Dentistry - UK - June 2017

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