The hidden cost of an empty surgery

Most practice owners know roughly what they pay per UDA.

Far fewer know the true cost of vacancy, what it really costs when a surgery is empty for a few weeks or months, or when an associate quietly underperforms all year.

On paper, it sounds like:

"We'll be a bit behind on UDAs this quarter."

In reality, an empty dentist chair can mean:

• lost NHS UDAs
• UDA clawback at year end
• expensive locum cover
• missed private treatment potential
• an underused nurse and surgery
• time, stress and disruption for your team

This article breaks down the cost of vacancy step by step, and how Dentello helps reduce it.

Lost UDAs, the obvious cost of an empty surgery

Example:

• Planned: 6,000 UDAs per year from one full-time dentist
• Vacancy: 3 months with no dentist in that surgery
• Lost activity: roughly 1,500 UDAs

If your UDA value to the practice is around £31 (in line with Dental Elite's published UK average), that is:

Some UDAs may be picked up by other associates, but a significant chunk usually never comes back, and later shows up as clawback or permanently lost income.

The private dentistry that never reaches your diary

An empty chair doesn't only hurt UDAs. It also wipes out private dentistry that would have flowed from that list:

• whitening and cosmetic upsell from routine exams
• composite bonding and smile makeovers
• Invisalign/aligners and implant cases
• private hygiene and perio maintenance

This is often where your real margin sits.

The cost of vacancy isn't just:

"We lost 1,500 UDAs."

It's also:

"We lost a year's worth of private opportunity from that surgery."

UDA clawback, when vacancy becomes a bill

Every month that surgery is empty or underperforming, your practice:

• slips further away from its UDA target
• increases its risk of UDA clawback

By the time you see the full impact, it's usually late in the financial year and hard to recover without burning out the rest of the team or overusing locums.

What felt like "a few quiet months" can easily become:

• a five-figure clawback,
• pressure to over-perform next year,
• and less room for investment or drawings.

Locum dentist cover, very expensive UDAs

Locums are often used to plug gaps.

Typical locum dentist rates:

• £500 to £600 per day
• roughly 20 to 30 UDAs per day

That means an effective UDA cost of roughly:

• £500 ÷ 30 ≈ £17 per UDA (best case)
• £600 ÷ 20 = £30 per UDA (worst case)

So while your associate contract might say £13 per UDA, your "emergency cover" may be costing £17 to £30 per UDA, with:

• no continuity,
• no long-term commitment,
• and no guarantee you'll hit your year-end target.

The extra nurse and surgery overhead

For each dentist, practices usually:

• recruit or allocate an extra dental nurse
• fully equip and stock a surgery
• adjust rotas to support it

When the dentist underdelivers or leaves, you still carry:

• the nurse's salary and on-costs
• equipment finance, maintenance, sterilisation and utilities

Those fixed costs don't vanish because there's no dentist in the chair.

Recruitment time, the invisible cost

While the surgery is empty, someone is:

• writing and posting adverts
• talking to agencies
• reviewing CVs
• arranging and running interviews
• negotiating offers

That time often comes from:

• owner clinical sessions
• private treatment lists
• practice management and strategy work

You don't see a "recruitment hours" line in your accounts, but it is a real, recurring cost.

Team morale, patient experience and reputation

Vacancy and churn lead to:

• pressure on remaining associates to pick up extra sessions
• stretched hygiene and therapy lists
• reception apologising for delays and cancellations
• patients seeing multiple different dentists in a short period

This affects:

• private case acceptance
• treatment completion
• reviews and word-of-mouth

Over time, that reputational hit becomes another hidden cost of vacancy.

Where Dentello fits in, vacancy protection, not just recruitment

Dentello is designed to reduce the chance of a surgery sitting empty, and to cushion the blow if it does.

Instead of:

• one-off CV introductions,
• a £5,000 + VAT agency invoice,
• and no real involvement once the dentist starts,

Dentello works as a clinical workforce partner, with:

• a pipeline of pre-vetted dentists matched to your UDA plan and clinic profile
• fees starting from £12.50 per UDA including our own fees
• most clinics in a £12.50 to 14.50 UDA band, depending on area and requirements
• a replacement guarantee for the full length of the contract

If a Dentello dentist does not work out at any point during the agreed term, Dentello is committed to replacing them under your agreement instead of charging a new one-off fee.

Dentello also supports clinics with:

• Skilled Worker sponsorship at cost,
• visa applications (with the legal fee element absorbed on Dentello's side),
• NHS performer onboarding,

so overseas recruitment and compliance don't become another source of vacancy.

The real cost of vacancy (and what you get back)

One dentist vacancy can easily mean:

• tens of thousands in lost NHS UDAs (e.g. 1,500 UDAs × ~£31 = £46,500)
• a potential five-figure clawback
• locum days at £500 to £600 with £17 to £30 effective UDA rates
• missed private cases that never reached consultation
• an underused nurse and surgery
• management time and stress

Of course, you're not going to let all of that just disappear:

• other associates will usually absorb some UDAs
• you may bring in a locum for key days
• the nurse will help elsewhere to stay busy

But even after that, a large chunk of the lost UDAs, lost private potential and wasted overhead never truly comes back.

That gap, the portion you cannot realistically recover, is the true cost of vacancy.

Next step: make vacancy cost-free

Vacancies will always happen. Dentists relocate, change plans or don't work out.

The real question is whether you pay heavily every time, or whether you have a structure that shares that risk.

Dentello's model is built so you don't:

• fees starting from £12.50 per UDA including our own fees
• a replacement guarantee for the full length of the contract
• support with sponsorship, visas and performers
• a pre-vetted pipeline of dentists matched to your UDA plan