Dental Earnings and Expenses, Great Britain, 2005/06 September 2007 Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. Dental Earnings and Expenses, GB, 2005/06 Contents Summary ........................................................................................................2 Table 1: Summary of the various dental business arrangements which are studied in this report. ..........................................................................3 Table 2: Summary of population and sample changes between 2004/05 and 2005/06, GB1. ....................................................................................5 Figure 1: Change in composition of the GDS/ PDS dental population between 2004/05 and 2005/06, GB. .........................................................6 Summary of net income estimates for all GDS dentists.............................7 Table 3: Comparison of GDS dentist net income by contract type, 2005/06, GB..............................................................................................7 GDS Non-associate dentists .........................................................................8 Table 4: 2005/06 main results: GDS non-associates, GB.........................9 Table 5: Comparison of expenses to earnings ratios (%) for GDS nonassociates between 1999/00 and 2005/06 by sex, age, partnership status and location, GB. ....................................................................................10 Table 6: Gross earnings, expenses and net income for non-associates, GB, 1999/2000 to 2005/06......................................................................10 Table 7: NHS earnings as a % of total earnings1, GB.............................11 NHS Commitment Analysis for GDS non-associates .................................13 Figure 2: Distribution GDS of non-associate dentists by level of NHS commitment, 2005/06 and 2004/05, GB. ................................................14 Table 8: NHS commitment summary, 2005/06, GB ................................14 Figure 3: GDS non-associate average gross earnings by level of NHS commitment 2004/05 and 2005/06, GB ..................................................15 Detailed Expenses Breakdown for GDS non associates............................16 Table 9: Average expenses breakdown, GDS non-associates, 2005/06, GB ..........................................................................................................16 Table 10: Average expenses breakdown, GDS non-associates, GB, 2001/02, 2003/04, 2004/05 and 2005/06 ................................................17 Table 11: Average expenses breakdown, GDS non-associates, 2005/06, by NHS commitment ...............................................................................18 GDS Associate dentists ..............................................................................19 Table 12: 2005/06 main results: GDS first party associates, GB ............19 Table 13: 2005/06 main results: GDS second party associates, GB ......20 Detailed Expenses Breakdown for GDS associates...................................21 Table 14: Average expenses breakdown, GDS first party associates, 2005/06, GB............................................................................................21 Table 15: Average expenses breakdown, second party associates, 2005/06, GB............................................................................................22 PDS Whole-Year dentists ............................................................................23 Figure 4: Distribution of EER among the PDS Whole-Year population...24 Table 16: Main results for PDS Whole-year Providers, GB.....................24 Table 17: Main results for PDS Whole-year Performers, GB. .................24 PDS Switched dentists ................................................................................25 Table 18: Main results for PDS Switched dentists, GB. ..........................25 Appendix: Methodology ..............................................................................26 Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 2 Summary This report provides a detailed study of the earnings and expenses of General Dental Service (GDS) and Personal Dental Services (PDS) dentists in Great Britain and is based on tax data for dentists with an accounting year ending in 2005/06. All averages in the report relate to both full- and part-time dentists with varying levels of earnings from the NHS. The earnings and expenses relate to NHS and private work. This report has been produced by the Information Centre for health and social care (IC). A joint working group with representation from the IC, the Department of Health (DH), the British Dental Association (BDA), the Doctors’ and Dentists’ Review Body (DDRB) secretariat and the NHS Business Services Authority Dental Services Division (DSD) was consulted on the content of the report. Changes from year to year are affected by estimates from samples of dentists and by changes in the composition of the workforce, including the shift to PDS 1 , in 2005/06. This is the first time that earnings results for PDS dentists have been published. It is not meaningful to discuss the average earnings of an average dentist as there is great variation in the different financial arrangements. However, the key findings among GB dentists in 2005/06 are: • Average net income among all GDS dentists was highest for first party associates (practice owners who work with other dentists who are not partners) at £114,068, with non-associates (dentists working in a standalone business) earning £94,639 and second party associates (dentists who rent the facilities of a first party associate) earning £61,125. • For GDS non-associates, the average Expenses to Earnings Ratio 2 (EER) was 57.8%; for GDS first party associates the EER was 67.8%; and for GDS second party associates the EER was 33.4%. • For GDS non-associates, earnings from the NHS accounted for, on average, 41.9% of total earnings from all sources. For those GDS nonassociates with a high NHS commitment (ratio of NHS earnings to total earnings between 67% and 100%), the average EER was 49.6% whereas those GDS non-associates with a low NHS commitment (ratio of NHS earnings to total earnings up to 33%) had an average EER of 62.8%. • For PDS Providers3 (dentists who hold a PDS contract with a PCT), average net income was £127,910 with an average EER of 59.5%. For PDS Performers (dentists who are not Providers but who work to deliver the requirements of a PDS contract), average net income was £65,852, with an average EER of 13.0%. 1 The proportion of dentists working in PDS was 23% at the end of 2004/05 and 37% at the end of 2005/06 The EER is a measure of how much of an individual’s gross earnings were consumed by business expenses. 3 An attempt to distinguish groupings has been carried out by the IC and the methodology is detailed in the Appendix. 2 Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 3 Introduction 1.1. This paper presents evidence on the self-employed earnings and expenses of General Dental Services (GDS) and Personal Dental Services (PDS) dentists in tax year 2005/06. The source for the data is the self assessment (SA) return held on HM Revenue and Customs (HMRC) SA system, which covers earnings from all self-employed sources including the GDS/PDS contract, private practice, and any other sources. Analyses were carried out on an anonymised dataset by HMRC statisticians; only aggregated data were supplied to the IC. 1.2. Dentists for the GDS analyses in this report were chosen from the Dental Rates Study Group (DRSG) in 2005/06 (as at 28 February 2006) whereas the whole population of PDS dentists (including dentists working for corporate bodies) were included for the PDS analyses (see appendix for further details). 