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Dentistry - UK - August 2019

Market Segmentation

  • NHS
  • Private GDS
  • Private cosmetic

Company Profiles

  • BUPA Dental Services
  • Colosseum Dental Services (formerly known as Southern Dental)
  • DPAS
  • Mydentist (formerly IDH Group)
  • Practice Plan
  • Rodericks Dental Limited
  • Simplyhealth Professionals (formerly Denplan)

“Although growth is forecast to slow over the next five years, the private sector is anticipated to have greater growth opportunities than NHS dentistry since the NHS faces a considerable challenge in providing high quality healthcare amid rapid demographic changes and constrained public spending.”
– Lewis Cone, Senior B2B Analyst

This report looks at the following areas:

  • NHS dentist accessibility problems adding to funding pressures that put future provision in doubt
  • Threat of additional tax payments and stagnating salaries could stall market growth

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Table of contents

  1. Overview

    • What you need to know
      • Covered in this Report
      • Executive Summary

          • Market size
            • Stagnant growth in dental care expenditure continues
              • Figure 1: Total UK dental care expenditure, 2015-19, (£ billion)
            • NHS accounts for largest segment but private dominates growth
              • Figure 2: Total UK dental care expenditure, by provider, 2015-19, (£ billion)
            • Dental earnings continue to fall
              • Figure 3: Average taxable income for all self-employed primary care dentists, England and Wales, 2012/13-2016/17, (£)
            • Slow market growth expected to continue – rising by just 6% to 2024
              • Figure 4: Forecast UK expenditure on dental care, 2020-24, (£ billion at 2019 prices)
            • Companies and brands
              • The consumer
                • Almost half of people have never used a private healthcare service
                  • Seven-in-10 ‘self-fund’ dental treatment
                    • What we think
                    • Issues and Insights

                      • NHS dentist accessibility problems adding to funding pressures that put future provision in doubt
                        • The facts
                          • The implications
                            • Threat of additional tax payments and stagnating salaries could stall market growth
                              • The facts
                                • The implications
                                • The Market – What You Need to Know

                                  • Stagnant growth in dental care expenditure continues
                                    • Segment overview
                                      • Slow market growth expected to continue – rising by just 6% to 2024
                                      • Market Size

                                          • Stagnant growth in dental care expenditure continues
                                              • Figure 5: Total UK dental care expenditure, 2015-19, (£ billion)
                                            • NHS treatment costs rise by 5% for the third consecutive year in 2019
                                                • Figure 6: NHS dental charges in England, per band, 2015-19, (£)
                                              • Over half of young children did not visit a dentist in 2018…
                                                • …whilst regional inequalities remain
                                                • Market Segmentation

                                                  • Segment overview
                                                    • Figure 7: Total UK dental care expenditure, by provider, 2015-19, (£ billion)
                                                  • Private treatments
                                                    • Cosmetic dentistry expenditure has risen by a quarter since 2015
                                                        • Figure 8: UK expenditure on private cosmetic dental care, 2015-19, (£ billion)
                                                      • NHS dentistry
                                                          • Figure 9: UK expenditure on NHS dental care, by payment segment, 2015-19, (£ million)
                                                        • Courses of NHS treatment decline in each band in 2018
                                                            • Figure 10: Number of courses of dental treatment under the NHS in England, 2013/14-2017/18, (000s)
                                                        • Market Forecast

                                                          • Planned introduction of new NHS dental contract next year has not eased uncertainty and tension in the profession
                                                            • Growth expected to remain subdued – rising by just 6% to 2024
                                                                • Figure 11: Forecast UK expenditure on dental care, 2020-24, (£ billion at 2019 prices)
                                                              • Private cosmetic growth expected to be industry’s crowning glory, whilst the NHS will continue to stagnate
                                                                • Figure 12: Forecast UK dental care expenditure, by segment, 2020-24, (£ billion at 2019 prices)
                                                              • Digital technology and equipment helping reduce time pressures on dentists and improve patient outcomes
                                                              • The Impact of the Economy

