A massive nudge and the impact in Dentistry of the minimum wage rise 2020

I woke up yesterday morning to the announcement of the minimum wage changes on the 31st December 2019, not from the news but from my husband announcing “My first pay rise in 5 years.”

It was welcomed as finally his company have been nudged into giving him what will be a significant rise of 6.2% after holding his salary for the last 5 years from a TUPE arrangement.  However my thoughts travelled to the impact on dental practices and that preparation for this change is essential.

Practices are struggling to recruit and retain team members especially dental nurses and a massive part of retention is getting your salaries sorted. There are other factors surrounding dental nurse shortages but let’s get a fundamental basic sorted first. If you don’t know what the changes are yet here they are: 

From April 2020 the new rates are: 

25 and above £8.72 

21-24 £8.20 

18-20 £6.45 

Under 18’s £4.55

Apprentices £4.15 

My top answer is always start with salary banding: This is now essential, as if you do not do this then the team members don’t know where they are heading and get restless, which means potentially looking for another job. 

The job that qualified nurses actually do is multi faceted with multiple roles that they have to get right, now something to remember if you are putting up with team members who are not fulfilling their contract and job description then this is HR land and you must deal with this. 

Asda made a decisive business decision to pay team members £9.18 nationally and £10.31 in London last year. I know that a number of other changes were made to implement this,  but you do have to make the changes that are right for your long term business future so take heed.

Where do I start? 

Salary banding needs to start with a base salary and then you work from there. The April changes mean in reality you are looking at paying £9.50/£10.50 depending on your area, per hour for a qualified nurse, so that you are above the retail sector, which you should be aiming for based on the expanse of the job. Salary needs to build from here based on additional qualifications that you are using in practice. There are three levels for this. 

Level 1 – Responsibility 

The higher responsibilities such as compliance responsibility, leader positions/senior nurse, cross-trained fully on another role i.e reception and treatment coordination need to be paid an additional amount per role between 50p to £1 per hour for each additionally used skill. Team members may have more than one of these. 

Level 2 – Additional skills 

There are lots of additional skills that you also need to take into account including radiography, oral health education, sedation, implants, photography, impressions/scanning. This is not an exhaustive list. Now for these skills, you can pay up to 50p an hour for each of these as long as they are at a fully competent level and you are using them regularly in the practice.

Level 3 – Longevity and experience 

Longevity increases. You have an opportunity to increase salary by an additional £1 per hour at 5 years service and then again at 10 years service. There is another option which is to increase holiday instead of salary to 5 weeks after 5 years service and 6 weeks after 10 years service. You may ask why would you do this, but then we go back to the longevity, if you want to retain the knowledge and experience that you have worked so hard to train in your business then you need to reward loyalty or team members with experience will leave to pastures new. You will be surprised how many conversations I have about this area so you are not alone. 

You may do your calculations and decide that the salaries have to increase a lot and this may worry you. You do need to do two further things. The first is you must budget for your employed wages (between 18% to 23% of your current gross turnover this includes Tax/NI/Pension contribution which is often left out of sums and must exclude employed hygienist/therapists). The second is that if you are already spending 23% and your nurses’ salary is low, and you are providing private dentistry then you will need to review your hourly rates to allow you to make further salary changes.

My last tip is that you need to work out what your salary budget is so that you can bespoke your practice’s salary banding. I can tell you first hand that if you don’t start moving this way, nurses will leave and ultimately you will recruit nurses that are more expensive than the ones that have left. This is the reality and this is the top reason why nurses move to another practice is that they have an opportunity to renegotiate their wages. You have an opportunity to change that. It will also help you with recruitment as you will be able to advertise confidently your salary banding without worrying what the effects fallout from the team there will be. 

In previous blogs I have done a series in 2019 about recruiting and retaining dental nurses so that will be a great series to read to support you so that is your reminder that you can. 

If you do have a questions, then don’t hesitate to send then across via email or social media and Laura and I will answer your question in our first podcast of 2020.

Happy New Year 


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