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Dentistry Market Report, 6th Edition

Best Price Guarantee Publisher Published Date SKU
from $4,150 LaingBuisson Ltd. November, 2022 LBU17768147
Best Price Guarantee
Price from $4,150
Publisher LaingBuisson Ltd.
Published Date November, 2022
SKU LBU17768147

Dentistry Market Report, 6th Edition

Will dentistry demand return to pre-pandemic levels?

The report shows a ‘High Street’ dentistry market, valued by LaingBuisson at £8.3 billion in 2020/21, which shrunk nearly 10% in real terms (after taking account of CPI) since the previous year. Of this, private sector dentistry accounted for £4.6 billion, while NHS spend amounted to £3.7 billion.

This new edition of the Dentistry UK Market Report evaluates the significant impact of the Covid-19 pandemic on the fragmented market. During 2020, much routine treatment ground to a halt, and when combined with the restrictions on aerosol generating procedures, only very urgent and emergency treatments could take place.

Updated figures show that demand decreased perhaps less than might have been expected to a level of 56% in 2020. By October 2021, 47% of patients had returned to a dental practice after the nationwide lockdown ease. However, half had not done so yet, meaning that they had not seen a dental professional at all for 18 months or more.

LaingBuisson predicts the market to continue an upward growth by an average of 2-3% in nominal terms in the next three years. This will mainly come from more spending on private dentistry, though much depends on the strength of the UK economy, and spending on NHS dentistry is expected to fall in real terms.

Challenges for the dentistry market are still focused on recruitment and retention. Providers continue to report challenges in the recruitment of dentists and dental care professionals. Some providers have reported labour shortages, resulting in the undershooting of NHS contracted activity, and an increased reliance on locum dentists. The shortage is affecting all roles, not just dentists. This comes at a time when a new NHS dentistry contract model, which aims to improve prevention and focus on patient outcomes, continues to be tested after many years of planning.

A positive outcome from the latest analysis showed that consolidation strengthened the market with several equity investments and transactions. This includes the recently announced merger of Portman Healthcare and Dentex.