                                                                • Annual GDP growth falls to six-year low in 2018
                                                                  • Figure 13: Annual GDP growth rate, 2014-18, (%)
                                                                • Bank rate remains at 0.75%
                                                                  • Figure 14: Bank rate, 2008-18, by date of adjustment, (%)
                                                                • Household real incomes are on the rise but continued NHS charge rise offsetting potential impact on dental visits
                                                                    • Figure 15: GDP per head at current market prices and real household disposable income per head, Q1 2015-Q1 2019, (£)
                                                                • Market Trends

                                                                    • Dental earnings continue to fall
                                                                      • Figure 16: Average taxable income for all self-employed primary care dentists, England and Wales, 2012/13-2016/17, (£)
                                                                      • Figure 17: Associate rates per UDA, by region, (£)
                                                                    • Dental practice profits fall in 2018 after rising in 2017…
                                                                      • …although practice sales remain healthy
                                                                        • London and the Home Counties
                                                                          • South & South West Wales
                                                                            • Midlands
                                                                              • North
                                                                                • Scotland
                                                                                • Market Drivers

                                                                                    • Although Brexit is still not resolved, there has been an impact on recruitment and costs
                                                                                      • Ageing population to drive dental treatment demand
                                                                                          • Figure 18: UK population estimate and projection, 2019 and 2024, by age group, (millions of people)
                                                                                        • Both NHS dentist activity and the number of patients increased in 2018
                                                                                            • Figure 19: Dentists with NHS activity in England, 2013/14-2017/18, (no. of dentists and % annual change)
                                                                                            • Figure 20: Dental patients seen in England under the NHS over the previous 24 months, at 30 June, 2014-18, (000s of patients)
                                                                                          • Student intake boosted by additional government funding, but large number of vacancies remain for current dental positions
                                                                                            • Figure 21: Target number of dental students and actual intakes in England, 2013/14-2017/18, (number of students)
                                                                                          • Lending to the industry is rising despite uncertainty
                                                                                          • Companies and Brands – What You Need to Know

                                                                                            • Investor demand for practices remains strong, but average price growth diminishes
                                                                                              • New co-ownership model continues to thrive and provide alternative
                                                                                              • Industry Structure

                                                                                                  • Investor demand for practices remains strong, although average price growth diminishes
                                                                                                    • ADG and IHPN enter partnership
                                                                                                      • Market share
                                                                                                          • Figure 22: Number of UK dental practices, 2018, by corporate operator and ownership, (number)
                                                                                                        • Recent M&A activity
                                                                                                          • Sector structure
                                                                                                              • Figure 23: Analysis of changes in the structure of the dental practice sector, 2014-2018, (number of companies and practices)
                                                                                                              • Figure 24: Analysis of the employment structure of the dental practice sector, 2017-2018, (total employees and number of companies)
                                                                                                              • Figure 25: Analysis of the financial structure of the dental practice sector, 2017 and 2018, (£000 and number of companies)
                                                                                                          • Competitive Strategies

                                                                                                            • New co-ownership model continues to thrive and provide alternative
                                                                                                              • Mydentist partners with Philips Sonicare and Superdrug to launch dental health campaign
                                                                                                              • Company Profiles