1.3. Table 1 below shows the various business arrangements in which selfemployed dentists can work in Great Britain, all of which are discussed further in the rest of this report. Table 1: Summary of the various dental business arrangements which are studied in this report. GDS/PDS Type Description GDS: Non-associate Works in a stand-alone business and includes dentists working in business partnerships. GDS: First party associate Practice owners working with other dentists who are not partners. GDS: Second party associate Rents the facilities of a first party associate. GDS: Partners of associates In a business partnership with an associate dentist. PDS: Whole-year Known to have worked under a PDS contract for the whole year of the study PDS: Switcher Known to have moved from working in the GDS to working under a PDS contract at some point during the financial year. Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 4 1.4. Prior to 2004/05, this report has provided analyses on GDS nonassociate dentists only. During this period, when all dentists were GDS, the expenses to earnings ratio for all GDS dentists was inferred from the non-associate results. This was based on the fact that, historically, the results for non-associates were broadly similar to the overall results covering all GDS dentists. 1.5. For GDS non-associate dentists, time series results are presented up to and including the financial year 2005/06. GDS non-associates are dentists who do not have formal business links with other dentists. PDS ‘Whole Year’ dentists were in the PDS for the entire 2005/06 tax year while PDS ‘Switchers’ moved from GDS to PDS at some point during that tax year. Given the changing populations of GDS and PDS dentists, all the time series presented should be treated with caution. 1.6. The IC is publishing information on PDS earnings for the first time by expanding the population to cover PDS dentists and those GDS dentists that switched to PDS in 2005/06. Last year, the Information Centre (IC) decided not to publish PDS results pertaining to the 2004/05 tax year due to concerns that the final sample of PDS dentists was too small. The main reasons were as follows: • Only a small number of dentists were working in PDS before the start of 2004/05, making estimates vulnerable to extreme values; • Information on PDS dentists’ contract status (whether working as a provider or a performer 3 ) or type of PDS scheme was unavailable; and • Where dentists switched to a PDS contract in 2004/05, their NHS earnings were from a mixture of GDS and PDS sources. Such dentists that had an accounting year that ended prior to quarter 4 will have worked in GDS for the whole year. Analysis of this cohort of dentists was therefore not considered to be meaningful. 1.7. Table 2 below shows the relative populations of each type of dentist, along with the size of the sample that was actually studied for the dental earnings reports of 2004/05 and 2005/06 produced by the IC. The population data is also shown graphically in Figure 1. 3 “PDS Providers” are providers of premises and facilities to Performers. In most cases, in 2004/05, Providers received direct payments from the PCT and, in turn, pay the Performers. Providers can have a number of arrangements with Performers. The IC identified “Providers” by assuming they are dentists with an EER greater than 0.3 and less than 0.9 “PDS Performers” work at the practice of the Provider in return for a share of the PCT payment received by the Provider. The IC identifies “Performers” as dentists having EER less than 0.3 Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 5 Table 2: Summary of population and sample changes between 2004/05 and 2005/06, GB1. 2004/05 Population 1 2005/06 Final HMRC Sample Population Final HMRC Sample GDS Non-Associates GDS First Party Associates GDS Second Party Associates GDS Partners of Associates 4,610 3,590 5,109 548 2,322 1,747 2,400 273 3,725 3,318 4,751 377 1,739 1,553 2,176 184 PDS Switchers 2,847 1,799 3,299 1,543 PDS Whole Year 1,030 341 3,746 2,198 All Dentists: 17,734 Note that this does not fully cover all dentists in Great Britain. 8,882 19,216 9,393 1.8. Table 2 shows that changes in the population in 2005/06 may affect the comparisons that are made between results for 2004/05 and 2005/06. 1.9. Furthermore, the General Dental Services Payment Report 2005/06, published by the Information Centre in September 2006, showed that in 2004/05, dentists who moved from GDS to PDS were more “committed” to the NHS, meaning that they “left behind” a GDS nonassociate population with a lower commitment to NHS work. It is possible that such migration may have occurred again, affecting the validity of any comparison between the level of NHS earnings done in 2004/05 and 2005/06. 1.10. Further to this, Figure 1 below shows graphically the data in Table 2, highlighting the migration to PDS contracts that has occurred between 2004/05 and 2005/06, as well as the reduction in the GDS nonassociate population – on whom NHS earnings analysis is based. Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 6 Figure 1: Change in composition of the GDS/ PDS dental population between 2004/05 and 2005/06, GB. 100% PDS w hole year, 1,030 PDS w hole year, 3,746 90% PDS sw itchers, 2,847 80% GDS Partners of assoc* PDS sw itchers, 3,299 % of total dentists (GB) 70% 60% GDS 2nd party associates, 5,109 GDS 2nd party associates, 4,751 50% 40% GDS Partners of assoc* GDS 1st party associates, 3,590 30% GDS 1st party associates, 3,318 20% GDS non-associates , 4,610 10% GDS non-associates , 3,725 0% 2004/05 2005/06 * GDS Partners of Associates 548 in 2004/05 and 377 in 22005/06. Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 7 Summary of net income estimates for all GDS dentists 2.1. A national gross earnings and expenses estimate for all GDS dentists together cannot be calculated due to the payment flows that occur between first and second party associates. This is likely to lead to double counting of some payments meaning that combined expenses ratios cannot be derived. It is possible, however, to calculate combined average net income results. 2.2. Table 3 provides a summary of the net income for all associate types. When comparing the earnings of the different associate types it is important to note that variation in the age and sex profiles of each group will affect results. This is particularly the case for the second party associate population which has a much higher proportion of females and a younger age profile than the other associate types. 2.3. Table 3 shows that, for GDS dentists, average net income was highest for first party associates and partners of associates (£114,068 and £104,908 respectively), with non-associates earning the next highest (£94,639) and second party associates earning the least (£61,125). Table 3: Comparison of GDS dentist net income by contract type, 2005/06, GB. GDS first party GDS second GDS partners of All GDS associates party associates associates associates GDS Nonassociates All GDS Dentists Population size Sample size 3,318 1,553 4,751 2,176 377 184 8,446 3,913 3,725 1,739 12,171 5,652 All dentists (GB) £114,068 £61,125 £104,908 £83,877 £94,639 £87,172 Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 8 GDS Non-associate dentists 3.1. This section updates the earnings and expenses analyses carried out annually on non-associate dentists. Non-associates are dentists who do not have formal business links with other dentists; that is, involving transfers of gross fee payments between two or more dentists with formal associate arrangements for meeting expenses costs. These dentists are mostly single-handed practitioners; although a small proportion (around 5%) are in partnership arrangements. 