Dental Earnings and Expenses Estimates 2019/20

This section shows average gross earnings, total expenses, and taxable income estimates by dental type and contract type for dentists in England. The expenses to earnings ratio (EER) is also shown as a percentage for ease of understanding.

When making comparisons across dental publications it is important to note the differences in the dental populations used in these reports:

Table 1.1: Differences in England dental populations between NHS Digital publications

When considering the results, it is important to keep some of the key differences between sources of income in the NHS and private dental systems in mind. These include that:

• NHS earnings in 2019/20 originated from a contract between the dental provider and the NHS England and NHS Improvement (Region). Private earnings are determined by the amount of demand from individual patients who chose to receive private dental care, which may be in addition to the receipt of NHS care.
• 1/12th of the NHS contract value is paid to the Provider each month to deliver the contracted/pre-agreed NHS dental services. Private patients will either pay per visit or contribute to an insurance/capitation scheme which will pay/contribute on their behalf, which means that the level of private income may not be consistent from one month to another.

At the end of the financial year the amount of activity performed by an NHS provider is compared to their contract. If the contractor did not deliver the agreed number of units of activity some earnings can be clawed back by the NHS England and NHS Improvement (Region) from the Provider, who may then claw back from their dental performers.

As part of the HMRC validation rules, dentists with non-dental income are excluded from the analysis.

This report considers only those primary care dentists who are self-employed and who have completed some NHS work in the financial year. The results shown cannot be used to make inferences about the size of the dental market; either in terms of total NHS spend on dentistry or the size of private revenues.

Table 1.2: Providing-Performer dentists – average earnings and expenses, by contract type, England, 2018/19 and 2019/20

^_Notes:  

^{_{1. Small sample (<125)}}   

^{_{2. Statistical significance relates only to the fact of a year-on-year change in taxable income. See 'Statistical significance explained'.}}

Year-on-year differences between taxable income estimates have been tested for statistical significance at a 95 per cent confidence level. An increase or decrease in estimates that is statistically significant is likely to be a genuine change, rather than resulting from chance, and means that users can have greater confidence that any apparent differences are applicable to the entire population in question.

Statistical significance in this report relates only to the fact of an increase or decrease in average income before tax and does not consider the size of the change; in some cases, apparently large changes may not be statistically significant and vice versa.

Average gross earnings and total expenses have not been tested, as standard errors were not available. Throughout the rest of the report, results and comparisons have not been tested for statistical significance unless otherwise stated.

Table 1.3: Associate dentists – average earnings and expenses, by contract type, England, 2018/19 and 2019/20

^{_{Note: 1. Statistical significance relates only to the fact of a year-on-year change in taxable income. See 'Statistical significance explained'}} 

Table 1.4: All self-employed primary care dentists – average earnings and expenses, by contract type, England, 2018/19 and 2019/20

^_Notes:

^{_{1. Statistical significance relates only to the fact of a year-on-year change in  taxable income. See 'Statistical significance explained'}}  

^{_{2 .Changes in the distribution of the population across dental and/or contract type will inevitably have some effect on the estimates for gross earnings, total expenses, taxable income, and EER}}

Cash and real term figures

Please refer to the accompanying Power BI visualisation for a time series of taxable income and total expenses for Providing-Performer and Associate dentists in England, for 2017/18 to 2019/20, in both cash and real terms. 

Report population changes

Last year a new methodology was implemented for determining dental type, which resulted in the reclassification of some dentists from Associate to Providing-Performer. Following a revision in methodology the earnings, expenses and report population were also recalculated for 2017/18. Using the new methodology, Providing-Performer dentists now account for approximately 19.0 per cent of the workforce in England compared to 19.9 per cent in 2018/19. 

It is important to note that this chart represents the changing report population that is used in the annual earnings and expenses estimates series of reports and does not represent the actual dental population. See the Introduction for further explanatory notes.