                                                                                                                • BUPA Dental Care
                                                                                                                    • Figure 26: Financial analysis of Bupa Dental Care, 2013-2017, (£ million)
                                                                                                                  • Colosseum Dental Services (formerly known as Southern Dental)
                                                                                                                      • Figure 27: Financial analysis of Colosseum Dental Services, 2014-2017*, (£ million)
                                                                                                                    • DPAS
                                                                                                                        • Figure 28: Financial analysis of DPAS, 2013-2017, (£000)
                                                                                                                      • Mydentist (formerly IDH Group)
                                                                                                                          • Figure 29: Financial analysis of Turnstone Equityco 1, 2014-2018, (£ million)
                                                                                                                          • Figure 30: Financial analysis of Whitecross Dental Care, 2014-2018, (£ 000)
                                                                                                                          • Figure 31: Financial analysis of Petrie Tucker and Partners, 2014-2018, (£ million)
                                                                                                                          • Figure 32: Financial analysis of Orthoworld 2000, 2014-2018, (£ million)
                                                                                                                        • Practice Plan
                                                                                                                            • Figure 33: Financial analysis of Practice Plan, 2013-2017, (£ million)
                                                                                                                          • Rodericks Dental Limited
                                                                                                                            • Figure 34: Financial analysis of Rodericks, 2014-2018, (£ million)
                                                                                                                          • Simplyhealth Professionals (formerly Denplan)
                                                                                                                              • Figure 35: Financial analysis of Simplyhealth Professionals, 2014-2018, (£ million)
                                                                                                                          • The Consumer – What You Need to Know

                                                                                                                            • Almost half of people have never used a private healthcare service
                                                                                                                              • Seven-in-10 ‘self-fund’ dental treatment
                                                                                                                                • People are most satisfied with appointment duration
                                                                                                                                • Last Dental Appointment

                                                                                                                                  • Almost half of people have never visited a private dentist
                                                                                                                                    • Figure 36: Last dental appointment, by time of last appointment and service type, April 2019, (% of respondents)
                                                                                                                                  • Likelihood of most recent NHS visit rises with age, but peaks at between 25 and 44 years old for most recent private visit
                                                                                                                                    • Figure 37: Last NHS dental appointment, by time of last appointment and by age and gender, April 2019, (% of respondents)
                                                                                                                                    • Figure 38: Last private dental appointment, by time of last appointment and by age and gender, April 2019, (% of respondents)
                                                                                                                                • Dental Payment

                                                                                                                                  • Seven-in-10 ‘self-fund’ dental treatment
                                                                                                                                    • Figure 39: Dental payment, April 2019, (% of respondents)
                                                                                                                                  • Over-65s twice as likely to self-fund than 16 to 24 year olds
                                                                                                                                    • Figure 40: Dental payment, by age and gender, April 2019, (% of respondents)
                                                                                                                                  • Self-funding of NHS treatment has risen over time with a decline in the proportion of free treatment…
                                                                                                                                    • Figure 41: Dental payment, by time of last NHS visit, April 2019, (% of respondents)
                                                                                                                                  • … whilst self-funding has declined in the private industry
                                                                                                                                    • Figure 42: Dental payment, by time of last private visit, April 2019, (% of respondents)
                                                                                                                                • Type of Treatment

                                                                                                                                  • Dental examination and check-up most common reason for treatment
                                                                                                                                    • Figure 43: Dental treatment, April 2019, (% of respondents)
                                                                                                                                  • Rise in check-ups and x-rays over the last year
                                                                                                                                    • Figure 44: Dental treatment, by time of last NHS visit, April 2019, (% of respondents)
                                                                                                                                    • Figure 45: Dental treatment, by time of last private visit, April 2019, (% of respondents)
                                                                                                                                • Service Satisfaction

                                                                                                                                  • People are most satisfied with appointment duration
                                                                                                                                    • Figure 46: Dental service satisfaction, April 2019, (% of respondents)
                                                                                                                                • Barriers to Dentist Visit

                                                                                                                                  • Affordability still preventing dental visits
                                                                                                                                    • Figure 47: Barriers to visiting a dentist, April 2019, (% of respondents)
                                                                                                                                • Appendix – Data Sources, Abbreviations and Supporting Information

                                                                                                                                    • Abbreviations
                                                                                                                                      • Methodology
                                                                                                                                      • Further Sources and Contacts

                                                                                                                                        • Trade associations
                                                                                                                                          • Trade magazines
                                                                                                                                            • Trade events

                                                                                                                                            Dentistry - UK - August 2019

                                                                                                                                            £1,495.00 (Excl.Tax)