R.A.J. Wallace and Associates, Northern Ireland

Background

R.A.J. Wallace is a well established and mixed general practice in a busy rural town. It offers extra services including orthodontics and dental implants. For 22 years, the practice was in a converted Victorian cottage in Union Road in Magherafelt.

Last year, the team moved premises to Rainey Street and is now settling in to the new, purpose built practice which is kitted out with brand new equipment, a comfortable and spacious patient waiting area and state of the art facilities such as digital radiography, intra oral cameras and flat screen televisions in the four surgeries.

The team, which consists of three full time dentists, four nurses, three receptionists and a recently appointed hygienist, is led by principle dentist Robert Wallace.

Robert qualified in 1982 from Queen’s University, Belfast and worked in general practice in Cookstown for three years before opening the practice in 1985.

Sharon McAuley joined the practice as an associate in 1992 after qualifying – also from Queen’s. In 2004 Claire McMullan, yet another Queen’s graduate, joined the practice as the third dentist, and became a partner in 2008.

As an NHS practice, staff found that they were working increasingly long hours. Claire McMullan remembers that the set up was becoming more and more unsatisfactory.

“Life was extremely busy and very rushed. This made it difficult to provide the quality of care, level of service and variety of treatment that we wanted to, which is unfulfilling as a clinician. Over the years NHS dentistry has become increasingly unprofitable. It was difficult to pay good, well trained staff appropriately under the NHS fee scale. We didn’t want financial constraints under the NHS to lead to a compromise in patient care.”

The practice team decided it was time to convert because they were determined not to make this compromise.

“Our first priority was to increase the quality of care by cutting down the workload. We wanted to spend more time with our patients, reduce the waiting time for appointments and offer more patient choice by providing a wider variety of treatments at convenient times. We also wanted to be able to offer the services of a hygienist to the patients. We felt we needed a shift in our ethos; by creating a more preventative led practice. Our first step was to move from a very run down building to a brand new purpose built practice. It also seemed to be the right time to convert.”

Solution

Claire says the first contact with any of the plan providers came through a colleague, Karen Kemp, who had recently started working for DPAS. The practice looked into other providers but DPAS worked out to be the most cost effective provider. This, combined with the knowledge that the practice would receive all the back up and support it would need from the DPAS team, meant that DPAS was the right practice plan provider for R.A.J. Wallace and Associates.

“Karen, our local DPAS area representative, was invaluable with her advice and support. She had successfully converted many practices before and was able to apply this knowledge, along with her vast experience in working in general practice, to our own practice. She reassured us when we had any concerns. I think the core of this was the training and support she gave to the team – especially the reception staff. Her excellent preparation and training, and the fantastic enthusiasm and dedication of our own staff meant the actual conversion process went very smoothly so very little additional support was required.”

DPAS organised the mail out for the surgery and wrote to every patient explaining the process and implications of converting to a payment plan. Every patient also received a new practicebranded brochure which DPAS arranged to have packed in the same envelope.

In the summer of 2008 the practice converted all fee paying patients to private treatment. The surgery continues to see registered non-fee paying patients and children on the NHS. The new contract with Primary Care Trusts as it stands in England, does not exist in Northern Ireland where dentists still work under the ‘old’ system.

Claire says that the practice team really appreciated the personal back up they received throughout the conversion process.

“We always knew that our DPAS representative would be available to offer us support as and when required. A specific member of staff from DPAS is assigned to each practice so you always get to talk to the same person.”

Benefits

The patients reacted very positively to the change. Most of them told the staff that they had been expecting a private conversion for a while, especially given all the negative coverage regarding the availability of NHS dentistry in the press.

Having a Dental Care Plan in place made the conversion a lot easier as it gave the patients more options. Claire says that the practice was keen to reassure patients about the costs involved.

”As some patients worry about the cost of private dental care, we included a fee guide in the mail out which showed both the charges for ‘fee per item’ patients and dental care plan members. This openness regarding fees reassures patients that their dental care remains affordable and allows them to see the benefits of becoming a plan member.”

It wasn’t just the patients who benefited from the conversion. The practice team were all keen to move forward with the changes; Claire says they knew it was going to improve their lives at work.

“Our staff were all extremely enthusiastic and supportive. They could immediately see the positive effect conversion would have on the day to day running of the practice and their working lives would be affected – for the better. In the end it was very much their hard work and enthusiasm, along with their cooperation with Karen, that lead to such a smooth and successful conversion. It actually required relatively little help from the dentists.”

As the practice had moved to new premises the year before, most of the structural changes had already taken place. It was, however, able to upgrade the computer system following the conversion in order to become paperless.

Claire says the atmosphere of the practice is much more relaxed. The conversion has allowed staff to spend more time with patients without interruption. Patients no longer have to wait so long for appointments and the surgery now offers far more flexibility with times – providing early morning and late night appointments for the patients.

Time is also kept free in order to deal with same day emergency appointments so they don’t need to be ‘squeezed in’, which in the old days, was a constant source of additional stress for everybody.

So what are the plans for the future?

The practice is re-branding itself. Plans are underway to change the name to Dental 32 and the team hopes the new, contemporary name will mark an exciting time of change for the practice and the increased variety of services it can now offer.

As part of the re-branding, the practice launched its own website in May. A new patient information pack has been designed which includes information on the Dental Care Plan, a fee guide and a smile check for patients to fill in before their consultation.

The introduction of the hygienist has also had a very positive effect in the practice for both staff and patients. The dentists have been able to plan more efficient treatment and better use of their time. The patients regard the hygienist appointments as an extension of the services the practice can now offer.

Converting to the private sector with DPAS has had other tangible benefits. The practice has already employed another member of office staff, which simply wouldn’t have been possible under the NHS. This has helped to relieve the immense pressure the staff were previously under and enables them to take a much more active role in the running of the practice.

In the same vein, since conversion, there has been more time for the nursing staff to go on courses – already they have all become fully qualified – a fact which has had a very positive effect of the nursing team.

Claire says there are absolutely no regrets about converting the practice in partnership with DPAS.

She offers this advice to other dentists who may be considering a conversion:

“One of the first priorities should be to get your staff on board. Let them see for themselves the benefit this will have on everyone. Their enthusiasm will help to reduce a lot of the stress and will drive the process forward. Encouraging staff to be actively involved in the decision making allows everyone to know how valuable their input is and has a very positive effect on team morale.”

To find out more about how DPAS can help smooth your journey from NHS to private practice, or to see how we can make your existing payment plan administration work more efficiently, please contact us.