3.2. Time series results for GDS non-associates are influenced by the changing population and the migration from GDS to PDS. In 2004/05, the final HMRC sample of GDS non-associates made up only 13% of all known dentists. In 2005/06, the corresponding cohort had shrunk to represent only 9% of all dentists. This means that it is not correct to assume that the results for non-associates in 2005/06 are indicative of the dentist population as a whole. In particular, the General Dental Services Payments Report 2004/05 (published by the IC in September 2006) showed that in 2004/05, dentists who moved from GDS to PDS were more “committed” to the NHS, meaning that they “left behind” a GDS non-associate population with a lower commitment to NHS work. It is possible that such migration may have occurred again; therefore a comparison of the proportion of NHS earnings over time should be viewed with this in mind. 3.3. The following tables show the headline findings for GDS nonassociates: Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 9 Men 1 2 Single-handed Table 4: 2005/06 main results: GDS non-associates, GB. London Rest of GB In partnership All men Women 4 Single-handed 3 Age <44 45+ < 35 35-44 45-54 55+ All ages DRSG Effective population returns 146 41 215 99 172 50 705 335 977 515 579 311 132 55 2,926 1,406 Average gross earnings £318,886 £205,687 £287,557 £258,209 £227,707 £199,722 £165,334 £233,143 Average expenses £218,228 £113,773 £188,371 £150,400 £125,743 £110,536 £80,665 £134,047 Average net income £100,658 £91,914 £99,186 £107,809 £101,964 £89,186 £84,668 £99,096 Expenses to earnings ratio (%) 68.4% 55.3% 65.5% 58.2% 55.2% 55.3% 48.8% 57.5% London All ages 117 36 £209,106 £132,466 £76,640 63.3% Rest of GB <44 45+ 345 279 125 142 £198,737 £114,992 £184,239 £109,886 £83,746 £74,353 57.9% 59.6% All ages 58 799 30 333 £135,783 £67,223 £190,613 £112,292 £68,560 £78,321 49.5% 58.9% 3,725 1,739 £224,019 £129,380 £94,639 57.8% In partnership All women All non-associate dentists Notes: 1. In ‘London’ refers to dentists registered within the London Government Office Region (GOR). “Rest of GB” refers to those outside the London GOR 2. Due to small numbers in detailed age groups, estimates of EER are unreliable therefore data was compiled for wider age groups. 3. 85 partners have been excluded from the regional and age group analysis due to a regional and age split for partners being unavailable. 4. 36 female dentists from the London GOR were excluded from the age group analysis due to full age breakdowns for this group being unavailable. Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 10 Table 5: Comparison of expenses to earnings ratios (%) for GDS nonassociates between 1999/00 and 2005/06 by sex, age, partnership status and location, GB. All non-associate dentists (GB) Men 7 Women Aged under 35 2 Aged 35-44 3 Aged 45-54 4 Aged 55 and over 5 Aged 44 and under Aged 45 and over 1 2002/03 2003/04 56.6% 55.6% 1999/00 55.4% 2000/01 55.9% 2001/02 56.8% 55.3% 55.8% 56.7% 56.4% 55.6% 56.6% 57.4% 58.0% 57.7% 58.5% 61.2% 55.9% 56.2% 57.0% 55.4% 55.8% 53.6% 54.5% 2004/05 58.3% 2005/06 57.8% 55.6% 57.8% 57.5% -0.5% 0.0% -0.3% 56.2% 60.4% 58.9% -1.4% 60.3% 56.1% 63.5% 65.5% 2.0% 57.1% 57.2% 59.7% 58.2% -1.4% 56.3% 56.7% 54.8% 56.4% 55.2% -1.2% 55.3% 54.9% 53.3% 56.2% 55.3% -0.8% 6 Partnerships 8 Single-handers London 9 Elsewhere in GB Percentage point change from 2004/05 to 2005/06 60.6% 55.8% 51.0% 55.7% 54.0% 56.1% 54.0% 57.0% 52.5% 56.9% 56.5% 55.6% 52.1% 58.6% 49.0% 58.1% -3.1% -0.5% 55.6% 55.3% 57.3% 55.4% 58.6% 56.1% 58.4% 56.0% 55.8% 55.6% 61.5% 58.1% 62.3% 57.4% 0.8% -0.8% Notes: 1. There were changes to the methodology between 2003/04 and 2004/05. Associate status data was validated and ‘Outliers’ were excluded (see methodology in appendix). 2. 2005/06: Based on 50 males not in London GOR. 3. 2005/06: Based on 335 males not in London GOR 4. 2005/06: Based on 515 males not in the London GOR 5. 2005/06: Based on 311 males not in London GOR 6. Due to small numbers in detailed age groups, estimates of EER are unreliable therefore data was compiled for wider age groups. 7. 2005/06: 36 female dentists from the London GOR were excluded from the age group analysis due to full age breakdowns for this group being unavailable. 8. 2005/06: 85 partners have been excluded from the regional and age group analysis due to a regional and age split for partners being unavailable. 9. The Thames Regional Health Authorities up to 2003/04; London GOR for 2004/05. Table 6: Gross earnings, expenses and net income for non-associates, GB, 1999/2000 to 2005/06 Average Gross Earnings Average Gross Expenses Average Net Income 1999/00 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 £143,230 £150,395 £162,902 £167,286 £174,415 £206,195 £224,019 £79,295 £84,064 £92,472 £94,734 £97,058 £120,215 £129,380 £63,935 £66,332 £70,429 £72,552 £77,357 £85,980 £94,639 Change, 2004/05 to 2005/06 8.6% 7.6% 10.1% Notes: 1. There were changes to the methodology between 2003/04 and 2004/05. Associate status data was validated and ‘Outliers’ were excluded (see methodology in appendix). Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 11 Table 7: NHS earnings as a % of total earnings1, GB 2003/04 2 2004/05 3 Percentage point change from 2004/05 to 2005/06 2005/06 1999/00 2000/01 2001/02 2002/03 All non-associate dentists (GB) 58.2% 57.4% 55.2% 55.7% 54.0% 47.6% 41.9% -5.7% Men Women 5 58.5% 56.2% 57.9% 54.9% 55.4% 54.1% 56.3% 52.9% 54.7% 50.7% 48.0% 45.8% 42.2% 40.8% -5.8% -5.0% Aged under 35 Aged 35-44 Aged 45-54 Aged 55 and over Aged 44 and under 4 Aged 45 and over 63.8% 57.6% 55.3% 60.3% 64.7% 57.3% 54.6% 58.0% 60.7% 56.2% 52.0% 54.8% 66.2% 54.6% 54.5% 53.2% 72.5% 52.1% 52.7% 54.6% 56.7% 45.3% 46.6% 48.5% 36.0% 40.0% 44.0% 47.4% 39.6% 44.1% -20.7% -5.3% -2.6% -1.1% London 7 Elsewhere in GB 46.6% 62.2% 45.4% 61.8% 42.1% 60.2% 47.7% 58.6% 46.7% 56.5% 43.9% 47.8% 37.9% 42.5% -6.0% -5.3% Single-handed In partnership 6 57.9% 62.7% 57.3% 59.3% 55.0% 56.7% 55.6% 58.0% 54.4% 47.3% 47.3% 53.7% 41.9% 43.1% -5.4% -10.6% Notes: 1. This is an approximation because the figures are for different time periods - GDS fee earnings cover the financial year, while the total gross earnings cover a 12-month period with accounting years ending at any time during the financial year 2. There were changes to the methodology between 2003/04 and 2004/05. Associate status data was validated and ‘Outliers’ were excluded (see methodology in appendix). Proportions in 2003/04 and 2004/05 include “other payments” (e.g. for maternity, sick pay, trainee grants, etc.). These account for approximately 0.4% of total NHS earnings. 3. 2005/06: ‘Aged under 35’ based on 52 males not in London GOR, ’Aged 35-44’ based on 351 males not in London GOR, ’Aged 45-54’ based on 531 males not in London GOR and ‘Aged 55 and over’ based on 320 males not in the London GOR. 4. Due to small numbers in detailed age groups, estimates of NHS earnings are unreliable therefore data was compiled for wider age groups. 5. 2005/06: 36 female dentists from the London GOR were excluded from the age group analysis due to full age breakdowns for this group being unavailable. 6. 2005/06: 85 partners have been excluded from the regional and age group analysis due to a regional and age split for partners being unavailable. 7. The Thames Regional Health Authorities up to 2003/04; London GOR for 2004/05. 3.4. The key findings are: • The expenses to earnings ratio was 57.8% in 2005/06, 0.5 percentage points lower than the ratio for 2004/05 (58.3%). This follows a rise of 2.7 percentage points between 2003/04 and 2004/05. It should be noted that the estimate of the ratio is subject to sampling error (the 95% confidence interval for the ratio is roughly ± 1 percentage points (actually 0.8% in 2005/06)); this will lead to some year on year volatility in the ratio estimates. As mentioned above, comparisons between years are also affected by the fact that the population has changed over time. • Table 6 shows average gross earnings rose by 8.6% between 2004/05 and 2005/06, with a comparable rise of 7.6% in average expenses. These were lower than the rises between 2003/04 and 2004/05 of 18.2% for gross earnings and 23.9% for average expenses. Average net earnings increased by 10.1% in the period to £94,639, a similar increase as in the previous period (11.1%). Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 12 • Average gross General Dental Service (GDS) NHS earnings in 2005/06 accounted for 41.9% of the total gross earnings reported for non-associates, compared with 47.6% in 2004/05 - this represents a fall of 5.7 percentage points. The measured changes are most pronounced for younger dentists, and can be attributed to the change in population from one year to the next, and are also due to the continued trend towards a higher proportion of income coming from private sources. Table 7 shows that, amongst GDS non-associates, the proportion of NHS earnings as a percentage of total earnings was steadily falling up to 2003/04 with particularly steep decreases between 2003/04 and 2005/06. • The gender breakdown shows that average gross earnings for men are higher than for women. The averages are affected by the length of the working week; women tend to work a shorter week on average so their gross earnings tend to be lower than men’s (see ‘Survey of General Dental Practitioners’ Workload’: DDRB, 2001). The difference between the average gross earnings for men and women has grown from £33,940 in 2004/05 to £42,530 in 2005/06. The expenses ratio for women is higher than it is for men (1.4 percentage points difference). This compares to a difference of 2.6 percentage points found in 2004/05. Average expenses have risen from £123,410 in 2004/05 to £134,047 in 2005/06 (a rise of £10,637) for men while women have experienced a smaller increase during the same period (a rise of £4,012 from £108,280 in 2004/05). Table 7 shows that women have a lower proportion of NHS earnings as a percentage of total earnings than men. However, this gap has been narrowing and was different by only 1.4 percentage points in 2005/06. • The age group analyses show that younger dentists had higher expenses to earnings ratio than older dentists. This might be a reflection of the higher expenses incurred by younger dentists when establishing practices. Expenses ratios declining with age has been consistent over time (except in 2003/04 for the 35-44 age groups). Table 7 also shows that up to 2005/06, dentists under 35 completed the greatest proportion of NHS work. After a steady rise in this proportion from 2001/02 to 2003/04 there was a steep decrease of 15.8 percentage points between 2003/04 and 2004/05 (72.5% to 56.7%). Latest figures show a further decrease of 20.7 percentage points in NHS earnings as a percentage of total earnings for the under 35 age group. However, the analyses are based on a small sample of 50 males in the non-London area and, as explained earlier, will be influenced by the population changes. They should therefore be treated with caution. Dentists outside the London GOR complete around 42.5% of their work for the NHS compared to dentists within the London GOR who do the least, at around 37.9%. • The Expenses to Earnings Ratios have decreased for all age groups in 2005/06 except for the under 35 where there was an increase of 2 Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 13 percentage points. However, this figure was based on a small sample of 50 males not in the London region. Due to small sample sizes, the statistics for the detailed age groups are not fully robust but can be used as a guide to trends. • Partnership agreements: Table 5 shows that the expenses ratio for partnerships is generally lower than the average for single-handers. Dentists in both types of agreement arrangements have experienced a fall in expenses ratio between 2004/05 and 2005/06 while the difference in ratios has widened from 6.5 to 9.1 percentage points over this period. Note that the number of dentists in partnership is particularly small (85 in the sample); this result should therefore be treated with caution. NHS Commitment Analysis for GDS non-associates 3.5. The analyses presented in this paper so far are based on the dentists with an accounting year end in any quarter. In order to study NHS commitment more widely than in Table 7, this sub-section considers only those non-associate dentists with an accounting year ending in Q4, which most closely aligns with the financial year 2005/06. 3.6. This analysis, introduced for the 2003/04 report, investigates the earnings and expenses profiles of the non-associate population by level of NHS commitment. It is not possible to study NHS commitment among any other groups of dentists (other than GDS non-associates), because of the possibility of the transfer of gross fee payments between two or more dentists with formal associate arrangements. 3.7. This analysis compares the earnings and expenses of non-associate dentists by “NHS commitment band”. The band that a dentist falls into is determined by comparing their NHS income (total income from the GDS, including “additional payments” such as maternity pay, trainee grants, sick pay, etc.) with their total income as reported via tax selfassessment (SA). The proportion of a dentist’s total income earned from GDS is calculated and dentists are banded together into: • • • • “low” “medium” “high” “very high” (GDS / total < 33%); (33% < GDS / total < 67%); (67%< GDS / total < 100%); (100%< GDS / total < 110%). 3.8. Note that the “very high” commitment dentists are those for which GDS payments as a proportion of total income is between 100% and 110%. This is because the GDS payments data relates exactly to the financial year 2004/05, while the total income data relates to a 12month period ending at any point in the fourth quarter of the financial year. The data were considered to be close enough to warrant further Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 14 inspection. Where the ratio exceeded 110%, the data were not considered to be sufficiently reliable and these 31 cases were excluded. 3.9. The distribution of NHS commitment for the non-associate populations in 2005/06 and 2004/05 is shown in Figure 2. It must be noted that the populations will be different for both years, as explained in 3.3, however a year-on-year comparison within each ‘commitment band’ is more robust: Figure 2: Distribution GDS of non-associate dentists by level of NHS commitment, 2005/06 and 2004/05, GB. 14% % in 2005/06 % of dentists in the interval 12% % in 2004/05 10% 8% 6% 4% 2% 510 10 -1 5 15 -2 0 20 -2 5 25 -3 0 30 -3 5 35 -4 0 40 -4 5 45 -5 0 50 -5 5 55 -6 0 60 -6 5 65 -7 0 70 -7 5 75 -8 0 80 -8 5 85 -9 0 90 -9 95 5 -1 10 00 01 10 05 511 0 05 0% GDS Payment as a percentage of Total Gross Income 3.10. Table 8 shows how average gross earnings, expenses and net income vary by NHS commitment band Table 8: NHS commitment summary, 2005/06, GB NHS Commitment Level Low Medium High (67% to 100%) Very high Total DRSG population 1,658 681 1,207 178 3,725 Effective Returns 310 125 220 31 686 Average Gross Earnings £272,148 £255,476 £190,737 £140,959 £236,447 Average Average Net Expenses Income £170,892 £101,256 £149,341 £106,135 £94,577 £96,159 £75,566 £65,393 £137,662 £98,785 Expenses Ratio (%) 62.8% 58.5% 49.6% 53.6% 58.2% Notes: 1. These figures are not consistent with the analysis in the rest of the paper due to using Q4 data only (where NHS commitment is <110%). 2. The expenses estimates exclude disallowable expenses. Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 15 3.11. The key findings in Table 8 are as follows: • The expenses to earnings ratio decreases as NHS commitment increases from Low (<33%) to High (67% – 100%); • Average gross earnings and expenses decrease as NHS commitment increases from Low to High; • Average net income is highest for those with medium (33% - 67%) NHS commitment but appears to decrease with higher commitment levels. 