Shelley Clegg speaks to Deborah Parker, the site manager for two Links Orthodontics clinics in Manchester, about her practices' experience in working through the pandemic.
SC: As a mixed NHS and private orthodontic practice, do you feel that Covid-19 has had an impact on waiting times for treatment?
DP: The restrictions placed on us by governing bodies has meant that we’ve not been able to see as many patients – patient throughput is down by at least a third.
This has created an extended waiting list for NHS orthodontic treatment and then, adding to that pressure, we’ve been in a position where we needed to catch up on our existing cases and complete remedial work, such as broken appliances, which developed throughout the first lockdown. These factors have increased treatment times by up to six months on existing orthodontic cases.
From what we can see, availability of NHS treatment in general is reduced due to the restrictions that the profession now works under. We ourselves have only recently been in a position to start taking on new NHS cases again on a more regular level.
SC: What has the result of Covid-19 and the increase in waiting times been for your practice?
DP: The waiting times for NHS treatment is changing how patients view self-funded, private orthodontics. More and more patients are looking at accessing private treatment as they know they will likely access treatment a lot quicker as well as having more choices available.
As an NHS patient, they will receive fixed braces, whereas a private patient would be able to access the more well-known and potentially more desirable orthodontic treatments like Invisalign. Covid-19 has increased the number of enquiries we’ve had for these types of orthodontic systems.
From our perspective, the big impact of waiting times has been the increase in parents of our child NHS patients looking to self-fund their children’s orthodontics. We’re also receiving referrals from other local dental practices where their patients have specifically asked for a private consultation.
In terms of general applications, factors like patients being unable to live the kind of lifestyle they would usually, such as spending money on holidays or eating out, seem to be encouraging demand for orthodontics. This, alongside the increase in patients who have to look at their smile more regularly due to video calls, has resulted in a definite rise in enquiries – not always in converting into treatment, but certainly enquiries are up.
SC: Have you had to change the way your practice operates to meet demand?
DP: We take a balanced approach in terms of maintaining our NHS commitment, which is very important to us, and supporting our patients in getting the treatment they want. To achieve this, we’ve opened additional clinics on Sundays for private patients which falls outside of our NHS contract timeframes. Flexibility is key.
For many patients, particularly those who are self-referred from the NHS, private orthodontic options are a considerable expense. Even if we provide our most cost-effective option for private orthodontic treatment, it would be over £2k, which is a struggle for many.
Covid-19 has meant that some patients who we were sure would proceed with treatment have pulled out due to their concerns about job security and needing their savings as a safety net through these hard times.
Introducing patient finance has meant we’ve successfully provided patients with treatment funding, where they otherwise wouldn’t have been in a financial position to proceed. Patient finance has made a big difference for us in making the most of the increased enquiries we’ve received. We only introduced this facility this year, having previously had our own in-house payment agreements.
The options we have for zero per cent finance or interest-bearing finance over an extended period have helped patients overcome financial barriers and have proven to be extremely popular. We live in a world where we budget monthly and more and more is available on a ‘buy now, pay later’ basis. I think the mindset of people has changed, so that even if they could pay upfront from the beginning, they would still rather utilise a finance option. This seems to work best for their lifestyle.
The fact that a patient doesn’t have to go to the bank and can complete the application from the comfort of their own home when they feel ready to commit really makes the whole process a lot more convenient. It’s surprising how little changes can alter the likelihood of a patient taking up finance, and convenience is one of those.
SC: You mentioned you used an in-house payment scheme first, what made you change to patient finance?
DP: We knew that trying to manage our personal plans wasn’t effective for our team. It took a lot of time – generating reports to check which patients had paid, and so on. This time was better spent in having conversations with patients to encourage treatment uptake, so we were conscious of opportunities potentially being missed.
Our team doesn’t have to undertake any of that admin anymore, which is a weight off our shoulders.
There was also the concern that patients would begin treatment and then disappear into the ether. We learnt very early on in Invisalign cases that we can’t give the full set of aligners to a patient at the beginning because of this risk. Patient finance mitigates that risk.
Having a finance provider that was within the dental industry was important for us – we’re not in the business of selling a smile like a sofa or a mobile phone contract; this is a specific cosmetic/healthcare solution and requires specific support.
Finally, I think it’s really important who you choose as your finance provider. The FCA application process is difficult, so having the right support in this area really helped me through this process. I called on the experience of my representative at Medenta to help me and, in the end, it only took 90 minutes rather than the hours I would have spent trying to sort the process on my own.
SC: Any final thoughts on the future of orthodontics?
DP: Moving forward, I think orthodontics is something a lot of patients will actively look for on a private basis. We’ve seen more patients with greater expendable income and a greater desire for treatment than pre-Covid-19.
Once we emerge from these difficult winter months, when the economy begins to recover and things are more stable, there’s likely to be an even greater demand for orthodontics.