EXECUTIVE SUMMARY AND HIGHLIGHTS
1. MARKET
1.1 Market overview
1.1.1 Value of UK ‘high street’ dentistry
1.1.1.1 Historic growth
1.1.1.2 Future growth
1.1.2 Value of corporate UK ‘high street’ dentistry
1.2 Market supply
1.2.1 Supply headline trends
1.3 Market demand
1.3.1 Demand headline trends
1.3.2 Factors affecting demand for dentistry
1.3.3 Penetration of dentistry demand
1.4 Future market trends
2. POLITICS AND POLICY
2.1 Conservative policy ‒ 2015 onwards
2.2 NHS funding and the Long Term Plan
2.2.1 Prevention and oral health
2.2.2 Integrated care and accountable care
2.3 Access to NHS treatment
2.4 New dentistry contract
2.5 Workforce planning
2.6 Historic government policy
2.6.1 1990 reforms – The new dentist contract
2.6.2 Policy under Labour – From 1997 to the 2006 reforms
2.6.2.1 Investing in Dentistry (IID)
2.6.2.2 Personal Dental Services
2.6.2.3 Dental Access Centres
2.6.2.4 Modernising NHS dentistry – Implementing the NHS Plan
2.6.2.5 Options for change
2.6.2.6 Dentist workforce review
2.6.2.7 NHS dentistry reforms
2.6.3 Policy under Labour – The 2006 reforms
2.6.3.1 The new contract
2.6.3.2 Commissioning
2.6.3.3 The Steele Review
2.6.3.4 Implementing the Steele Review
2.6.3.5 Dental Access Programme
2.6.4 2010 ‒ Coalition policy for NHS dentistry
2.7 Government policy in Scotland
2.7.1 Recent developments
2.7.2 Historic policy
2.8 Government policy in Wales
2.9 Government policy in Northern Ireland
3. REGULATION AND REPRESENTATION
3.1 Overview
3.2 Streamlining regulation of healthcare professionals
3.3 Streamlining regulation of dental practices in England
3.4 OFT investigation into dentistry
3.4.1 OFT recommendations and actions
3.5 Regulators
3.5.1 Care Quality Commission (CQC)
3.5.2 General Dental Council (GDC)
3.6 Representative organisations
3.6.1 British Dental Association (BDA)
3.6.2 College of General Dentistry
3.6.3 Association of Dental Groups (ADG)
4. NHS FUNDING
4.1 NHS dentistry
4.1.1 Demand met by the NHS
4.1.2 Patients seen on the NHS in England
4.1.2.1 Current trends
4.1.2.2 Historical trends
4.1.2.3 Regional trends
4.1.3 Patients seen on the NHS in Scotland and Wales, and ‘health service’ in Northern Ireland
4.1.4 Treatment activity in England – UDAs and UOAs
4.1.4.1 UDA trends
4.1.4.2 Trends in UDA bands
4.1.4.3 Regional picture of UDAs in England
4.1.4.4 Trends in Units of Orthodontic Activity (UOAs)
4.1.5 Treatment activity in Scotland, Wales and Northern Ireland
4.1.5.1 UDAs in Wales
4.1.5.2 Courses of treatment in Scotland
4.1.5.3 Dental treatments in Northern Ireland
4.1.6 Spending on high street NHS dentistry
4.1.6.1 Current trends
4.1.6.2 Regional spending and contract clawback trends in England
5. DENTAL PROVISION
5.1 High street dental practices
5.2 Growth in the supply of high street dental practices
5.3 Supply trends – Dentists and dental care professionals
5.3.1 Dentist supply trends
5.3.1.1 Historic growth trends in NHS dentists
5.3.1.2 Regional variations in the supply of NHS high street dentists
5.3.1.3 Provider performer versus associates
5.3.1.4 Dentist education trends
5.3.1.5 New dentist registrations
5.3.2 Dental care professionals
5.3.3 Dental specialists
6. STAFF RECRUITMENT, TRAINING AND RETENTION
6.1 Overview
6.2 European Union dentists
6.3 Regional disparities
6.4 Dentist incomes
6.5 Dentist working patterns
6.6 Morale, motivation and satisfaction
6.7 Specialists and dental care professionals workforce
7. PRIVATE DENTISTRY
7.1 Overview
7.2 Private demand trends
7.2.1 The trend from NHS to private dental care
7.2.2 Growth in private dentistry
7.2.3 Factors influencing private demand
7.2.3.1 Main drivers
7.2.3.2 The growth of cosmetic dentistry
7.2.3.3 Age and social grade
7.3 Private supply trends
7.3.1 Supply by region
7.4 Future trends for private dentistry
7.5 Dental plans
7.5.1 Plan types
7.5.1.1 Individual care capitation plan
7.5.1.2 Practice-level capitation plan or dental maintenance plan
7.5.1.3 Dental insurance
7.5.1.4 Cash plans
7.5.2 Dental plan market
7.5.2.1 Key headline statistics
7.5.2.2 Key growth statistics and current trends
7.5.2.3 Historical growth trends
