Authors: Shaun Smith and Simon Nocton, Partners at The Dental Surgery
Shaun Smith graduated from Otago (New Zealand) in 1983 and joined The Dental Surgery in 1989. With extensive experience and post-graduate education in most areas of dentistry, his special areas of interest are the management of complicated restorative cases, stress-related dental problems and difficult cosmetic cases.
Simon Nocton qualified in 1987 and received the fellowship of Dental Implantology in 1992. He previously combined teaching at Guy’s Dental Hospital and private practice, but now maintains one of the leading implant referral practices in the UK and lectures nationally and internationally on all aspects of implant dentistry.
How We Did It Article
We have always believed in striving to be the best that we can, for us, for the patients and for the whole team. This requires us to continually invest in education, technology and staff training. In 1989 The Dental Surgery was a run down two-man NHS practice, today it is “possibly the best practice in the UK” with 14 surgeries, 30,000 private patients, and 200+ new patients a month! This growth was achieved without a marketing campaign, with the exception of one of the first dental websites, www.thedentalsurgery.co.uk (1997). We think the numbers prove that our approach is right, which is to treat people with respect and dignity, treating them with the best of ethics and morals, whilst communicating the need, implications and costs of the treatment transparently.
Back in 1998 The Dental Surgery was located in Plantation House, a landmark City building, and the owners British Land plc decided to redevelop the site (Plantation Place). This gave us an opportunity to relocate and redevelop and, after a lengthy process of viewing and negotiations, we decided to relocate to the Corn Exchange.
The Corn Exchange is a very special building; it has been the backdrop for countless films, television programmes and music videos. The Gwyneth Paltrow film Sliding Doors, for example, was filmed here and the glass elevators that lead to our surgery were used in one of the major scenes. It’s an iconic building; a special, unique place, unlike other sites it had parking inside and outside the building, which is ideal for the patients who have more sophisticated dentistry.
We actually decided to remodel and renovate The Dental Surgery four years ago, when the space next to our Corn Exchange offices became available. We had outgrown our offices as they were. We both felt we could and needed to improve on what we had, again for us, for the team and for the patient journey. The space next door was ideal for us as it had good lighting and, being adjacent, we thought it would marry easily into our existing space.
Then followed four very frustrating years of negotiations with our landlords – and many thousands of pounds – to successfully gain a lease for the new space. The landlords were incredibly difficult and didn’t appreciate that the only person who the space was of any interest to was us. They also ignored the fact that the biggest recession for 80 years was in full flow! We are incredibly grateful to our main negotiator Colin Hargreaves and our lawyers Rochman Landau for the deal that was finally struck.
Once we finally resolved terms, which eventually worked out very favourably for us, we were able to commence the planning and design stage of the process.
The big issues when you’re in a City building revolve around landlords and consent, which aren’t particularly difficult to organise but they can be frustratingly slow to resolve. In our case, it took about six to eight weeks to obtain authorisation. We surrendered our existing lease in April 2011 and took a new 15-year lease on the combined space.
The building work started in June 2011 and was effectively completed in January 2012. We benefited from having a very familiar team to work with – we’ve known Mark Wheatstone and Darren Hare of The Dental Directory for 20 years. They’ve helped us with four major projects in that time, including the build and fit-out of seven surgeries in 1991 in Plantation House and the initial 11-surgery build when we first moved to the Corn Exchange in 1998. During this time we’ve all developed both personally and professionally and, in a sense, grown up together. This brings an understanding and trust with mutual respect that would be impossible to put a value on. Also, the rest of the 1998 team were on board: Robert Bird, the design and project manager, and Clive Thomas and his team at Oakleys, who were the builders.
The look and feel of the new practice evolved over time and was very much a team effort, as indeed everything is here. In particular, our Practice Manager Bridget McGrade was heavily involved in the whole process and we’re very grateful for her dedication and hard work in making it happen as smoothly as it did. Andrew Robinson at Mindcorp, our marketing and PR company, also had considerable input on the new style and branding.
More than anything, we did not want the premises to look like ‘a dental surgery’, so we introduced beautiful thick, curved marble walls in the reception area and waiting room. Smooth on one side, and textured on the other. The ‘leaves’ theme continues throughout the practice, including our new stationery. As for the colour scheme, there’s a nice contrast between the earthy, neutral shades in the main areas and the blue theme that we’ve introduced in the dentists’ and hygienists’ rooms.
