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Dentistry - UK - June 2017

“‘Skill mix’ has helped free up the time available to general dental practitioners, which can then be used to fulfill more patient appointments and increase the time allocated to private work.”

– Lewis Cone, B2B 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 could the market be affected by Brexit?
  • 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?

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Table of contents

  1. Executive Summary

      • Market size
        • Figure 1: UK expenditure on dental care, 2013-17
        • Figure 2: UK expenditure on dental care, by segment, 2013-17
      • Market trends
        • Higher levels of competition have impacted earnings
          • Division found in regional private treatment fees
            • Rising number seek orthodontic treatment
              • Market factors
                • Uncertainty surrounding Brexit will affect practice costs, recruitment and legislation
                  • Spring Budget includes several changes that will impact the industry
                    • Rising and ageing population underpins demand for dental care
                      • Figure 3: UK population estimate and projection, by age group, 2017 and 2022
                    • Consumer
                      • People are nearly three times as likely to have seen an NHS dentist in the last 12 months than a private dentist
                        • Figure 4: Last dental appointment, by time of last appointment and service type, April 2017
                      • Most would visit the same dentist at their next appointment
                        • Website reviews and advice from friends and family influences choice of new dentist
                          • Good hygiene, suitable appointment lengths and staff friendliness most observed at practices
                            • Most people ‘self-fund’ dental treatment
                              • Industry structure
                                • Forecast
                                  • Stable growth expected although doubts over contract implementation and other uncertainties could dampen development
                                    • The value of the dentistry market is forecast to increase by between 2.7% and 4.9% per annum until 2022
                                      • Figure 5: UK dental care expenditure forecast, by segment, 2018-22
                                    • What we think
                                    • Key Insights

                                        • With the introduction of the NHS dental contract pushed back, what is the long-term sustainability of NHS dentistry?
                                          • How has the operational model adapted to meet changing demand?
                                            • What does the future hold for the industry?
                                            • Introduction

                                                • Definitions
                                                  • Methodology
                                                    • Abbreviations
                                                      • Market positioning
                                                        • The role of the NHS
                                                          • Dental practices
                                                            • Regulators
                                                              • General Dentist Council
                                                                • Care Quality Commission
                                                                  • Regulation of Dental Services Programme Board
                                                                    • Recent regulation
                                                                      • Market demand
                                                                      • UK Economy

                                                                        • Key points
                                                                          • Overview
                                                                            • Figure 6: UK GDP, 2007-17
                                                                            • Figure 7: UK output, by industry, 2008-17
                                                                            • Figure 8: Quarters after GDP peak, 1979, 1990 and 2008
                                                                          • Inflation
                                                                            • Interest rates
                                                                              • House prices
                                                                                • Figure 9: UK house price changes, 2006-17
                                                                              • Consumer spending
                                                                                • Manufacturing
                                                                                  • Figure 10: UK manufacturing, 2014-17
                                                                                • Business investment
                                                                                  • Figure 11: UK GFCF 2006-17
                                                                                • Imports
                                                                                  • Exports
                                                                                  • Market Factors

                                                                                    • Key points
                                                                                      • Uncertainty surrounding Brexit will affect practice costs, recruitment and legislation
                                                                                        • Rising and ageing population underpins demand for dental care
                                                                                          • Figure 12: UK population estimate and projection, by age group, 2017 and 2022
                                                                                          • Figure 13: UK population estimate and projection, by age group, 2017 and 2022
                                                                                        • Inflationary pressures are harming disposable income growth, which could see the number of dental visits fall
                                                                                            • Figure 14: GDP per head at current market prices and real household disposable income per head, Q1 2012-Q4 2016
                                                                                            • Figure 15: GDP per head at current market prices and real household disposable income per head, Q1 2012-Q4 2016
                                                                                          • Stagnant growth in dentists’ NHS activity recorded alongside decline in population treated
                                                                                            • Figure 16: Dentists with NHS Activity in England, 2011/12-2015/16
                                                                                            • Figure 17: Number of dentists with NHS activity in England, 2011/12-2015/16
                                                                                            • Figure 18: Dental patients seen in England under the NHS over the previous 24 months, at 30 June, 2012-16
                                                                                            • Figure 19: Dental patients seen in England under the NHS in previous 24 months, at 30 June, 2012-16
                                                                                          • Student intake target reduced to calm oversupply concerns, although future recruitment levels may need to be boosted
                                                                                            • Figure 20: Target number of dental students and actual intakes in England, 2010/11-2015/16
                                                                                            • Figure 21: Target number of dental students and actual intakes in England, 2010/11-2015/16
                                                                                        • Market Size