Table 2.1: All self-employed primary care dentists - average earnings and expenses from NHS and private dentistry, by dental type and gender, England, 2019/20

^_Notes:

^{_{1. The results show that regardless of dental type classification, on average in 2019/20, male dentists had higher gross earnings, total expenses and taxable income than their female counterparts}} 

^{_{2. This report includes both full-time and part-time dental earnings and expenses, and given that on average male dentists tend to work longer weekly hours compared to their female counterparts (Dentists' Working Patterns, Motivation and Morale - 2018/19 and 2019/20), this could be a contributory factor to the differences observed in earnings and expenses by gender.}}  

For the purposes of this report, dentists’ ages were calculated as at 30 September 2019 – the mid-point of the 2019/20 financial year.

Table 3.1: All self-employed primary care dentists - average earnings and expenses from NHS and private dentistry, by dental type and age, England, 2019/20

_^Notes:

_{^{1. Small sample (<125)}} 

_{^{2. Further explanatory notes can be found in the Terms, definitions and report content Chapter of this report}} 

Table 4.1: Self-employed primary care Providing-Performer dentists - average earnings and expenses from NHS and private dentistry, by gender and age England, 2019/20

_^Notes: 

_{^{1. Small sample (<125)}} 

_{^{2. Male dentists earned more than their female counterparts in every age band; this will be due to a number of factors including variation in the number of weekly hours worked and the fact that a higher proportion of men are Providing-Performer dentists whilst a higher proportion of female dentists are Associates}}

Table 4.2 Self-employed primary care Associate dentists - average earnings and expenses from NHS and private dentistry, by gender and age England, 2019/20 

^{_{Note: Female Associate dentists consistently have a lower expenses to earnings ratio (EER) when compared to their male counterparts, with female dentists under 35 years having an EER of 26.2% compared to an EER of 29.2% for male dentists under 35}}

Table 4.3: All self-employed primary care dentists - average earnings and expenses from NHS and private dentistry, by gender and age England, 2019/20

Dental Working Patterns Survey findings: earnings and expenses estimates for dentists by weekly hours devoted to dentistry

Table 5.1: All self-employed primary care dentists - average earnings and expenses from NHS and private dentistry, by dental type and weekly working hours, England, 2019/20

^{_{Note: Some survey respondents may have also included time spent in employed, as opposed to only self-employed, dental work (such as time spent working in dental schools) and as a result, the measure of weekly working hours is not restricted to self-employed work within a dental practice}}

Dental Working Patterns Survey findings: earnings and expenses estimates by gender and weekly hours devoted to dentistry

Table 5.2: Self-employed primary care Providing-Performer dentists - average earnings and expenses from NHS and private dentistry, by gender and weekly working hours, England, 2019/20

^_Notes:

^{_{1. Small sample  size (<125)  mean that values are subject to more uncertainty, as extreme values can have noticeable effects on the averages}}  

_{^{2. Further explanatory notes can be found in the Terms, definitions and report content chapter of this report}}

Table 5.3: Self-employed primary care Associate dentists - average earnings and expenses from NHS and private dentistry, by gender and weekly working hours, England, 2019/20

Table 5.4: All self-employed primary care dentists - average earnings and expenses from NHS and private dentistry, by gender and weekly working hours, England, 2019/20

_^Notes:

_{^{1. Small sample (<125)}}

_{^{2. Further explanatory notes can be found in the Terms, definitions and report content chapter of this report}} 

Dental Working Patterns Survey findings: earnings and expenses estimates by percentage of time spent on NHS dentistry

Table 6.1: All self-employed primary care dentists – average earnings and expenses from NHS and private dentistry, by percentage of time spent on NHS dentistry and dental type, England, 2019/20

^_Notes: 

^{_{1. Results are based on responses from The Dental Working Patterns Survey. This survey was only sent to dentists who carried out some NHS work in 2018/19 or 2019/20; therefore, percentage of time spent on NHS dentistry cannot equal zero}}   

^{_{2. Small sample (<125)}}   

_{^{3. Further explanatory notes can be found in the Terms, definitions and report content chapter of this report}} 

