Business in Focus - Winter 2020

BUSINESS

IN FOCUS EDITION 03 | WINTER 2021

It’s in our nature to grow your business.

NEW INVESTMENT OPPORTUNITIES Practices for sale See page 8

LONDON AND HOME COUNTIES FOCUS FINANCE

•

THE SHIFT IN POWER FOR DENTAL PRACTICE RECRUITMENT, BUT FOR HOW LONG?

VALUATIONS

mediholdings.co.uk 01332 609318 contact@mediholdings.co.uk

•

ADVICE

YOUR UPDATE ON THE ANNUAL INVESTMENT ALLOWANCE •

RECRUITMENT

UPDATE

Welcome to 2021 - the new year (of hope)

By Maja Thompson Welcome to the latest edition of Business in Focus.

Since the last edition of Business in Focus, the ever changing landscape of 2020 has moved significantly. A number of developments stand out amongst the rest: First COVID vaccines have been distributed to fight the pandemic and the UK has secured a Brexit trade agreement with the EU. By the time this is published, both will have moved on somewhat, but it is worth noting the significance of each of the developments and their impact on our lives in 2021.

After a year of lockdowns, which continue into 2021, several COVID vaccines are now on the market, approved by the MHRA in record time, and being administered to the population. In the UK, the vaccine is starting to be delivered in order of priority based on vulnerability, risk and need but it gives us hope about life post lockdowns. There are so many things we have missed, and have taken for granted prior to 2020, like the hug of our loved ones or how distant the world has become after being used to seeing distant places on the planet as (only) a plane ride away. If the planes are not flying (much) the planet becomes a distant place. However, the glimmers of the less socially distanced life are on the horizon, bringing hope and excitement about the new year.

Having loomed over us for over four years, Brexit is here.

Regardless on which side of the fence you were on when voting, and now with a trade deal, we have left the EU on 31st Dec 2020 so life in 2021 will be different to what most of have been used to during our lifetimes. Is the change going to be felt in everyday life? Without a doubt, and probably in so many ways that most of us do not realise yet. As with the pandemic, change will challenge us, making us feel uncomfortable in the beginning but in the true British spirit, I am certain that grit and determination will eventually lead us to a new, less turbulent world.

2

At Mediholdings, 2021 brings many new opportunities and our team are ready to meet them. Having been part of the Henry Schein group for over three years, there had never been a better time to pause and take stock of how significant that is.

From the start of the pandemic, which brought unforeseen challenges, MediHoldings, Software of Excellence, Henry Schein Dental, Optident and all the other Henry Schein Dental Group companies worked as one team - as oneSchein. The ability to leverage knowledge, skills and insights across the group has given us an unrivalled advantage in satisfying our customer’s needs across the product, equipment and services. In the past, while we may have operated independently, addressing the immediate need that the customer had, we have broadened our approach to be able to share insights across the group and bring further improved solution to our customers.

This will be the new normal going forward, with the ability to ‘plug-into’ shared information across the group so we can approach our customers holistically. Exciting times lie ahead, and we believe the value that will be delivered to customers, enabling them to excel in the new world, through the solutions we offer as oneSchein is unrivalled on the market.

We look forward to an exciting 2021 and serving our customers in what will be a year of new beginnings and hope.

To find out more about dental practices sales and valuations, dental recruitment or finance, please contact MediHoldings: 01332 609318 mediholdings.co.uk

MARKET INSIGHTS

2020 market insights

By Dean Barker

Offers made on dental practices in 2020

As expected there has been a strong end to the year with a total of £502m of offers made on dental practices in 2020.

We head into the new year with a really active acquisitions market and expect this to continue throughout 2021.

£80,000,000

£40,000,000

£20,000,000

£0

Jan

Feb

Quarter 4 Offers on Dental Practices

Activity levels in this period has more than doubled compared to 2019.

This has been a result of corporate and group activity increasing significantly, which is creating a more competitive edge on dental practices which fit the criteria of these types of buyers.

With this competitive edge, it is pushing multiples for some practices to the very high levels similar to the end of 2019 into practice ownership, which has increased exit options for practice owners looking to sell their business.