                                                                                          • Key points
                                                                                            • Private services drive market development
                                                                                              • Figure 22: Total UK dental care expenditure, 2013-17
                                                                                              • Figure 23: UK expenditure on dental care, 2013-17
                                                                                            • NHS treatment costs rise by 5% in 2017 following similar rise in 2016
                                                                                                • Figure 24: NHS dental charges in England, 2013-17
                                                                                                • Figure 25: NHS dental charges in England, 2013-17
                                                                                              • The number of dental schemes is on the rise
                                                                                                • Other underlying factors
                                                                                                • Market Segmentation

                                                                                                  • Key points
                                                                                                    • Segment overview
                                                                                                      • Figure 26: Total UK dental care expenditure, by segment, 2013-17
                                                                                                      • Figure 27: UK expenditure on dental care, by segment, 2013-17
                                                                                                    • Private treatments
                                                                                                      • Dentists react to strong cosmetic dentistry growth
                                                                                                          • Figure 28: UK expenditure on private cosmetic dental care, 2013-17
                                                                                                          • Figure 29: UK expenditure on private cosmetic dental care, 2013-17
                                                                                                        • NHS Dentistry
                                                                                                          • Figure 30: UK expenditure on NHS dental care, by payment segment, 2013-17
                                                                                                          • Figure 31: UK expenditure on NHS dental care, by payment segment, 2013-17
                                                                                                          • Figure 32: Number of courses of dental treatment under NHS, in England, 2011/12-2015/16
                                                                                                          • Figure 33: Number of courses of dental treatment under NHS, in England, 2011/12-2015/16
                                                                                                        • Dental insurance cover and cash plans offer alternative routes to affording treatment
                                                                                                        • Market Trends

                                                                                                          • Key points
                                                                                                            • Higher levels of competition have impacted earnings...
                                                                                                              • Figure 34: UK dental salaries, by job role and region, 2016
                                                                                                            • ...with additional non-performance related costs adding to profitability challenge
                                                                                                              • Cost is the biggest reason why employees avoid going to the dentist
                                                                                                                • Division found in regional private treatment fees
                                                                                                                  • Figure 35: Average private practice prices for the five most common dental treatments, at May 2016
                                                                                                                  • Figure 36: Average private practice prices for the four most common dental treatments, by five most expensive dental check-up locations, at May 2016
                                                                                                                  • Figure 37: Average private practice prices for dental implants, by five most expensive dental check-up locations, at May 2016
                                                                                                                  • Figure 38: Average hourly rate for hygienists, by region, 2015
                                                                                                                  • Figure 39: Average UDA rate, by region, 2015
                                                                                                                  • Figure 40: Average UDA rate, by region, 2015
                                                                                                                  • Figure 41: Average price of at-home tooth whitening, by region, 2015
                                                                                                                  • Figure 42: Average price of single tooth implants, by region, 2015
                                                                                                                  • Figure 43: Average price of porcelain veneers, by region, 2015
                                                                                                                  • Figure 44: Average price of crowns, by region, 2015
                                                                                                                  • Figure 45: Average price of composite restorations, by region, 2015
                                                                                                                  • Figure 46: Average price of dentures, by region, 2015
                                                                                                                • Rising number seek orthodontic treatment
                                                                                                                  • Dental professionals become wary of online patient reviews
                                                                                                                  • The Consumer – Last Dental Appointment

                                                                                                                    • Key points
                                                                                                                      • People are nearly three times as likely to have seen an NHS dentist in the last 12 months than a private dentist
                                                                                                                          • Figure 47: Last dental appointment, by time of last appointment and service type, April 2017
                                                                                                                          • Figure 48: Last dental appointment, by time of last appointment and service type, April 2017
                                                                                                                        • Older females represent most recent NHS users
                                                                                                                          • Figure 49: Last NHS dental appointment, by time of last appointment and by age and gender, April 2017
                                                                                                                          • Figure 50: Last NHS dental appointment, males, by time of last appointment and by age and gender, April 2017,
                                                                                                                          • Figure 51: Last NHS dental appointment, females, by time of last appointment and by age and gender, April 2017
                                                                                                                          • Figure 52: Last private dental appointment, by time of last appointment and by age and gender, April 2017
                                                                                                                          • Figure 53: Last private dental appointment, males, by time of last appointment and by age and gender, April 2017
                                                                                                                          • Figure 54: Last private dental appointment, females, by time of last appointment and by age and gender, April 2017
                                                                                                                      • The Consumer – Repeat Visit

