To understand more about the impact of COVID-19 on our clients and the local Brighton community, we have decided to ask them some questions.
This time, we spoke to Christina Chatfield, an award-winning Hygienist at Dental Health Spa in Brighton & Hove. Dental Health Spa is a local independent Dental Practice offering a wide range of Dental Treatments. They have been named as previous winners of the Brighton & Hove Business Awards for Best Customer Service. They were the very first practice to offer walk-in hygiene appointments, since opening on Brighton high street in 2007. Since then, they have gone on to provide work for 16 team members and they have successfully trained 8 Dental Nurses via their apprentice scheme.
- When did COVID-19 affect your business and was it immediate or gradual?
We were affected by Covid-19 when Brighton reported some of the first cases of the deadly virus in Great Britain and this led to some of the local schools being closed. This is when we first started to see cancellations as people were weary of travelling into Brighton from February this year. Then in March, due to the rapid spread of Covid-19, we saw a drastic reduction in patient numbers. This is when we started to send out reminders to advise patients that if they were showing symptoms of Covid-19 that they should not come into the practice.
We were then forced to close due to the Government guidelines introduced on 26 March, which resulted in an immediate and drastic impact, as we could no longer treat patients.
Forced closure meant a loss of revenue overnight as we cannot sell online like letting agents and estate agents.
- How did you communicate this impact with your team and clients?
We had to quickly communicate this to our team and patients and we held a staff briefing explaining that we were forced to close as we had been advised the following;
The Chief Dental Officers (CDOs) have issued further COVID-19 letters which end all routine care, and most or all urgent care, in general dental practices throughout the UK. A financial support package for NHS practices in England has also been announced.
The key new points were:
- Cease ALL routine dental care (including orthodontics) (UK-wide)
- Cease ALL aerosol generating procedures (UK-wide)
- Offer patients with urgent needs appropriate advice and prescriptions over the phone (UK-wide)
- Cease ALL face-to-face urgent care (England, Scotland)
- Update practices’ messaging and websites
- Stop all community outreach activities
We sent an email or letter out all of our patients advising that we had to close and that if they needed advice they could email or call us and we would update them as we knew more. We were, therefore, forced into rescheduling any booked appointments for future dates or to cancel them.
Our website and social media platforms were updated to advise of the closure too.
- What decisions have you had to take in respect of your business?
In respect of our business, we had to furlough our team of 4 Dental Nurses, 2 receptionists, 2 admin staff and we had to lay off our 2 Self-Employed Dentists, as well as 4 Self Employed Hygienists and 1 Self Employed Manager. With the business closed, we then had to try to fight for help from the Government.
Dental Health Spa is not a failing business but cash flow is king, we had recently borrowed money for a £30,000 Digital scanner which I cancelled (but kept the amount borrowed) a week ahead of the country going into total lockdown. That vital cash has allowed me to pay my furloughed staff and bills but once it is gone, I fear so will we and Brighton will lose a strong independent public service on the high street.
- Have you accessed or will you be accessing any of the Government support schemes and grants?
Private Practices like us here at Dental Health Spa are not able to receive any funding, unlike the NHS Practices. Our rates are too high, at £42,000, to receive the Small Business Grant and dental has been excluded from the Rates Relief and therefore there is no Retail Grant. Our Rateable Value describes us as shop front, the rates are extremely high as they class us as retail, not the lower rate for dental. Our predicament is compounded because we are paying retail rates. As a dental business, we have been excluded from the Retail Rates Relief and £25,000 grant afforded to other businesses like hairdressing salons, beauty salons, estate agents, betting shops, nail salons, opticians, restaurants, pubs, and retail outlets. If our rates were under £15k we would have received £10k Grant but with retail rates of £42k and £475 per square meter, we pay at its highest compared to an average of £175 for dental. The Grant would allow us to purchase air purifying units to extract the aerosols and adequate PPE to get us up and running and cash flow.
All businesses need to be treated the same, dental businesses need the same Relief Rates & Grants as other businesses, such as the betting shops, hairdressers & tanning shops. We have a number of essential running costs as a business, such as, equipment & material costs, the dentist’s fee, the wage of assisting Nurses, rent, rates, bills, external Dental Technician rates & fees all while and running a reduced number of surgeries to adhere with social distancing.
I have previously taken my retail argument to the tribunal for true reassessment for the retail part of this business, I went from A1 to D1 in 2007, we have tried with the VO but that seems to be tied to the rental value rather than a change of use- I have been advised that this fight would take 1 to 2 years.
It is unjust and unfair that requirement for Dental Practices to continue paying business rates, despite a mammoth loss of their commercial incomes due to being unable to practice in light of the dangerously high transmission risks associated with COVID-19 and when they are allowed to open again, huge restrictions will be placed at increased PPE costs.
- Do you think the Government support goes far enough?
I do not think that the Government support goes far enough – especially not for the forgotten Private Dental and Hygiene Practices. I wrote to our Chancellor Rishi Sunak: this is an extract of the email I sent:
Support for the dental industry during the Covid-19 crisis
“These are unprecedented and challenging times for us all. I understand that you and your staff at the Treasury are working around the clock to provide economic certainty for a worried UK workforce, as we all pull together as a nation to protect healthcare and save lives.
