Whether you've found a buyer to take over your practice, or you're considering closing a practice rather than selling it, commercial arrangements obviously will need to be made when the time comes to move on.
But there are also some important professional and ethical responsibilities that need taking care of before you can relax and enjoy your next adventure.
Commercial arrangements for practice sale or closure
It's wise to seek advice from a dental specialist solicitor to make sure your next steps are managed appropriately and the process is as efficient and stress free as possible.
We recommend you seek advice from an accountant about retiring and submitting final accounts and returns to HMRC.
Some of the key issues, including information about due diligence, sale and purchase agreements, and staffing considerations, are covered in a previous DDU article by Faisal Dhalla of Hempsons' national corporate commercial dental team.
Communicating your plans to all stakeholders is a necessary task that requires careful management. Staff and patients may be very disappointed to see you moving on, particularly if your departure might mean there is some impact on their employment status or change to the service.
- Ensure staff are among the first to know about your plans.
- If you have any NHS general dental services involvement you'll also need to inform the relevant NHS team, and agree a date for your departure from the practice/removal from the NHS performer's list.
- You should notify the body responsible for monitoring and inspecting the health and social care services that you cease to be a registered provider (Care Quality Commission, Health Inspectorate for Wales/Scotland or the RQIA).
- The Health and Safety Executive may need to be told in respect of the practice's registration to use ionising radiation (IRR 2017).
- Don't forget that any patient group directive you have set up may need revising if practice ownership is changing.
- Notify colleagues, particularly if you have historically accepted referrals from them.
- You may have social media accounts linked to your business that will need updating, suspending or closing.
- Staff in a patient-facing role should know what information has been provided to patients and have been trained to give accurate and consistent advice to patients.
Continuity of care for patients
It's worth keeping in mind that as well as any contractual obligations, the GDC would expect registrants who leave a practice to behave in a professional way and to ensure that patients are not disadvantaged.
It is advisable to inform patients in writing of the practice sale or closure, so they have sufficient time to complete any necessary treatment and are fully informed about future arrangements for the continuity of their dental care and understand how they can access copies of their dental records if necessary.
If you are selling your practice, we suggest you seek to agree a plan with the purchaser for communicating details of the sale and the arrangements for ongoing care to your patients, and to introduce your successor.
When a practice is sold, the new owner has an obligation to operate a complaints procedure - but only you can respond in detail about care you have personally provided, and it is in your best interests to do so. We advise that you keep the new owner updated with your contact details and make sure you are notified if a complaint or claim arises about your treatment after you retire.
DDU indemnity is occurrence based, so you can seek our assistance in the usual way if you were a member at the time of the incident.
In 2018 the UK General Data Protection Regulations came into force along with a revised Data Protection Act. Under the 2018 Regulations, if you are a practice owner you are likely to be a registered with the Information Commissioner's Office (ICO) as a data controller.
Data controllers must comply with the UK GDPR and are responsible for the data collected, including secure storage, controlling access and retention and disposal procedures.
If dental records are being transferred to a new owner of a practice, the new owner must register as data controller with the ICO.
If you are closing the business without a sale, you will be required to remain registered as the data controller for the practice records that remain under your control.
If you are relinquishing control of the data held at a practice you are selling, you should instruct your solicitors handling the sale to ensure that any sale agreement incorporates a clause about safe and confidential storage and retention of your records. This should also allow you reasonable access to records you might rely upon in the event of a claim or complaint arising.
If you remain responsible as the data controller, you should ensure records are securely stored for the appropriate period, either on your own premises, or by engaging a commercial confidential records archiving facility.
The Records Management Code of Practice published 5 August 2021 sets out how to manage records correctly. The code contains detailed retention schedules which set out the minimum periods records should be retained for.
- In general dental services, adult records should be retained for a period of 15 years after the patient was discharged or last seen. (Based on Limitations Act 1980. This applies to all dental care settings and the BSA. This also includes FP17 or FP17O forms.)
- For children, dental records should be retained for ten years after the date of the last entry until the child reaches their 25th birthday - or if the child was 17 at the conclusion of their treatment, until their 26th birthday, whichever is longer.
Although the General Data Protection Regulation 2018 (GDPR) stipulates that data should not be retained for longer than necessary, it's worth noting that complaints and claims can arise many years after the treatment in question.
Without the records, you might have trouble in adequately responding if your standard of care is called into question. Our advice would therefore be that all records should ideally be retained indefinitely, as they can then be relied upon if a complaint or claim arises.
We recommend checking if records might be needed for treatment reasons, dento-legal purposes or forensic identification before disposing of them.
Retention periods can legitimately be extended beyond the minimum periods where a well-reasoned case for doing so is made. Ultimately, the data controller is responsible for the data held and should have a protocol for records retention with justifiable rationale. Both the retention protocol and the data that is held should be reviewed regularly.
Communicating your plans to all stakeholders is a necessary task that requires careful management.
Disposing of records
When the time comes to dispose of the records, this should be done in a way that protects patient confidentiality, and in accordance with national and local waste disposal requirements.
If outsourcing the destruction of records, you should use a licensed confidential waste disposal company and have a suitable written agreement with them that acknowledges their confidential nature and confirms they will take all reasonable steps to protect that confidentiality.
Don't forget that study casts are classified as gypsum-based clinical waste, and must be handled and stored appropriately and disposed of in accordance with Environmental Permitting Regulations 2010.
We recommend that you talk to an IT professional to ensure that electronic patient records are destroyed appropriately.
Indemnity and registration arrangements post-retirement
If you are stopping dentistry altogether, there is no need for you to retain your name on the dentists register. You may wish to voluntarily remove yourself from the register or decide to simply not renew your registration at the year's end.
However, it is important to realise that in either case, you would have to go through the reapplication process in order to be restored if you wanted to register again in the future. This involves a restoration fee as well as the annual retention fee, submitting evidence of good health and character, and compliance with the GDC's recertification CPD requirements.
Similarly, if you cease to be included in any NHS Performers List and then later decide you wish to practice in the NHS GDS in some capacity, you would need to reapply and satisfy the requirements for inclusion.
If you have decided to work as an associate after the sale or closure, you may want to take advantage of the DDU's associate contract checking service, which can offer impartial practical advice on the application of associate contracts.
When you retire altogether from any involvement in clinical dentistry or involvement in a dental practice, let us know and you will be transferred to free retired membership. You will still have full access to our website, app and journals, and you will still have access to the benefits of membership for Good Samaritan acts.
Whatever your plans, it is important that you adjust your DDU membership to reflect your changing circumstances. You can contact our membership team, either by email or on 0800 085 0614, quoting your membership number.