3.12. Figure 3 compares the average gross earnings of non-associate dentists, by NHS commitment level, in 2004/05 and 2005/06 Figure 3: GDS non-associate average gross earnings by level of NHS commitment 2004/05 and 2005/06, GB £300,000 Expenses Net Income Average Gross Earnings £250,000 £200,000 £170,892 £158,780 £149,341 £136,746 £150,000 £96,583 £94,577 £100,000 £50,000 £89,000 £101,256 £90,513 (pop. 1,658) 2005/06 (pop. 985) 2004/05 £106,135 £83,601 £96,159 £0 (pop. 1736) 2004/05 Low (<33%) (pop. 681) 2005/06 Medium (33% to 67%) (pop. 1595) 2004/05 (pop. 1,207) 2005/06 High (67% to 100%) NHS Commitment Level 3.13. Average net income of dentists with a “medium” commitment to the NHS increased by 17% between 2004/05 and 2005/06 compared to 14% for “low” and 15% for “high”. Expenses for dentists with a ”medium” commitment increased by 9%, compared to 8% for “low” and a decrease of 2% for “high” NHS commitment dentists. This meant that “low” and “medium” commitment dentists saw their expenses to earnings ratio fall by 1 and 2 percentage points respectively between 2004/05 and 2005/06, whereas the drop for those with “high” commitment was 4 percentage points. 3.14. The population sizes fell for all levels of NHS commitment, reflecting the shift to PDS contract arrangements. Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 16 Detailed Expenses Breakdown for GDS non associates 3.15. HMRC statisticians were commissioned to provide a breakdown of the total average expenses figure for non-associates in 2005/06 into the broad sub-categories used in the tax SA return. Results are provided in Table 9: Table 9: Average expenses breakdown, GDS non-associates, 2005/06, GB Total 1 Expenses Business Premises Employee Car and travel Interest Depreciation Other Net capital allowances All non-associate dentists (GB) £138,054 £12,475 £11,547 £41,845 £2,673 £3,459 £5,973 £55,325 £4,757 Men Women8 £143,099 £119,583 £13,040 £10,405 £11,923 £10,169 £44,259 £33,009 £2,860 £1,989 £3,595 £2,964 £6,144 £5,346 £56,400 £51,392 £4,879 £4,310 Aged under 352 Aged 35-443 Aged 45-544 Aged 55+5 £200,784 £160,184 £134,670 £118,563 £18,158 £14,149 £12,899 £10,436 £12,547 £11,663 £11,091 £10,883 £61,703 £48,166 £42,114 £39,189 £2,418 £2,718 £3,067 £2,884 £7,404 £5,024 £2,886 £1,640 £9,791 £7,122 £5,719 £4,966 £79,768 £65,297 £52,911 £44,970 £8,996 £6,045 £3,982 £3,594 Aged 44 and under6 Aged 45 and over £163,379 £126,355 £14,222 £11,719 £12,495 £11,262 £47,753 £39,313 £2,480 £2,856 £5,045 £2,552 £7,287 £5,427 £67,745 £49,299 £6,350 £3,927 London9 Elsewhere in GB £158,774 £138,309 £13,526 £12,535 £16,152 £11,078 £44,712 £42,206 £2,921 £2,668 £4,423 £3,411 £6,101 £6,116 £65,418 £55,522 £5,523 £4,773 Single-handed In Partnership7 £141,076 £82,025 £12,669 £8,864 £11,764 £7,511 £42,545 £28,877 £2,702 £2,134 £3,548 £1,823 £6,114 £3,363 £56,860 £26,875 £4,875 £2,576 Notes: 1 Total expenses include disallowable expenses (i.e. expenses that are not allowed, for tax purposes, because they are for personal, and not business, use). Figures in preceding tables excluded disallowable expenses and averages are as a result slightly lower. 2 <35:Based on 50 males not from the London GOR. 3 35-44: Based on 335 males not from London GOR. 4 45-54: Based on 515 males not from the London GOR 5 55+: Based on 311 males not in the London GOR 6 Due to small numbers in detailed age groups, estimates of expenses are unreliable therefore data was compiled for wider age groups. 7 85 partners have been excluded from the age and regional analysis due to an age breakdown and regional split for partners being unavailable 8 36 female dentists from the London GOR have been excluded from the age breakdown analysis due to full age breakdowns for this group being unavailable. 9 The Thames Regional Authority up to 2003/04; London GOR for 2004/05 3.16. Expenses breakdown key findings: • On average, the biggest expenses incurred by dentists are “other” expenses (40%) and employee costs (30%). The main elements of “other” expenses are cost of sales and other direct costs associated with dental practice. • Men have uniformly higher expenses than women do across all categories (20% higher overall). This is a reflection of the higher volume of work carried out on average by men, with women working a shorter week on average. However, it is interesting to note that women experienced a significant growth in expenses between 2003/04 and 2004/05 of 31% while expenses for women increased by almost 3.9 percentage points (from £115,110 in 2004/05 to £119,583 in 2005/06). This compares to a 22% increase between 2003/04 and 2004/05 for men and an increase of 8% (from £132,190 to 143,099) for 2005/06. Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 17 The expenses to earnings ratio of women decreased by 1.4 percentage points in 2005/06 to 58.9%. The ratio for men decreased by the lesser 0.3 percentage points to 57.5%. • Average expenses are highest for dentists in the under-35 age group and lowest for the over-55s, and this is the case in all the subcategories with one exception. Car and travel expenses are the lowest for the under-35 age group. The under 35 age group showed the largest overall growth in expenses with an increase of 33%; although this was based on a relatively small sample of 50 males from the nonLondon GOR. However, the more representative youngest age group, 44 and under, had a higher average expenses of £163,370 when compared to £126,355 for the older age group. The expenses to earnings ratio of the under-35s increased by 2 percentage points to 65.5%. This followed a rise of 7.4 percentage points in 2004/05. Additionally, these results must be treated with caution due to the small sample size of this group over time which will lead to some degree of year-on-year volatility in the expenses estimates. • The detailed expenses breakdown for 2005/06 can also be compared with the breakdowns in 2004/05, 2003/04 and 2001/02: Table 10: Average expenses breakdown, GDS non-associates, GB, 2001/02, 2003/04, 2004/05 and 2005/06 Average 2001/02 Proportion of total expenses Average 2003/04 Proportion of total expenses Average 2004/05 Proportion of total expenses Average 2005/06 Proportion of total expenses Total 1 Expenses £99,630 Business £9,360 Premises £8,920 Employee £28,500 Car and travel £2,580 Interest £3,020 Depreciation Other £4,610 £37,970 Net capital allowances £4,680 £104,590 9% £10,260 9% £9,290 29% £31,790 3% £2,480 3% £2,550 5% 38% £4,840 £38,570 5% £4,800 £128,590 10% £11,490 9% £10,570 30% £39,430 2% £2,620 2% £3,080 5% 37% £5,700 £50,750 5% £4,960 £138,050 9% £12,470 8% £11,550 31% £41,850 2% £2,670 2% £3,460 4% 39% £5,970 £55,330 4% £4,760 9% 8% 30% 2% 3% 4% 40% 3% Notes: 1 Total expenses include disallowable expenses (i.e. expenses that are not allowed, for tax purposes, because they are for personal, and not business, use). Figures in preceding tables (except table 7) excluded disallowable expenses and averages are as a result slightly lower. 3.17. HMRC statisticians have also supplied the detailed expenses breakdown by NHS commitment band. This is shown in Table 11: Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 18 Table 11: Average expenses breakdown, GDS non-associates, 2005/06, by NHS commitment NHS Commitment Level Low Medium High Very High Total Total Expenses Business Premises Employee Car and travel Interest Depreciation Other Net capital allowances £181,159 £157,693 £101,717 £81,661 £146,366 £15,335 £13,407 £10,524 £7,055 £13,028 £15,223 £12,136 £9,845 £8,642 £12,601 £53,567 £47,182 £33,358 £26,213 £44,542 £2,872 £2,672 £2,465 £2,580 £2,689 £4,717 £4,013 £2,653 £1,735 £3,777 £7,690 £5,655 £4,409 £3,225 £6,041 £75,115 £67,627 £35,058 £29,327 £58,575 £6,641 £5,001 £3,406 £2,884 £5,113 Notes: 1 These figures are not consistent with the analysis in the rest of the paper due to using Q4 data only. Excludes data where commitment level >110%. 