Sarah is an NHS Adviser in the BDA’s Business Team. Sarah advises members on all aspects of NHS dental regulations and agreements.
The need or wish to relocate your practice may arise for a variety of reasons. For example your lease may not be renewed by your landlord or you might not be able to agree new terms. Or you may be planning to expand or refurbish and feel that new premises would be more practical. However, there are many considerations if you want or need to move premises and you must think them all through.
You will need to think carefully how the relocation will affect your patients, the benefits you can highlight to them and how you will communicate these. At the most basic your patients may have chosen you initially due to location being convenient for them, so any move, regardless of the personal goodwill you inspire, could make you less convenient for them.
Map where your patients live and consider the transport routes they would need to take to get to you. Do some market research amongst your patients and on the wider demand in the area where you plan to relocate (NHS practices in England and Wales need to provide the commissioners with evidence of your consultation with your patient group in relation to any proposed move). There are many market research firms that can help you set up and run focus groups for you so you can get professional input and analysis. Also look at the characteristics of the population you will serve and their oral health needs, a lot of demographic data is available freely from your local authority or the census.
Plan how you will promote your new practice location to current patients (and potential new patients). Your message may want to highlight the practice facilities, how to get there and the continuity of care that you will offer with the familiar practice team.
NHS Contract considerations
NHS contracts in England and Wales are location specific, there will be a clause in your contract which sets out the address of the premises to be used for the provision of services. This means that a written variation notice is required to provide the service from another address which has to be agreed and signed by NHS England or the local Health Board. There is no automatic right for this to be approved and consent can be withheld by the commissioners. It’s vital to seek agreement before moving, otherwise it could constitute a breach and possible termination of the contract.
Practices that receive a Scottish Dental Access Initiative grant need to check that their planned new location complies with the terms for the grant.
You need proper planning consent for your new premises. Class D1 planning permission is required for England, Wales and Northern Ireland. Class 2 is required in Scotland. Check with your local authority whether you need to apply for planning permission for a change of use.
It is also important to ensure that any new premises are fit for purpose. You may need to refurbish them, install equipment and make sure they meet health and safety requirements such as HTM 01-05. The premises must also be approved by local quality standards regimes – the CQC in England, Combined Practice Inspection in Scotland (or Healthcare Improvement Scotland if you are wholly private), Healthcare Inspectorate Wales (HIW) and the RQIA in Northern Ireland.
Make sure you can shift the contracts with your utility suppliers or that you can terminate them without penalty. You need to check notice periods for doing so and whether there are any penalty payments for early termination.
If moving to new premises you will required to make sure they are compatible with the Equality Act. As a dentist you have a duty to make reasonable adjustments to ensure that disabled people can access your services. This could involve the following: ramps, handrails, wide doors for wheelchairs, low reception counters, a disabled toilet and hearing loops. A disability access audit, carried out by a properly qualified surveyor, can assist you with advice on the steps that should be taken.
Tenure of premises
Consider whether you are going to buy the premises as a freeholder or lease it. If you are going to lease your premises it is crucial to secure a tenancy that protects this asset in the long term while providing the flexibility to expand, modify or move elsewhere if business needs change. The duration of a lease for commercial premises tends to be around 10 to 20 years. It is essential to take independent legal advice from a solicitor on the terms of the lease and any restrictions it may contain.
Consult with staff to seek their views on the proposed move. Their place of work will be defined in their employment contracts. So they may need to agree to a move. If they would encounter great difficulties in getting to or from the new premises they may be able to object.
Moving will be a costly process. Work out the cost and effect of your move on your cash-flow. You need to research any change to premises costs, building and equipment costs and staff costs. And factor in any potential changes to income from your patient base. You may also need to approach your bank or another lender to help with the costs.