Life beyond NHS Contracts

In 1999, at a business development meeting in Glasgow organized by 3M Unitek, I proclaimed to my specialist orthodontic colleagues, the need to build private incomes while fulfilling our NHS orthodontic contracts. My rationale had always been that the NHS part of my practice was the fundamental building block, while my private practice was a lucrative business opportunity.

At the time, we assumed that government contracts did not usually follow commercial protocols, but were subject to changes, which would almost certainly be outside any orthodontist's control. It did not come as a surprise in 2018, when commissioning for new NHS service contracts arrived with little fanfare in the South East. We were all confused, bewildered and shocked in equal measure by the application parameters and protocols. The end result for me was, that after 21 years of service to the National Health Service, I lost my NHS contract, accepted a 2-year wind down arrangement, and then became entirely reliant on my private income. My NHS contract was substantial, and the anticipated private income growth rate would not be fast enough to replace the loss.