2 The expenses estimates include disallowable expenses whereas the earlier NHS commitment analysis excluded disallowable expenses. 3.18. Table 11 shows that the higher average expenses for dentists with a low NHS commitment (and hence the high expenses to earnings ratio) can mainly be explained by higher ‘”other” expenses. HMRC statisticians investigated this further, as part of the 2003/04 analyses, and found that over two thirds of the “other” expenses for dentists with low NHS commitment were “cost of sales”, i.e. cost of purchasing raw materials/ items sold. This is likely to include the laboratory cost elements, e.g. crowns and dentures. HMRC statisticians also reported that a further 15% of the “other” expenses for these dentists were “other direct costs associated with dental practice”, such as costs of bought in services. This might take the form of engagement of a private hygienist, and possibly other private services, e.g. bought-in cosmetic dentistry services. Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 19 GDS Associate dentists 4.1. This section of the paper provides high level earnings and expenses analyses on GDS associate dentists. Associates are dentists who have formal business links with other dentists. Such links take the form of associate arrangements whereby gross fee payments are transferred between two or more dentists for the meeting of expenses costs. There are three types of associates: • • • First party: provide premises and facilities in return for an agreed share of the fees of the second party – this group makes up an estimated 27% of the GDS population; Second party: pay a contribution to the first party in return for use of premises and facilities – estimated to make up 40% of the GDS population; Partners of associates: partners who are themselves not associates but are in partnership with an associate - estimated to make up 3% of the GDS population. Average net income results only are supplied for this group. 4.2. The weighted results for each associate type, by detailed group, can be found in Tables 12 and 13: Table 12: 2005/06 main results: GDS first party associates, GB Age < 44 London 45+ < 352 35-443 Rest of GB 45-544 55+5 All men Women Men 1 All ages < 44 Rest of GB 45+ 6 All women London All dentists DRSG Effective population returns 214 48 244 95 153 40 716 331 950 525 414 215 2,691 1,254 118 298 211 627 3,318 32 135 132 299 1,553 Average gross earnings £418,897 £408,226 £330,818 £368,791 £360,154 £347,085 £367,799 Average Average Expenses net expenses ratio (%) income £296,769 70.8% £122,127 £286,732 70.2% £121,494 £225,285 68.1% £105,532 £244,029 66.2% £124,763 £240,300 66.7% £119,854 £231,232 66.6% £115,854 £247,742 67.4% £120,057 £287,158 £298,940 £289,000 £293,378 £205,349 £208,820 £199,439 £205,010 71.5% 69.9% 69.0% 69.9% £81,809 £90,119 £89,560 £88,367 £353,735 £239,667 67.8% £114,068 Notes: 1. “London” refers to dentists registered within the London Government Office Region (GOR). “Rest of GB” refers to those outside the London GOR 2. <35 based on 40 males not in London GOR 3. 35-44 based on 331 males not in the London GOR. 4. 45-54 based on 525 males not in the London GOR 5. 55+ based on 215 males not in the London GOR. 6. 32 females from the London GOR were excluded from the detailed age group analyses due to full age breakdowns for this group being unavailable. Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 20 Men Table 13: 2005/06 main results: GDS second party associates, GB Age < 35 35-44 London1 45+2 < 35 35-44 Rest of GB 45-54 55+ All men <35 35-44 45+ < 35 35-44 Rest of GB 45-54 55+ All women 258 159 66 789 695 297 71 2336 89 64 37 397 384 172 42 1185 £72,888 £68,677 £55,309 £79,210 £68,270 £66,505 £76,706 £72,170 £19,505 £16,244 £13,544 £24,070 £21,002 £20,402 £25,226 £21,391 26.8% 23.7% 24.5% 30.4% 30.8% 30.7% 32.9% 29.6% £53,383 £52,434 £41,765 £55,141 £47,268 £46,104 £51,480 £50,779 All dentists 4,751 2,176 £91,827 £30,702 33.4% £61,125 London Women DRSG Effective population returns 234 54 160 51 158 67 714 313 579 241 340 164 230 101 2415 991 Expenses Average Average to net gross Average earnings income earnings expenses ratio (%) £101,395 £34,229 33.8% £67,166 £130,685 £61,450 47.0% £69,235 £113,445 £43,279 38.1% £70,166 £102,414 £32,123 31.4% £70,291 £123,522 £44,495 36.0% £79,027 £121,581 £47,139 38.8% £74,442 £83,118 £28,158 33.9% £54,960 £110,837 £39,707 35.8% £71,130 Notes: 1 London” refers to dentists registered within the London Government Office Region (GOR). “Rest of GB” refers to those outside the London GOR 2 Due to small numbers in some of the detailed age group, estimates of EER are unreliable therefore data was complied for wider age groups. 4.3. The key findings are as follows: • Average net income for first party associates and partners of associates were £114,068 and £104,908 respectively with second party associates earning the least, £61,125. • The gender breakdowns show that, as was seen for nonassociates, men have higher earnings, expenses and net income than women across all associate types. This may, in part, be a result of the fact that women tend to work a shorter week than men, as has been discussed previously • The regional breakdowns reveal that, generally, the net income of first party associates in London is higher than that of dentists elsewhere in Great Britain. The only exception to this is for women, but the sample of female first party associates in London is very small and therefore results for this group should be treated with caution. • The average EER for all first part associates is 67.8%, higher than the 57.8% EER measured for non-associates, reflecting the fact that first party associates normally cover some of the expenses of Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 21 second party associates who in turn have lower expenses ratios (33.4%). Detailed Expenses Breakdown for GDS associates 4.4. Tables 14 and 15 provide, for each associate type, a breakdown of expenses into the broad sub-categories used in the tax selfassessment return: Table 14: Average expenses breakdown, GDS first party associates, 2005/06, GB Total Car and Expenses1 Business Premises Employee travel All first party associates (GB) Men Women6 250,655 259,073 214,529 2 18,657 16,182 74,215 19,637 14,450 16,649 14,180 77,076 61,941 2,860 3,035 2,110 Interest 4,529 4,586 4,285 Depreciation 7,763 7,833 7,461 Other Net capital allowances 119,588 6,861 123,224 103,980 7,033 6,123 Aged under 35 Aged 35-443 Aged 45-544 5 Aged 55+ Aged 44 and under for males in L Aged 45 and over £236,685 £255,145 £250,932 £243,879 £253,908 £250,557 £17,989 £19,196 £19,199 £18,841 £18,360 £19,177 £13,782 £16,068 £15,221 £17,657 £15,693 £16,644 £67,220 £72,735 £82,761 £78,001 £70,332 £78,777 £2,581 £2,729 £3,128 £3,259 £2,665 £3,054 £7,328 £5,309 £3,829 £2,309 £5,982 £3,337 £9,216 £8,165 £7,327 £6,925 £8,782 £7,072 £106,911 £123,722 £112,928 £111,759 £123,994 £116,486 £11,658 £7,220 £6,539 £5,129 £8,102 £6,009 London7 Elsewhere in GB £285,046 £243,431 £20,787 £18,209 £19,386 £15,509 £69,374 £75,232 £3,045 £2,822 £6,107 £4,197 £8,264 £7,658 £150,655 £113,061 £7,429 £6,741 Notes: 1. Total expenses include disallowable expenses (i.e. expenses that are not allowed, for tax purposes, because they are for personal, and not business, use). Figures in preceding tables excluded disallowable expenses and averages are as a result slightly lower 2. <35 based on 40 males not in London GOR 3. 35-44 based on 331 males not in the London GOR. 4. 45-54 based on 525 males not in the London GOR 5. 55+ based on 215 males not in the London GOR. 6. 32 females from the London GOR were excluded from the detailed age group analyses due to full age breakdowns for this group being unavailable. 