                                                                                                                        • Key points
                                                                                                                          • Most would visit the same dentist at their next appointment
                                                                                                                              • Figure 55: Repeat dental practice visit, April 2017
                                                                                                                              • Figure 56: Repeat dental practice visit, by age and gender, April 2017
                                                                                                                              • Figure 57: Repeat dental practice visit, males, April 2017
                                                                                                                              • Figure 58: Repeat dental practice visit, females, April 2017
                                                                                                                          • The Consumer – Research Sources

                                                                                                                            • Key points
                                                                                                                              • Website reviews and advice from friends and family influences choice of new dentist
                                                                                                                                  • Figure 59: Research sources, April 2017
                                                                                                                                  • Figure 60: Research sources, April 2017
                                                                                                                              • The Consumer – Service Opinion

                                                                                                                                • Key points
                                                                                                                                  • Most practices are ‘squeaky clean’
                                                                                                                                      • Figure 61: Dentistry service opinion, April 2017
                                                                                                                                      • Figure 62: Dentistry service opinion, April 2017
                                                                                                                                      • Figure 63: Service opinion, by last NHS visit, April 2017
                                                                                                                                      • Figure 64: Service opinion, by last private visit, April 2017
                                                                                                                                  • The Consumer – Dental Payment

                                                                                                                                    • Key Points
                                                                                                                                      • Most people ‘self-fund’ dental treatment
                                                                                                                                          • Figure 65: Dental payment, April 2017
                                                                                                                                          • Figure 66: Dental payment, April 2017
                                                                                                                                        • Use of insurance to fund treatment declines with age
                                                                                                                                          • Figure 67: Dental payment, by age and gender, April 2017
                                                                                                                                        • Self-funding of NHS treatment has risen over time
                                                                                                                                          • Figure 68: Dental payment, by last NHS visit, April 2017
                                                                                                                                          • Figure 69: Dental payment, by last private visit, April 2017
                                                                                                                                      • Industry Structure

                                                                                                                                        • Key points
                                                                                                                                          • Increasing presence of corporate dentistry
                                                                                                                                            • Growing importance of dental hygienists and therapists is changing operational structure
                                                                                                                                                • Figure 70: Analysis of GDC-registered dental professionals, May 2017
                                                                                                                                              • Market share
                                                                                                                                                  • Figure 71: Estimated dental care providers’ market share, 2016
                                                                                                                                                  • Figure 72: Estimated dental care providers’ market share, 2016
                                                                                                                                                • Industry M&A
                                                                                                                                                  • Sector structure
                                                                                                                                                    • Figure 73: Analysis of changes in the structure of the dental practice sector, 2012-16
                                                                                                                                                    • Figure 74: Analysis of the employment structure of the dental practice sector, 2015-16
                                                                                                                                                    • Figure 75: Analysis of the financial structure of the dental practice sector, 2015 and 2016
                                                                                                                                                    • Figure 76: Analysis of the financial structure of the dental practice sector, 2016
                                                                                                                                                • Company Profiles

                                                                                                                                                  • BUPA Dental Services

                                                                                                                                                        • Figure 77: Financial analysis of Bupa Dental Services, 2011-15
                                                                                                                                                      • Company strategy
                                                                                                                                                      • Mydentist (formerly IDH Group)

                                                                                                                                                            • Figure 78: Financial analysis of Turnstone Equityco 1, 2012-16
                                                                                                                                                          • Subsidiary companies
                                                                                                                                                            • Figure 79: Financial analysis of Whitecross Dental Care, 2012-16
                                                                                                                                                            • Figure 80: Financial analysis of Petrie Tucker and Partners, 2012-16
                                                                                                                                                            • Figure 81: Financial analysis of Orthoworld 2000, 2012-16
                                                                                                                                                          • Company strategy
                                                                                                                                                          • Oasis Dental Care

                                                                                                                                                                • Figure 82: Financial analysis of Oasis Healthcare International (formerly Duke Street Capital Oasis Holdings), 2012-16
                                                                                                                                                                • Figure 83: Financial analysis of Oasis Dental Care, 2012-16
                                                                                                                                                                • Figure 84: Financial analysis of Oasis Dental Care (Central), 2012-16
                                                                                                                                                                • Figure 85: Financial analysis of Oasis Dental Care (Southern), 2012-16
                                                                                                                                                              • Company strategy
                                                                                                                                                              • Rodericks Dental Limited

                                                                                                                                                                  • Figure 86: Financial analysis of Rodericks, 2012-16
                                                                                                                                                                • Company strategy
                                                                                                                                                                • Southern Dental