I am afraid you have forgotten dental practices in your business rates holiday. NHS dental practices can get rebates and grants but private dentistry, making up more than half of the sector with approximately 5,500 practices get no help. Routine dental care has been closed down on Government advice (PHE and CDO). Therefore, as things stand, many dentists working exclusively or largely in the private sector have no means of earning, and can expect no protection from the state. They have mostly been trained at great public expense but are now in danger of losing their livelihoods through Government action.
All the shops in my street do not pay rates and are eligible for grants; the pub, beauty salon, restaurants, coffee shops, hotel, gym and theatre. This really highlights the disparity, despite all being in the same situation.
The impact on the oral health of the nation would be catastrophic if private practice were to disappear. That has to be a real possibility if no support is offered through this health and financial crisis. Either allow us to open to treat carefully triaged emergency cases (taking the pressure off the NHS) using the appropriate PPE or keep us closed and exempt us from business rates.”
- What effect will this pandemic have on your business in the long term?
The effect this Covid-19 pandemic will have on our business long term is one of rebuilding and trying to recoup our lost months of revenue. It’s going to be a struggle and especially if the current social distancing and PPE restrictions are going to be on-going for many months, this could be catastrophic. If we do not receive the same support from the Government as other businesses it is possible that many healthcare services like dental including us will not be able to survive and will be lost when cash flow runs out. My team need a job to come back to and our patients need access to care.
The only reason I am still here is because in February I borrowed £50k from our bank to pay off our overdraft and buy a 3D digital scanner, which I cancelled 6 days before lockdown- it is that money that has allowed me to pay my rent, April rates and my staff until their furlough came in and my fixed costs etc. Once that is gone, I have 6 weeks left at most. We were not failing business and after 13 years of fighting for our place to be here it’s unjust for us to lose it now.
- Do you have a crisis management plan now in place?
We have a crisis management plan that is in place, but without a specific return date or Government information on new PPE measures to be able to treat patients it is very difficult to establish an exact plan to execute.
We like other healthcare professionals need adequate PPE and as this is extremely difficult to get hold of, we are unable to order any supplies at present.
We are also awaiting any new guidelines on Infection Control and how we can treat patients in a safe environment with the now added pressures of Covid-19.
- What decisions are being made now for when you are able to get back up and running?
We are having weekly Management meetings via Zoom to make decisions on how we can get back up and running and during these assessing any new guidelines or information.
Plan for reopening
- reopening with extended hours, longer down time in between patients
- alternating the use of our 4 surgeries
- training the team on new regulations
- our team will be medically checked to ensure they are fit to work and if not then we will follow isolation guidelines
- a medical check for any patients attending an appointment ensuring they are not presenting any symptoms associated with Covid-19– this may include checking their temperature
- some staff will be on reduced hours
- deep cleaning, removing any fabric furniture and replacing with washable chairs in our waiting area
- limiting the number of staff and patients in the practice at any one time following social distancing regulations of 2 meters
- we have a portal check-in that allows patients to fill out their Medical History forms and updated details at home
- Patients can check-in via a portal with their own mobile phone or tablet.
- not taking cash and contactless payments where we can
- we are reviewing our PPE and awaiting advice on the best solution to keep our team and patients safe.
- Air filtration units
- How do you think the business landscape will change in Brighton?
I think that sadly, the business landscape in Brighton will change – not for the better: we will see many of our independent businesses on the Brighton high street closed due to the impact of the Covid-19 crisis.
Some of the larger stores will vanish from our town too, independent health care and our vibrant restaurant and pub scene will be dramatically reduced due to the impact of the extended and financial pressures. We are well known for our wonderful independent and vibrant shopping areas such as the Lanes and North Laines, however they will not be as they once were as there will be many independents that will sadly close down forever. Additionally, more people will work from home and this means that less people will be in town shopping, purchasing food and drink and using public transport.
Brighton is a tourist hotspot and with so much to offer in our glorious City I am sure that the tourism will bounce back and many business will come through this stronger, sadly though not all.
- What tips can you give other businesses currently going through the crisis?
- Keep active with your client base, let them know of any updates and offer any help where you can in terms of support.
- Plan for a reopening and be prepared with a plan to include any Covid-19 prevention measures.
- Use social platforms to remain active
- Be quick thinking and be prepared to adapt to change
- Information share with other local business and help each other where you can
- If you can offer physical support, put together a list of local support networks and share this with your clients to let them know you are here for them in these uncertain times. If you are able to get funding then use this to help you get back to business.
- Invest in your team, utilise this time of closure to retrain if they are not furloughed
- Keep in touch with your team offer advice and help if any are suffering with mental health issues due to the current situation
- You are not alone, reach out for help and support from your local network
- Finally… Good Luck and Positivity… goes a long way when the chips are down! Fight for your business you have worked hard to build.
Author; Christina Chatfield @ Dental Health Spa
T: 01273 710831
Date Published: 12 May 2020