7. “London” refers to dentists registered within the London Government Office Region (GOR). “Rest of GB” refers to those outside the London GOR Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 22 Table 15: Average expenses breakdown, second party associates, 2005/06, GB Total Expenses1 Business Premises Employee Car and travel Interest Depreciation Other Net capital allowances All second party associates (GB) £32,755 £4,326 £2,517 £2,835 £1,466 £291 £666 £19,827 £827 Men Women £42,541 £22,636 £5,105 £3,520 £3,568 £1,431 £4,760 £844 £1,827 £1,093 £485 £90 £1,048 £271 £24,538 £14,956 £1,209 £431 Aged under 35 Aged 35-44 Aged 45-542 Aged 55+3 £29,328 £35,639 £36,704 £28,785 £4,118 £4,240 £5,126 £4,020 £2,103 £2,689 £2,648 £3,320 £1,493 £3,071 £5,253 £4,019 £1,286 £1,529 £1,565 £1,774 £140 £493 £293 £157 £486 £1,057 £519 £107 £19,006 £21,556 £20,498 £14,590 £695 £1,003 £802 £798 Aged 45 and over £34,680 £4,800 £2,993 £4,813 £1,688 £271 £439 £18,865 £810 London Elsewhere in GB £34,251 £32,339 £4,832 £4,185 £2,615 £2,490 £4,295 £2,428 £1,677 £1,407 £482 £237 £798 £629 £18,548 £20,184 £1,003 £778 Notes: Total expenses include disallowable expenses (i.e. expenses that are not allowed, for tax purposes, because they are for personal, and not business, use). Figures in preceding tables excluded disallowable expenses and averages are as a result slightly lower. 2 Based on dentists not in the London GOR. 3 Based on 101 males and 42 females not in the London GOR. 1 4.5. The key findings are: • In line with the non-associate results, the biggest expense incurred by all associate types is “other” expenses. For first party associates, the next biggest expense is that incurred on paying employees. This is not the case for second party associates however, who, on average, incur employee costs that constitute only 9% of their expenses. • There are differences between men and women, with men generally incurring higher expenses than women. However, given that men work longer hours than women, it is possible that the results reflect different business arrangements among associates, which may depend on hours worked. • Among the first and second party associates, expenses are higher in London than they are in the rest of Great Britain. Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 23 PDS Whole-Year dentists 5.1. This section of the paper provides high level earnings and expenses analyses on PDS Whole-Year dentists. A PDS Whole-Year dentist is defined as a dentist who was working on a PDS contract prior to 1 April 2005 and who remained as a PDS dentist until at least March 31st 2006. Hence they were a PDS dentist for the whole year of the study. 5.2. There are two classes of PDS Whole-Year dentists which can be defined as follows. • PDS Providers: A Provider is a dentist who has signed a legal contract with a PCT to provide dental services to the general public. The Provider is legally responsible for ensuring that the required dental services are delivered, and that they comply with pre-defined standards to ensure that the public receives adequate dental care. A Provider does not necessarily have to do all of the work required by the contract him/her self. • PDS Performers: A Performer is a dentist who actually performs clinical work on patients. A Performer works under the PDS contract held by a Provider (see above) and the Provider can employ more than one Performer in order to deliver the dental care that the contract requires. It is possible for a Provider to also act as a Performer in order to deliver dental care 5.3. There is no central record to indicate who among the PDS population are Providers and who are Performers. To solve this problem an assumption was made by considering the Expenses to Earnings Ratios (EER) of the PDS Whole-Year population as shown in Figure 4 below. Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 24 Figure 4: Distribution of EER among the PDS Whole-Year population. 900 800 700 NO. OF DENTISTS 600 500 400 300 200 100 0 0 0%-10% 10%-20% 20%-30% 30%-40% 40%-50% 50%-60% 60%-70% 70%-80% 80%-90% over 90% Expenses to Earnings Ratio 5.4. Given the distribution shown above, the population was split by assuming that those with an EER less than 30% were Performers (since they would have little or no business expenses being an employee of another dentist) and those with an EER greater than 30% were Providers (since they would incur the expenses associated with running a dental practice). Note that there is uncertainty as to the exact Provider/Performer status of those dentists with an EER around the 30% mark. 5.5. Further to this, any Providers with an EER greater than 90% were considered to be outliers and were excluded from the analysis. The results for Providers and Performers are shown below. Table 16: Main results for PDS Whole-year Providers, GB. Providers have been identified by assuming that they are dentists with an Expenses to Earnings Ratio greater than 0.3 and less than 0.9. All Quarters Capital Other Total Net Expenses to Earnings Ratio Sample Population Income Allowances Expenses Expenses Income All 1,243 2,094 £315,859 £6,218 £181,731 £187,949 £127,910 59.5% Table 17: Main results for PDS Whole-year Performers, GB. Performers have been identified by assuming that they are dentists with an Expenses to Earnings Ratio less than 0.3. All Quarters Capital Other Total Net Expenses to Earnings Ratio Sample Population Income Allowances Expenses Expenses Income All 955 1,609 £75,698 £710 £9,136 £9,846 £65,852 13.0% 5.6. Key findings are that for PDS Providers average net income was £127,910, with an average EER of 59.5%, while for PDS Performers the average net income was £65,852, with an average EER of 13.0% Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 25 PDS Switched dentists 6.1. This section of the paper provides high level earnings and expenses analyses on PDS Switched dentists. A PDS Switched dentist is defined as a dentist who switched from a GDS to a PDS contract at some point during the year i.e. between April 1st 2005 and March 31st 2006. Hence their tax returns show a mixture of earnings from GDS and PDS contracts, although it is not possible to determine what proportion of the earnings came from which source. Further to this, it is not possible to determine whether the dentist entered the PDS contract as a Provider or as a Performer. Hence, the results shown are for all PDS Switchers combined. 6.2. The weighted results for PDS Switched dentists (combined providers and performers) are shown below. 6.3. It is not possible to determine what proportion of earnings came from GDS and PDS contracts, nor is it possible to determine whether the dentist entered the PDS contract as a Provider or a Performer. Table 18 below is included to provide a complete picture of dental contract arrangements. Table 18: Main results for PDS Switched dentists, GB. All Quarters Capital Other Total Net Expenses to Sample Population Income Allowances Expenses Expenses Income Earnings Ratio 1,543 3,299 £191,714 £3,368 £98,955 £102,323 £89,391 53.4% All Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 26 Appendix: Methodology 7.1. The data for the GDS population were sourced from the Business Services Authority: Dental Services Division (DSD) for England & Wales and NHS Scotland for Scotland. Dentists were chosen if they were in the Dental Rates Study Group (DRSG) in 2005/06 (as at February 28th 2006). The DRSG excludes the following: • • • • • • Dentists that have only worked for part of the period, possibly because they have just started work; Dentists that retired; Dentists working in PDS only; Dentists working under both GDS and PDS contract arrangements; Dentists with no scheduled earnings in the last 6 months of the period; and Dentists working for corporate bodies. 