^{_{4. For Associate dentists, average taxable income decreased as the percentage of their time spent on NHS dentistry increased. A potential explanation for these findings could be that Associate dentists may retain a higher percentage of the fees generated by performing private dentistry than they do for NHS dentistry as the Providing-Performer dentists might take a lower proportion of the private fees}}

Table 7.1: Self-employed Providing-Performer dentists - detailed expenses breakdown by contract type, age, gender and activity demographics, England, 2019/20

_^Notes:

_{^{1. Further explanatory notes can be found in the Terms, definitions and report content chapter of this report}} 

_{^{2. Small sample (<125)}}

Table 7.2: Self-employed Associate dentists - detailed expenses breakdown by contract type, age, gender and weekly working hours, England, 2019/20

^_Notes:

^{_{1. Associate dentists are less likely than their Providing-Performer counterparts to employ staff, and this is reflected in the percentage of all expenses that were Employee costs, at 12.2 per cent (£3,600) and 31.3 per cent (£85,700) respectively}}

_{^{2. Further explanatory notes can be found in the Terms, definitions and report content chapter of this report}}

Table 7.3: All self-employed primary care dentists - detailed expenses breakdown by contract type, age, gender and weekly working hours, England, 2019/20

_{^{Note: Further explanatory notes can be found in the Terms, definitions and report content chapter of this report}} 

Longitudinal Study of Earnings and Expenses Estimates, 2017/18 to 2019/20

This section of the report shows the results of a longitudinal study of the earnings and expenses estimates of self-employed primary care dentists, for the three financial years 2017/18 to 2019/20.

Changes in the composition of the dental population (as well as the sample used to produce Dental Earnings and Expenses Estimates) need to be kept in mind when making comparisons between results for different financial years. 

The longitudinal study controls for this population change by considering those dentists who have performed some primary care NHS dentistry in each of the three years 2017/18, 2018/19 and 2019/20, but have not changed their dental type or contract type during this period. 

The following changes occurred during the period of the longitudinal study that are not controlled for, which may contribute to any change shown over the three-year period:

• Each year the value of dentists' contracts is reviewed, and an uplift made to GDS contracts and PDS agreements accordingly. Each uplift will affect the gross earnings of dentists. Uplifts are applied from 1 April in the relevant financial year
• The awards relevant to the period covered by the longitudinal study for England were 1.14 per cent in 2017/18, 1.68 per cent in 2018/19 and 2.5 per cent in 2019/20

The results of the longitudinal study show that for all self-employed Providing-Performer dentists:

• taxable income from NHS and private dentistry increased by 1.4 per cent between 2017/18 and 2019/20, from £117,900 to £119, 600
• the trend shown differs from those found in the main findings of the report. This highlights the effect that changes to the overall dental population and to contract types has on the earnings and expenses of the entire population

Eng_L1: Self-employed Providing-Performer dentists – longitudinal earnings and expenses from NHS and private dentistry, by contract type, England, 2017/18 to 2019/20 

For all self-employed Associate dentists taxable income from NHS and private dentistry increased by 4.7 per cent from £59,600 in 2017/18 to £62,400 in 2019/20.

Eng_L2: Self-employed Associate dentists – longitudinal earnings and expenses from NHS and private dentistry, by contract type, England, 2017/18 to 2019/20

For all self-employed primary care dentists:

• the longitudinal study shows that overall, average taxable income from NHS and private dentistry increased by 3.6 per cent between 2017/18 (£72,400) and 2019/20 (£75,000). Both gross earnings and total expenses also increased, rising 5.2 per cent and 6.6 per cent respectively.
• for all self-employed primary care dentists, the trends shown differ from those presented in the main findings of this report. This highlights the effect that changes to the overall dental population and to contract types have on the earnings and expenses estimates of the entire population.

Eng_L3: All self-employed primary care dentists – longitudinal earnings and expenses from NHS and private dentistry, by contract type, England , 2017/18 to 2019/20