Table of Contents
Executive Summary
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- Market size
- Stagnant growth in dental care expenditure continues
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- Figure 1: Total UK dental care expenditure, 2015-19, (£ billion)
- NHS accounts for largest segment but private dominates growth
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- Figure 2: Total UK dental care expenditure, by provider, 2015-19, (£ billion)
- Dental earnings continue to fall
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- 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
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- 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
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- 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
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- Stagnant growth in dental care expenditure continues
- Segment overview
- Slow market growth expected to continue – rising by just 6% to 2024
Market Size
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- Stagnant growth in dental care expenditure continues
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- Figure 5: Total UK dental care expenditure, 2015-19, (£ billion)
- NHS treatment costs rise by 5% for the third consecutive year in 2019
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- 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
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- Segment overview
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- Figure 7: Total UK dental care expenditure, by provider, 2015-19, (£ billion)
- Private treatments
- Cosmetic dentistry expenditure has risen by a quarter since 2015
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- Figure 8: UK expenditure on private cosmetic dental care, 2015-19, (£ billion)
- NHS dentistry
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- Figure 9: UK expenditure on NHS dental care, by payment segment, 2015-19, (£ million)
- Courses of NHS treatment decline in each band in 2018
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- Figure 10: Number of courses of dental treatment under the NHS in England, 2013/14-2017/18, (000s)
Market Forecast
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- 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
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- 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
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- 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
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- Annual GDP growth falls to six-year low in 2018
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- Figure 13: Annual GDP growth rate, 2014-18, (%)
- Bank rate remains at 0.75%
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- 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
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- Figure 15: GDP per head at current market prices and real household disposable income per head, Q1 2015-Q1 2019, (£)
Market Trends
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- Dental earnings continue to fall
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- Figure 16: Average taxable income for all self-employed primary care dentists, England and Wales, 2012/13-2016/17, (£)
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- 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
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- Although Brexit is still not resolved, there has been an impact on recruitment and costs
- Ageing population to drive dental treatment demand
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- 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
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- Figure 19: Dentists with NHS activity in England, 2013/14-2017/18, (no. of dentists and % annual change)
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- 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
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- 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
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- Investor demand for practices remains strong, but average price growth diminishes
- New co-ownership model continues to thrive and provide alternative
Industry Structure
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- Investor demand for practices remains strong, although average price growth diminishes
- ADG and IHPN enter partnership
- Market share
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- Figure 22: Number of UK dental practices, 2018, by corporate operator and ownership, (number)
- Recent M&A activity
- Sector structure
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- 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)
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- Figure 25: Analysis of the financial structure of the dental practice sector, 2017 and 2018, (£000 and number of companies)
Competitive Strategies
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- New co-ownership model continues to thrive and provide alternative
- Mydentist partners with Philips Sonicare and Superdrug to launch dental health campaign
Company Profiles
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- BUPA Dental Care
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- Figure 26: Financial analysis of Bupa Dental Care, 2013-2017, (£ million)
- Colosseum Dental Services (formerly known as Southern Dental)
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- Figure 27: Financial analysis of Colosseum Dental Services, 2014-2017*, (£ million)
- DPAS
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- Figure 28: Financial analysis of DPAS, 2013-2017, (£000)
- Mydentist (formerly IDH Group)
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- Figure 29: Financial analysis of Turnstone Equityco 1, 2014-2018, (£ million)
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- Figure 30: Financial analysis of Whitecross Dental Care, 2014-2018, (£ 000)
- Figure 31: Financial analysis of Petrie Tucker and Partners, 2014-2018, (£ million)
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- Figure 32: Financial analysis of Orthoworld 2000, 2014-2018, (£ million)
- Practice Plan
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- Figure 33: Financial analysis of Practice Plan, 2013-2017, (£ million)
- Rodericks Dental Limited
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- Figure 34: Financial analysis of Rodericks, 2014-2018, (£ million)
- Simplyhealth Professionals (formerly Denplan)
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- Figure 35: Financial analysis of Simplyhealth Professionals, 2014-2018, (£ million)
The Consumer – What You Need to Know
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- 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
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- Almost half of people have never visited a private dentist
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- 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
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- 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
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- Seven-in-10 ‘self-fund’ dental treatment
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- Figure 39: Dental payment, April 2019, (% of respondents)
- Over-65s twice as likely to self-fund than 16 to 24 year olds
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- 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…
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- Figure 41: Dental payment, by time of last NHS visit, April 2019, (% of respondents)
- … whilst self-funding has declined in the private industry
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- Figure 42: Dental payment, by time of last private visit, April 2019, (% of respondents)
Type of Treatment
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- Dental examination and check-up most common reason for treatment
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- Figure 43: Dental treatment, April 2019, (% of respondents)
- Rise in check-ups and x-rays over the last year
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- 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
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- People are most satisfied with appointment duration
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- Figure 46: Dental service satisfaction, April 2019, (% of respondents)
Barriers to Dentist Visit
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- Affordability still preventing dental visits
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- Figure 47: Barriers to visiting a dentist, April 2019, (% of respondents)
Appendix – Data Sources, Abbreviations and Supporting Information
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- Abbreviations
- Methodology
Further Sources and Contacts
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- Trade associations
- Trade magazines
- Trade events
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