We’ve also updated the staff uniforms. Before, we had green for the dentists and mauve for the hygienists. Now, we’re all wearing the same blue coloured uniforms so there’s no demarcation between staff members, emphasising that we’re all part of the same team.
As previously mentioned, our first project at the Corn Exchange was a completely new build – it was literally an office space with no walls – whereas this time we were looking at a refurbishment, but that is actually more difficult to do. We were integrating a lot of new space, but we still had to work within the constraints of what was already there. Plus, we wanted to do it all properly – not just glossy fronts for the patients, we wanted it to look right ‘behind the scenes’ as well.
As we saw it, the difficulty was twofold. Firstly, marrying the old and the new together seamlessly and, secondly, how to keep functioning as a dental practice during the project. We addressed the first point by redoing the whole of the existing premises and, through strict organisation and the support of our wonderful patients, successfully managed the second point: we didn’t close down for a single day.
We really do have the nicest patients in the world; they took a genuine interest in what we were trying to achieve and it made the transition so much easier. We set up a temporary waiting room in what is now our administration area and we’ve had nothing but positive feedback from our patients about the new-look practice.
A major criticism we had of our old operation was that everyone had to enter and exit the practice through the same door. Added to this, the reception area and waiting room were in very close proximity. As a result, it could get very busy, sometimes seeming like grand central station. Patients were able to hear conversations about financial matters and treatment issues as they sat in the waiting area– absolutely not the ‘first impression’ we wanted to achieve.
The original layout had one long corridor which completely divided the dental surgeries and hygienists’ areas – literally splitting the team – and was one of the priority areas to rectify.
Now, we have a much better flow where patients come in, are welcomed at reception and they relax in the waiting area. We have a greeting team who can help with any queries and make sure that patients are comfortable and kept informed, telling them if the practitioner is running on time, for example. Patients are called, collected from the main meet and greet area by their dentist or hygienist and, upon completion of the appointment, delivered to the main administration area, where further appointments are made, monies collected and so on, in a more private area.
We’ve added a separate door for our team members to access the new staff room, which means they can go on their break or exit the practice without passing through the waiting room or reception. Their coats and bags are there, so patients aren’t disturbed by any bustle, or see the team without their uniform on, allowing us to maintain a very professional image at all times.
The refurbishment enabled us to gain three extra surgeries taking us up to 14; all of which had to be visually high impact and aesthetic as well as functional and compliant with industry regulations. Each surgery also has the latest equipment, such as remote controlled cameras, as well as strips of blue lighting that not only fits the new theme but also gives a feeling of daylight.
We have a separate room dedicated to our state-of-the-art CT scanner and we’re very proud of our new central sterilising and disinfecting area, which is potentially one of the best in the country. It’s all about getting the staff and the systems right.
There were relatively few companies involved
in the project and that suited us very well. We dealt with the financial side ourselves and the rest of it just flowed because we’ve established such good working relationships with our contacts.
Our accountants and lawyers advised us to borrow part of the funding because the interest rates have been so low for so long. It was the first time we’ve borrowed money and our bank was delighted. The overall cost was around a million pounds and the bank loan funded half of that.
We quickly adapted to our new surroundings. There was no need to change any systems or structures, apart from taking on new members of staff. We appointed a new receptionist, two more members of the central sterilising area, a hygienist and a half dentist (three additional days of dentistry).
Looking back at the project, although we are very pleased with the outcome, there are a few things we would do differently. Closer monitoring of the cost and timeline, for example, to reduce surprises and frustrations, and managing expectations – we thought it’d be quicker to accomplish.
Overall, however, we’re incredibly proud of our staff and their behaviour, attitude and response both during the project and afterwards. We’ve seen them grow dramatically, getting involved and taking ownership and we can tell how much they want the practice to grow, improve and succeed. Some of the team members have been here for 20 years and they still managed to surprise and impress us.
We have worked together at The Dental Surgery for 20 years and we both aspire to be the very best in our profession. We have shared ethics and morals, which we hold as very sacred and have been lucky enough build a team around us that share these qualities. Currently, we not only have a team of 40 staff that we’re very proud of, but also a physical practice that has no peers. In fact, it has been suggested by someone in the profession that ours is probably the best practice in the UK.
The Dental Surgery is our legacy. However, the journey is not yet finished. We continually want to develop for ourselves, for the team and especially for our amazing patients.