7.2. Note that, although the DRSG excludes PDS dentists, it has been possible to analyse the earnings of PDS dentists separately, also using DSD data, and results are included in the later sections of this report. Unlike the data for the GDS analyses, the PDS data includes all dentists (including dentists working for corporate bodies). 7.3. The data on the associate status of the DRSG dentists was validated via a survey exercise conducted on behalf of the IC. The final sample of dentists was made up of all dentists who responded to confirm their associate status. Dentists were also allocated to one of the 20 strata depending on their gender, age group and region. This allowed results to take account of known differences in the earnings profiles for these groups and to correct for differing response rates within each group. 7.4. The IC passed details of the dentists in the sample to statisticians in the HMRC Knowledge, Analysis and Intelligence (KAI) division, who were then able to trace most of the dentists in the sample, extract the relevant expenses and earnings information from the self-assessment database and create an anonymised dataset for analysis. The IC then received this information in aggregated tables. HMRC statisticians confirmed that the accounts of dentists in the final sample covered a full 12-month period and ended between 6th April 2005 and 5th April 2006 7.5. The number of dentists in the final dataset to be analysed by HMRC statisticians who were successfully traced, submitted a valid tax return and passed the validation rules was 9,393. The information included earnings from all income but only for those dentists who are classified as self-employed during a 12-month accounting period, regardless of when in 2005/06 the accounting year ended. Dentists with a mixture of self-employment and salaried earnings (NHS and private) are present Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 27 on the final dataset as dentists were only excluded if they reported zero in the income fields relating to their self-employment. This report concentrates on their self-employment income and it is these figures that are used in the analysis. Any salaried incomes they have reported are ignored. The analyses does not look at their total income being the sum of salaried and self-employed income and the report does not look at what proportion of their total income is salaried. 7.6. The non-associate population for the enquiry excludes “outliers” (those non-associates with expenses to earnings ratios less than 0.2 or greater than 0.9) and individuals known to have income from nondental sources. This brought the methodology into line with similar reports on GP earnings and led to the exclusion of 2.3% of the final sample of non-associates (40 individuals). 7.7. The above exclusion criteria for outliers have been applied to first party associates i.e. those with expenses to earnings ratios less than 0.2 or greater than 0.9 have been excluded: this led to 4.5% of the first party associates (74 individuals) being excluded. However, different rules have been applied to second party associates. Those second party associates with expenses to earnings ratios less than 0.2 are included in analysis. Low ratios are common in this population and are not “outliers” as such. Only those second party associates with an expenses to earnings ratio greater than 0.9 have been excluded. This resulted in 0.2% of second party associates being excluded (4 individuals). 7.8. For PDS Providers, (those with an expenses to earnings ratio greater than 30%), 51 outliers (3.9% of that population) were removed because they had an expenses ratio grater than 90%. There were no exclusion criteria for PDS Performers, who were assumed to be those PDS dentists with an expenses to earnings ratio less than 30%. 7.9. To maintain taxpayer confidentiality and reduce the likelihood of estimates being vulnerable to extreme values, HMRC statisticians did not provide information on any sub-groups of 30 or less. This necessitated the combining of some strata and hence the suppression of results for some groups of dentists from certain detailed analyses. Footnotes are provided in such cases. Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 28 Other Publications Other publications on Dental statistics include: • General Dental Services Payment Report 2005/06 This report examines the changes in average gross fee income of General Dental Service (GDS) dentists in England and Wales up to 2005/06. Available on the IC website via this link: http://www.ic.nhs.uk/statistics-and-data-collections/primarycare/dentistry/general-dental-service-payment-report-2005-06 • NHS Dental Statistics for England: 2006/07 This report considers NHS dental activity and workforce in the first year of the new dental contract. Available on the IC website via this link: http://www.ic.nhs.uk/statistics-and-data-collections/primary-care/dentistry/nhsdental-statistics-2006-07 • NHS Dental Activity and Workforce Report England: 31 March 2006 This report covers treatment provided under the General Dental Service (GDS) and the Personal Dental Service (PDS), often referred to as “high street dentists”, In England up to 31 March 2006, the day before the new NHS dental contract was introduced. Most of the data are presented over a tenyear period. Detailed data at PCT, SHA and parliamentary constituency level are included as annexes to this report. The boundaries used are as at 31 March 2006. Available on the IC website via this link: http://www.ic.nhs.uk/pubs/dwfactivity • Dental Earnings and Expenses Report 2004/05 This report provides a detailed study of the earnings and expenses of General Dental Service (GDS) dentists in GB (from all sources - NHS and private) and is based on tax data for dentists with an accounting year ending in 2004/05. All averages in the report relate to both full-time and part-time dentists. For non-associate dentists, time series results are presented up to and including the financial year 2004/05. Non-associates are dentists who do not have Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 29 formal business links with other dentists. For associate dentists, headline analyses are provided for 2004/05 only. Available on the IC website via this link: http://www.ic.nhs.uk/statistics-and-data-collections/primarycare/dentistry/dental-earnings-and-expenses-report-2004-05 • Dental Contracts Statistics DH publishes regular information on dental commissioning and progress in resolving contracts signed in dispute. Available on the DH website via this link: http://www.performance.doh.gov.uk/dental_contracts/index.htm Note that this data collection is not directly comparable with the activity statistics presented earlier in this report as the DH collection asks for UDAs commissioned for a forward looking 12 months so cannot be compared to actual activity in the previous 12 months. • Survey of General Dental Practitioners’ Workload: DDRB, 2001. Available on the National Statistics website via the link: http://www.stats.gov.uk/statistics For general enquiries • 0845 300 6016 or [email protected]; or The Information Centre website: http://www.ic.nhs.uk Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. 30 Primary Care Statistics Published by the Information Centre Part of the Government Statistical Service Price: Free ISBN: 978-1-84636-154-8 This publication may be requested in large print or other formats. For further information contact: online: www.ic.nhs.uk telephone:0845 300 6016 email: [email protected] Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved. This work remains the sole and exclusive property of The Information Centre and may only be reproduced where there is explicit reference to the ownership of The Information Centre. This work may only be reproduced in a modified format with the express written permission of The Information Centre. Copyright © 2007, The Information Centre, Primary Care Statistics. All rights reserved.
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