7.5.2.4 Future growth trends
7.5.3 Plan providers
7.5.3.1 Entries and exits
7.5.3.2 Dental capitation/care maintenance plan providers
7.5.3.3 Dental insurance plan providers
7.5.3.4 Health cash plan providers
7.6 Business profiles ‒ dental plan market players
7.6.1 Simplyhealth Group
7.6.2 AXA Health
7.6.3 Bupa
7.6.4 Cigna
7.6.5 WPA
7.6.6 Unum
7.6.7 Boots
7.6.8 Wesleyan Group (Practice Plan, DPAS and Quality Plan)
7.6.9 Patient Plan Direct
7.6.10 AGILIO
8. CORPORATE DENTISTRY
8.1 Size of the UK corporate dentistry market
8.2 Growth and consolidation between 2014 and 2022
8.3 Market entrants
8.4 Growth in the 2010s
8.5 Consolidation trends
8.6 Corporate growth strategy and preferences
8.7 Profitability
8.7.1 Average profit per principal dentist
9. INVESTMENT IN UK DENTISTRY
9.1 Current trends and the role of private equity
9.1.1 2022 activity
9.1.2 Post-Covid recovery
9.1.3 2017‒2020
9.1.4 Historic acquisitions and investments
9.1.4.1 Major acquisitions since 2010
9.2 Major equity investors in UK dental groups
9.2.1 Apposite Capital
9.2.2 August Equity
9.2.3 Carlyle Group
9.2.4 CBPE Capital
9.2.5 Core Equity Holdings
9.2.6 Jacobs Holding AG
9.2.7 Palamon Capital Partners
10. MARKET POTENTIAL
APPENDIX 1. GLOSSARY
APPENDIX 2. REGULATORS
APPENDIX 3. TRADE BODIES AND ASSOCIATIONS
APPENDIX 4. MAJOR PROVIDERS
APPENDIX 5. FINANCIAL APPENDIX
LIST OF TABLES
Table 1.1 Value of ‘high street’ dentistry market by funding sector, UK, 2006/07-2020/21
Table 1.2 Net proportion of people (adults) visiting a dentist in the last year by age group, 2013‒2020
Table 1.3 Percentage of adults who said they went to a dentist in the last year, 2020
Table 4.1 Type of care received by adults (aged 15+ years) on last visit to dentist (covering people who go at least once every two years), UK, 1998 to 2020
Table 4.2 Rates of success in getting an appointment at an NHS dentists in the last one or two years, England, 2021
Table 4.3 Demand met for NHS primary care dentistry – NHS registrations in England and Wales 1990/91– 2005/06, patients seen in England 2006/07–2021/22
Table 4.4 Patients participating in NHS dentistry in Scotland in the last 24 months, NHS patients seen in last 24 months in Wales, and dental practice ‘health service’ registrations in Northern Ireland, 2006/07–2020/21
Table 4.5 NHS high street dentistry Units of Dental Activity (UDAs), millions, by user group, England, 2006/07–2021/22
Table 4.6 NHS high street dentistry Units of Dental Activity (UDAs, millions) by treatment group, England, 2006/07–2021/22
Table 4.7 UDAs per 100,000 people by NHS commissioning region and category of treatment, England, 2020/2021
Table 4.8 Total spending on NHS dentistry and real growth in England, Scotland, Wales, Northern Ireland (health services), and UK, 2006/07–2020/21
Table 4.9 Patient spending (NHS charges paid) on NHS dentistry and real growth in England, Scotland, Wales, Northern Ireland (health services), and UK, 2006/07–2020/21
Table 4.10 Government spending (total spending less NHS patient charges paid) on NHS dentistry and real growth in England, Scotland, Wales, Northern Ireland (health services), and UK, 2006/07– 2020/21
Table 4.11 Value of NHS high street dentistry (GDS and PDS contracts) and value of contract clawbacks by region, England, 2018/19
Table 5.1 Number of qualified persons registered to practice dentistry, UK, at 31 December 1970–2022
Table 5.2 Dentists contracted to provide NHS primary care dentistry by country, 1985–2022
Table 5.3 Population per NHS dentist during 2021/22 by NHS Commissioning Area in England
Table 5.4 Number of dentists and dental care professionals registered in the UK, at 30 November 2021, with 3 year, 5 year and 7 year CAGRs
Table 7.1 Proportion of adults receiving private dental care on last visit to dentist, 2013-2021 (and last course of treatment, 1988‒2009)
Table 7.2 Views about the differences between NHS and private dental care, 2000
Table 7.3 Average cosmetic procedures carried out across practices surveyed by the American Academy of Cosmetic Dentistry, 2017 and 2019
Table 7.4 Proportion of adults receiving private dental care on last visit to dentist, by age range, 2017 and 2020