Mar

Apr

May

Jun

Jul

Aug

Sep

Oct

Nov

Period

2020

2019

% Change

October

£77,963,933

£39,043,078

100%

November

£34,386,850

£38,474,571

-11%

December

£96,881,000

£11,200,062

765%

Total

£209,233,803

£88,719,730

135%

2019 v 2020

Despite a tough year, the dental sector continues to be a place where investors are willing to invest and banks are very willing lend to all types of buyers in the market. Private equity based in the UK and Europe are still looking to enter the UK dental market, and the entities who are already in the market are placing further investments to increase their practice portfolio.

Taking into consideration the pandemic the dental sector has seen in 2020, it hasn’t had a huge impact on the offers we have seen for dental practices. In 2019, offers were a total of £528m, and for the same period this year, offers are a total of £502m which is only a 5% drop in a year which is unprecedented.

How dentists look at their own dental practice has significantly change in 2020, more now than ever dentists want to be the master of their own destiny.

In 2020 we have had a 42% increase in new buyers registering compared to 2019, this reinforces how the appetite for dental practices is higher than ever.

The growth of multi-site owners in the market has continued to rise in 2020, with the multiples being offered by these types of buyers competing with the larger corporates in the market, thus ensuring there is enough competition for practice owners to realise the best price possible for their practice.

We can also see a noticeable change in deal structures offered to practices by corporates in the market since COVID-19. Some purchases have longer tie in periods and, on the flip side, higher multiples can be paid along with additional earn outs for the practice owners on top of the original deal price for the dental practice. To conclude, dental practice owners should start thinking about exiting earlier than expected due to longer tie in periods, however they could benefit from a higher payout.

3

MARKET INSIGHTS

London & Home Counties Focus It’s a general rule of thumb that wherever there are large urban areas the demand for dental practices will be higher, but in this area of the country it is ever increasing, and even more so than in recent years.

London was once seen as the hot spot, however demand has gradually spread outwards from the capital beyond the M25 into the Home Counties. In these areas, we regularly have over 20 interested buyers for every practice. Demand for practices often exceeds supply so competition for practices that do come to market is fierce, which in effect is driving prices up and increasing the speed of sale of those practices.

As you can see below, the Home Counties accounted for just 37% of the buyer viewings on practices in London and the Home counties region in 2019. In 2020 this has increased to 49% and further emphasises the demand in the regions surrounding London.

London & Home counties region

London & Home counties region

split of Buyer viewings in 2019

split of Buyer viewings in 2020

49%

51%

37%

63%

London Home counties

London Home counties There are various types of buyers who are interest in these areas: Corporates & Multisite operators

Some of these buyer types have private equity investment whilst others are still 100% owned by the individual and are self-funded. Whilst most corporates will look to buy in almost all areas of the country, there are many multi-site operators who are looking in specific areas, like the Home Counties and for practices that can be part of a “buy and build� scenario. These buyers have identified areas with high populations, reasonable levels of disposable income and better recruitment opportunities because the return on investment for practices in these areas is likely to be strong.

Independent / Associate

Rather than trying to build a practice from scratch, most buyers are attracted to an already established practice which they can take over and build upon, usually by increasing private revenue. With bank lending readily available due to the strength of the dental market, it makes it a very viable option.

Volume of Buyers

As can be seen below, this chart shows the current number of buyers registered with MediEstates who are looking to purchase a practice in these areas and highlights the demand for practices in London & Home Counties.

1400

1266

1000

838

600

0

4

637

742 617

453 West Sussex

Surrey

London

Kent

Hertfordshire

Essex

484 East Sussex

659

576

Buckinghamshire Berkshire

RECRUITMENT

The shift in power for dental practice recruitment, but for how long?

By Phillip Barker It’s the end of 2020, which means it’s time to start predicting what the future has in store for 2021. If you’re reluctant to make predictions, we don’t blame you! At the end of 2020, who would have thought pre pandemic, the candidate-driven market would be replaced with dental practices having an abundance of candidates available now more than ever before.

