • British Society for Restorative Dentistry
                                                                                                                                                                                                                            • British Society for the Study of Prosthetic Dentistry
                                                                                                                                                                                                                              • Trade magazines
                                                                                                                                                                                                                                • British Dental Journal
                                                                                                                                                                                                                                  • Dental Health
                                                                                                                                                                                                                                    • Dental Nursing
                                                                                                                                                                                                                                      • Dental Practice
                                                                                                                                                                                                                                        • Dentistry – Finlayson Media Communications
                                                                                                                                                                                                                                          • Fusion – Dental Fusion Organisation
                                                                                                                                                                                                                                            • The Business of Dentistry
                                                                                                                                                                                                                                              • The Dentist
                                                                                                                                                                                                                                                • Trade exhibitions
                                                                                                                                                                                                                                                  • British Dental Conference & Exhibition 2016
                                                                                                                                                                                                                                                    • BDIA Dental Showcase
                                                                                                                                                                                                                                                      • International Orthodontic Congress 2015
                                                                                                                                                                                                                                                        • The Dentistry Show 2016

                                                                                                                                                                                                                                                        Companies Covered

                                                                                                                                                                                                                                                        To learn more about the companies covered in this report please contact us.

                                                                                                                                                                                                                                                        Dentistry (B2B) - UK - August 2015

                                                                                                                                                                                                                                                        US $1,935.88 (Excl.Tax)