Table 7.5 Proportion of adults receiving private dental care on last visit to dentist, by social grade, 2017 and 2020
Table 7.6 Number of dental plan people covered, subscriptions earned and claims paid, UK 2007‒2020
Table 7.7 Company paid and individually paid dental plan people covered and subscriptions earned, UK, 2007‒2020
Table 7.8 Average prices, and real price inflation (based on CPI) for dental capitation and dental insurance, 2008‒2020
Table 7.9 Dental plan providers in the UK, 2020
Table 7.10 Entries and exits in the dental capitation and dental insurance sectors
Table 8.1 Leading 40 for-profit dentistry groups by number of registered dental services, UK, 2022
Table 8.2 Penetration of corporate dentistry and leading corporates by value, including NHS and private market shares of high street dentistry market, UK, 2020/21
Table 8.3 Revenues of major dental group companies, UK, 2013/14–2020/21
Table 8.4 Major corporate consolidation acquisitions since 2000
Table 8.5 EBITDAR margin and pre-tax profit/loss margin for major for-profit dentistry group operating companies – latest accounting period, and previous year shown in brackets
Table 8.6 Average profit per principal by type of practice, 2020/21
Table 9.1 Dental groups backed by private equity and their market share
Table 9.2 Sale of the major corporate dentistry groups since 2000
LIST OF FIGURES
Figure 1.1 Value of ‘high street’ dentistry market by funding sector, UK, 2006/07‒2020/21
Figure 1.2 Time since last visit to dentist for adults, 2020, 2017, 2015, 2014 and 2011
Figure 4.1 Accessing NHS dentist appointments ‒ When did you last try to get an NHS dental appointment for yourself?
Figure 4.2 Experience of NHS dental services ‒ Overall, how would you describe your experience of NHS dental services?
Figure 4.3 Adult and child NHS registrations in England and Wales, 1991/92–2005/06, and adult and child patients seen in England, 2005/06–2021/22
Figure 4.4 NHS adult patients seen in the previous 24 months at 30 June 2022 as a proportion of the population, and NHS child patients (under 18s) seen in the previous 12 months at 30 June 2022 as a proportion of the population by region
Figure 4.5 Proportion (%) of the population with NHS dentistry – Scotland (participating), Wales (patients seen), and Northern Ireland (practice registrations), 2012/13 to 2020/21
Figure 4.6 Share of UDAs across Bands by user group – adults pay, adults non-pay, and child, England 2012/13, 2017/18 and 2021/22
Figure 4.7 UDAs per 100,000 people by NHS commissioning region, England, 2021/2022
Figure 4.8 Units of Orthodontic Activity, England, 2008/09 to 2021/22
Figure 5.1 Breakdown of high street dental practices by region, UK, August 2022
Figure 5.2 Population (adults + children) per high street dental practice by region, UK, August 2022
Figure 5.3 Breakdown of registered dentistry professionals (dentists and dental care professionals), UK, at 31 December 2021
Figure 5.4 Population per NHS dentist during 2020/2021 by region in England
Figure 5.5 Number of students accepted to read dentistry, UK, 1980–2021
Figure 5.6 UK dentist registration additions by origin of qualification, 2011–2020
Figure 6.1 Average gross earnings and taxable income for dentist associates in England and Wales, 2006/2007–2020/21
Figure 7.1 Consolidated Google searches for cosmetic dentistry procedures, 2021
Figure 7.2 Average proportion (%) of total hours spent on private dentistry by dentist type in England & Wales, 2006/07 - 2019/20
Figure 7.3 Type of care provided by practices in the UK, 2018‒2019
Figure 7.4 Proportion of adults going only private during the last course of dentistry treatment in the UK (last two years) by region, 2020
Figure 7.5 Persons covered (000s) by dental plans by type of plan, UK, 2007–2020 (at year end)
Figure 7.6 Persons covered by company paid & individual paid/employee paid dental plans
Figure 7.7 Real spending indices for UK dental plans by type of plan, 2007‒2020 (2007=100, deflated by Consumer Price Index (CPI))

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