During the latter half of 2020, MediCruit has seen a shift towards the dental practice when it comes to being selective.

In recent years, candidates held the power and drove the dental recruitment market. Decrease in vacancies during the pandemic has turned the market upside down. This is largely attributed to practices having to stay closed, NHS practices running shorter hours and the widespread use of furlough. In simple terms, decrease in jobs means higher competition per role, which enables practices to be more selective, whereas associates and support staff may not have the luxury of selection anymore.

The below table shows the comparison of applications MediCruit has received compared to the same time frame last year.

This shows there has been a 62% increase in applications when considering the amount of vacancies that are available during that period.

Number of Applications June 1st – Dec 15th 2020

Number of Applications June 1st – Dec 15th 2019

350

350

250

250

150

150

100

100

50

50

300

300

200

0

200

Jun

Applications Vacancies

Jul

Aug

Sep

Oct

Nov

Dec

0

Jun

Applications Vacancies

Jul

Aug

Sep

Oct

Nov

Dec

Whilst we are not completely ‘out of the woods’, things are certainly looking up. The release of regulated vaccines to the UK population has instilled a lot of confidence, the UK government have set a 200,000 vaccine target a day which should see us hit 14 million people by mid February this is a huge step forward in returning to a new normal life during the early stages 2021.

A recent survey said that 70% of organisations that have furloughed or laid off employees during the COVID-19 pandemic will backfill roles that were eliminated. If we take that consensus into the dental market, knowing that our industry can stand, within reason, the test of the pandemic we would estimate that there will be an increase of large proportion in vacancies registered during the first 6 months of 2021. Taking into account the above graphs, we expect to see the number of vacancies increase to be followed by a number of applications for those roles.

That’s great news for dental practices and candidates alike, but what does it mean for the current ability to attract the right candidate? Right now, practice managers and owners are looking for specific skill sets, personality types and a certain practice fit. The pandemic has shown us that flexibility and self-management are key when choosing the right candidate.

If you haven’t already, determine how you’ll handle candidate sourcing and selection now is the time to make sure that you have everything in place.

We would suggest that the time to look for these personality types and skill sets are now before the flood of positions opens in just a few months, where many dental practices may find themselves competing for the right candidate in the way they have been during recent years.

Partnering with MediCruit will enable you to identify the skills your dental practice needs, inform you of the market changes, provide valuable resources and free up your time to focus on driving your practice forward.

To find out more how we can help please contact us on: 01332 609318 mediholdings.co.uk

5

CASHFLOW

Cashflow Forecasting

By Dan Alder Chartered Financial Planner

What is Cashflow Forecasting?

Simply, Cashflow Forecasting projects your expected money inflows and outflows each year from now to your 100th birthday. For the very first time, it shows you how you can live your future. Driven by a detailed assessment of your future expenditure and what can be achieved with your sale proceeds, property, savings and pensions, it provides a no-nonsense evidence-based display, showing you when you can sell and when you can stop work.

Most importantly, this means that you will be able to see whether your financial future looks ‘secure’, i.e. you will outlive your money, ‘just right’, i.e. it lasts until age 100 or ‘not so good’ and therefore action is needed.

‘If action is need’ this means that you can assess the various options available to you to improve the situation and take proactive action today, not when it’s too late.

If your financial position is secure, We will often encourage you to live well now and not to wait until your state pensions start at age 67. How much is your state pension worth?

We’ll find this out for you and advise you if you need to top it up. It might surprise you that a couple today will typically have over £18,000 pa inflation-protected income from age 67. When we know this, we will help you enjoy that level of income now by spending down your capital so you enjoy your retired income at, say, age 60 instead of waiting so long when you might be less active. Its all shown in the cashflow.

A common feeling with our clients is that they would like to treat their family whilst they are still alive, so that they can see the impact gifts can have rather than passing everything on once they have died. The cashflow chart (see below for an example) helps us calculate what level of gifting is sensible.

