The Essex Smile Centre

Project Information

Brothers Stephen and Declan Keane had done well with a mixed practice, taking it to £1.8m turnover through their own fees by bolting on Denplan work and doing plenty of fee per item cosmetic dentistry. But they wanted to know how to get off this plateau (typical for practices that have reached a critical mass) and keep growing. They were thinking about expanding the premises, but wondered whether a deeper look at the way the business was run was in order first.
  • Client : The Essex Smile Centre
  • Date : 2018
  • Skills : Commercial Strategy

Result Driven

Achieved initial growth target of 33% over 18 months
Just had best ever month (March 2019) which would track for a massive 66% growth
Ready to stop NHS work ahead of schedule
Ready to recalibrate strategy for next growth phase
Investment in embedding strategic oversight has trebled the value of the practice

Challenge & Solution

Our analysis showed that NHS work was stifling the business. It generated a quarter of revenue but took up nearly half their resources. The Keanes thought like NHS dentists, so a change in perception was needed. If they could understand the economics inside the practice, rather than thinking in a linear NHS fashion — "there's more work, therefore we need more space" — they could scale up.
Drop NHS work over a two year period
Giving an NHS contract back may sound scary, but not when you realise it's costing your business money. Our analysis found that it was having an airbrake effect on the business, sapping energy and creating ambivalence among patients owing to the two-tier patient journey.
Rebrand and refurb
This was about making the business look outwardly like a private practice, but equally as important was changing how the principals and the team saw themselves.
Redefine roles and responsibilities
We introduced monthly board meetings with Hive's shadow board to instil objectivity, so that directors were held accountable. A business manager was recruited. The two principals, as the lead revenue generators, had allowed others to operate in a vacuum, so we began examining the effectiveness of all staff.
Introduce strategic formality
Stephen and Declan's success as fee earners was not going to help them leverage the business. Instead we set up a business hub, and changed the patient journey. We asked them to spend a day a week out of surgery to work strategically on the business.

Our Process

This process was about helping Stephen and Declan believe they were running a private practice. We did that by giving them the direct experience of it through a new approach to their work. The point at which they were able to have real strategic conversations with us at the monthly board meeting was a significant way point of progress. They now have the mindset, empirical evidence and people in the right place to steer the ship strategically. This is a significant achievement. We continue to attend monthly board meetings.


We first engaged Hive to be our accountants. As part of this process, they recommended the owners undertook a Diagnostic Day to look at all aspects of profitability and how it could improve drastically with Hive’s support. The Diagnostic Day was extremely helpful and informative and a real eye-opener for the business. It highlighted key areas of the business where profitability and productivity could be improved substantially.

At this point, we did not start working with Dan but started the process of changing the business ourselves. We changed the structure of the practice, introduced new dentists with different specialities, bought in new sales structures, and started thinking more strategically about the business.

It did however come to a point where we felt stuck and needed help to drive it forward. Dan and Ross came in and did another Diagnostic Day to see where we were at this point. We had made huge progress but to really move the business forward we definitely needed their help.

We set up a board and Dan became part of that and really put formality in place. He comes to our offices once a month and we focus on marketing, staff, financials. Each of us, as board members, have a specific role and we take full responsibility for ensuring we report back monthly on what we have achieved and what we hope to achieve in the following month. The formality ensures we stay focused on the task of growing the financials of the business.

Personally, for me, I do not think I could do my job without Dan. As the business owners also work in practice it makes them extremely busy and not always accessible, also they are very dentally focussed rather than business focussed (as is the case with many dentists).

If I need advice or just a moan, Dan is always there for me. He just gets it. He always has a wise or kind word and always a fantastic solution. Dan is friendly, kind, super intelligent and knows how to drive a business. He also knows how to focus people to think strategically to grow their business successfully.

I always look forward to Dan coming into the office on board meeting days. When he walks in my first words are ‘the cavalry has arrived’. He has helped me to see that everything I do is a success even if it may not be perfect! All of our meetings are positive and meaningful.

Ross attends board meetings occasionally. His view is always objective and he has a great way of making us question our decisions as to how we could make them better and more effective for the business. He totally thinks outside of the box financially and seriously knows his stuff to grow the financials or more important keep the financials at the centre of all we do.

Dan and Ross have become our friends really. Board meeting days are always finished off with a dinner somewhere and some friendly banter. They are great fun to work with. A day with them is never boring and the day after we always feel that we have achieved massive strides.

My advice would be, have a Diagnostic Day, see where your business could go and then get Dan and Ross on board to help you do it.

Michelle Murphy – Operations Manager at The Essex Smile Centre

About Us

We improve the financial performance of dental practices with business services underpinned by in-house management consulting, accountancy and marketing.

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