                                                                                                                                                                      • Figure 87: Financial analysis of Southern Dental, 2011-15
                                                                                                                                                                    • Company strategy
                                                                                                                                                                    • Simplyhealth Professionals (formerly Denplan)

                                                                                                                                                                          • Figure 88: Financial analysis of Simplyhealth Professionals (formerly Denplan), 2011-15
                                                                                                                                                                        • Company strategy
                                                                                                                                                                        • DPAS

                                                                                                                                                                              • Figure 89: Financial analysis of DPAS, 2011-15
                                                                                                                                                                            • Company strategy
                                                                                                                                                                            • Practice Plan

                                                                                                                                                                                  • Figure 90: Financial analysis of Practice Plan, 2011-15
                                                                                                                                                                                • Company strategy
                                                                                                                                                                                • Simplyhealth Access

                                                                                                                                                                                      • Figure 91: Financial analysis of Simplyhealth Access, 2011-15
                                                                                                                                                                                    • Company strategy
                                                                                                                                                                                    • Western Provident Association

                                                                                                                                                                                          • Figure 92: Financial analysis of Western Provident Association, 2011-15
                                                                                                                                                                                        • Company strategy
                                                                                                                                                                                          • Figure 93: Profiled companies’ turnover, 2011-15
                                                                                                                                                                                      • Forecast

                                                                                                                                                                                        • Key points
                                                                                                                                                                                          • Market size
                                                                                                                                                                                            • New NHS dental contract still undergoing prototype testing...
                                                                                                                                                                                              • ...while there is a lack of government announcements around its dentistry plans
                                                                                                                                                                                                • Brexit stance concerns industry
                                                                                                                                                                                                    • Figure 94: UK expenditure on dental care forecast, 2018-22
                                                                                                                                                                                                    • Figure 95: UK dental care expenditure forecast, 2018-22
                                                                                                                                                                                                  • Market Segmentation
                                                                                                                                                                                                    • Private services are the jewel in the dentistry crown
                                                                                                                                                                                                      • Figure 96: UK dental care expenditure forecast, by segment, 2018-22
                                                                                                                                                                                                      • Figure 97: UK dental care expenditure forecast, by segment, 2018-22
                                                                                                                                                                                                    • NHS Dentistry
                                                                                                                                                                                                      • Private GDS
                                                                                                                                                                                                        • Cosmetic dentistry
                                                                                                                                                                                                          • NICE introduces new quality standard to promote good oral health
                                                                                                                                                                                                          • Further Sources and Contacts

                                                                                                                                                                                                            • Trade associations
                                                                                                                                                                                                              • Association of Dental Administrators and Managers
                                                                                                                                                                                                                • The Association of Dental Anaesthetists
                                                                                                                                                                                                                  • Association of Dental Groups
                                                                                                                                                                                                                    • Association of Dental Implantology
                                                                                                                                                                                                                      • British Academy of Cosmetic Dentistry
                                                                                                                                                                                                                        • 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 Disability and Oral Health
                                                                                                                                                                                                                                          • British Society of Paediatric Dentistry
                                                                                                                                                                                                                                            • British Society for the Study of Prosthodontics
                                                                                                                                                                                                                                              • Trade magazines
                                                                                                                                                                                                                                                • British Dental Journal
                                                                                                                                                                                                                                                  • Dental Health
                                                                                                                                                                                                                                                    • Dental Insider
                                                                                                                                                                                                                                                      • Dental Nursing
                                                                                                                                                                                                                                                        • Dental Supplies
                                                                                                                                                                                                                                                          • Dentistry
                                                                                                                                                                                                                                                            • Primary Dental Journal
                                                                                                                                                                                                                                                              • Private Dentistry
                                                                                                                                                                                                                                                                • The Business of Dentistry
                                                                                                                                                                                                                                                                  • The Dentist
                                                                                                                                                                                                                                                                    • Trade exhibitions
                                                                                                                                                                                                                                                                      • British Academy of Cosmetic Dentistry Annual Conference
                                                                                                                                                                                                                                                                        • British Dental Conference & Exhibition 2018
                                                                                                                                                                                                                                                                          • BDIA Dental Showcase
                                                                                                                                                                                                                                                                            • Dental Technology Showcase 2018
                                                                                                                                                                                                                                                                              • Oral Health Conference and Exhibition
                                                                                                                                                                                                                                                                                • The Dentistry Show 2018

                                                                                                                                                                                                                                                                                Companies Covered

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

                                                                                                                                                                                                                                                                                Dentistry - UK - June 2017

                                                                                                                                                                                                                                                                                US $1,935.88 (Excl.Tax)