Lifetime cashflow forecast £2,000,000

£1,800,000

£1,600,000 £1,400,000 £1,200,000 £1,000,000 £800,000

Normal income plus practice sale

proceeds at age 52, invested to help create desired income in retirement Repayment of debt

£600,000

CGT payable on practice sale

£400,000 £200,000 £0

Cash inflows Cash outflows

55

60

65

70

75

Age

80

To find out more how we can help please contact us: www.montgomerycharles.co.uk

advice@montgomerycharles.co.uk 01225 777999

6

85

90

95

100

CASHFLOW Capital chart

What do these annual differences in income and expenditure ultimately mean? This is where the Capital Chart comes in.

The Capital Chart shows the cumulative affect of each year on your financial position – any surplus money is added, or any annual deficit is deducted. Over time, this shows whether your money will outlive you or will run out at a certain date in the future.

Essentially the real financial risk in life is outliving your money. Cashflow Forecasting therefore provides peace of mind and clarity by answering these important questions that can rattle in your mind, especially when retirement is near.

Capital chart £3,500,000 £3,000,000 £2,500,000 £2,000,000 £1,500,000 £1,000,000 £500,00 £0

52 54 56 58 60 62 64 66 68 70 72 74 76 78 80 82 84 86 88 90 92 94

Age

Capital in 2020 terms £

Cashflow forecasting will answer these questions for you

How much do I need to sell my practice for to achieve the life I want?

When will I be able to afford to retire?

How much can I pass down to my bloodline and still have financial security?

What would happen if I sold as soon as possible?

Bringing your retirement forward

For you, this really means that you may be able to retire sooner, with less money than you think you’ll need, which allows you to live the same lifestyle as you do now. Bingo!

Selling your annual earnings (your practice) for a lump sum (the sale value) is scary and it is no wonder people overestimate what they need to sell their practice for – we all want peace of mind! However, you will be surprised how good investment advice can release the income you need.

Drawing money from your investments can be a lot more tax efficient than earnings from dentistry. By using annual exemptions, allowances and investment vehicles, we are able to make a huge difference, meaning your money will outlast you. Strategic tax planning can be a game changer.

Will I ever run out of money?

Being prepared for life’s transitions

Cashflow Forecasting takes the uncertainty away, answering the ‘what if’ questions and replaces them with clarity.

So, what’s next?

Once we have a clear picture of your current position and a view of what your future looks like, we can then, and only then, answer these questions: Do we have the right financial building blocks in place?

Are you investing your money wisely enough?

Ultimately, Cashflow Forecasting gives you confidence and peace of mind over your future and takes those annoying money questions out of your head.

If this has interested you or you have any questions, please do not hesitate to contact me for an informal chat.

Please note - This does not constitute advice and you should consult a financial planner prior to any action.

Your individual circumstances will significantly alter the advice you require.

To find out more how we can help please contact us: www.montgomerycharles.co.uk

advice@montgomerycharles.co.uk 01225 777999

7

INVESTMENT

Find your dream practice We’ve done the searching for you Practices for sale

ID 57394

ID 57821

Hertfordshire - Private

•• Advanced practice offering a variety of private treatments •• Suitable for both a group or individual acquisition •• Desirable and affluent location •• Both partners are happy to stay on post sale •• Opportunity to build on the current capitation scheme in place

ID 57568

•• •• •• •• ••

Tenure: leasehold Surgeries: 3 Lease (p/a): iro £30,000 Turnover 2020: £846,148 Profit: £320,518

£1,400,000

Surrey - Private

•• Very affluent and soughtafter Surrey location •• Refurbished in 2018 to a high standard - new equipment and cabinetry throughout •• Low cost base with good profit margin •• No spend on marketing since opening

•• •• •• ••

Tenure: leasehold Surgeries: 2 Lease (p/a): iro £15,960 Turnover 2020: £187,369

West Yorkshire Predominantly NHS •• Established for over 50 years •• Two NHS contracts (77.1%) •• Two surgeries with room to add an additional two •• Well presented practice new to the market •• Fully computerised with SOE •• Great growth potential •• •• •• •• ••

Tenure: leasehold Surgeries: 2 Lease (p/a): iro £9,000 Turnover 2020: £366,896 Turnover 2019: £370,673

£694,752

£350,000

The above is a small selection of the 100+ practices we have for sale.

Interested? Visit mediestates.co.uk or call 01332 809318

Practice success stories ID 55845 Surrey

LD

SO

•• Excellent growth potential •• Very well established •• 2 addition plumbed and wired rooms •• Fitted to high standard

£250,000 8

ID 54491 Hampshire

D L SO

ID 50787 Lancashire

D L SO

•• Opportunity to acquire a 4-surgery, mainly private practice •• Significant capitation scheme in place accounting for 60% of turnover •• Predominantly general dentistry with scope to introduce more specialist treatments in house

£1,200,000 •• In excess of 35,000 UDAs •• Well presented and equipped.

Specialist equipment included in the sale •• Huge property – room to add 4/5 surgeries •• Genuine potential to increase private income surgeries

£1,805,000 + freehold option

MEET THE TEAM

Meet the team Ian Simms Practice Valuation Manager Ian has been working for MediEstates just under 10 years where he has valued over 1000 practices and helped value practices from £15,000 to £5million.

Learn more about Ian below…

What does a typical day look like for you?

What does it allow you to do?

No two days are the same, one day I could be driving hundreds of miles to visit a client at their premises, another day I could be at home formulating valuations, or I could be flying to Scotland/Northern Ireland/Republic of Ireland providing our services to clients. I am also a part of our valuation panel who meet every week to agree the valuations of the whole team of Practice Valuation Managers.

With working from home I enjoy a lot of freedom and it allows me to manage my time effectively. I can prioritise what needs doing and what could be done later. A lot of clients are surprised to receive a call from me at 21:00 at night as I like to catch them at home when they have had chance to relax a little and have their tea in peace without being disturbed.

What do you interact with clients about?

I spend the majority of my time in front of practice owners providing a relevant insight into the current dental market, as well as helping to plan exit strategies tailored to vendors own circumstances.

How do you try to make them feel when they’re working with you?

I treat all of my clients as if they are the only client I am working for.

What are your credentials/past experience, for working in your position?

I have previously worked in the telecoms industry formulating deals for clients – Call centre based so helped with effective listening techniques. I have also worked in recruitment so I understand about staffing and I have worked in Insurance in a face to face role so have always been used to meeting business owners and talking about their business requirements.

What do you like about working at MediEstates?

It isn’t like having a job – it’s a lifestyle. Everyday is a day where you learn something new, even when you have worked in the business as long as I have.

Who does it allow you to become?

It allows you to become more confident - since I have worked at MediEstates I feel as though I am more of a business counsellor/coach/mentor – I do the right thing, because it is the right thing to do.

What’s the culture like?

We have an ever changing culture, we are constantly striving to do things better. Our practice Valuation meetings often turn into a business improvement meeting when one of us comes up with an idea as to how we can do or make something better.

What are the values that drive you?

Honesty, Integrity, dependability, reliability, loyalty What do you enjoy doing when you are not working?

I enjoy spending time with my beautiful wife Clare, enjoy watching Formula 1, and the highs (and often lows) of being a Stoke City supporter.

What are your 3 top tips for practice owners?

• Plan when you want to exit the business.

• Keep your overheads low.

• Grow the business income where possible.

To find out more about dental practices sales and valuations, dental recruitment or finance, please contact MediHoldings: 01332 609318 mediholdings.co.uk

9

RESULTS

Thinking of selling your dental practice?

What deal structures are currently available?

With the current acquisitions market being very buoyant and with record offers on practices being received, at the same levels if not higher than before COVID-19 hit the UK, it has made the deal structures for practice owners looking to sell more diverse than ever before, with a variety of different options available.

This stems from the activity of the corporates along with the multi-site practices owners, looking to grow their group and work with outgoing practice owners.

There are many questions that contribute to how you would like the landscape view after sale, will you actually have sold your practice?

Are you still tied to the liabilities? How long till you receive your full sale figure? Can you transform from employer to employee if required?

These largely depend on who buys your practice below is a summary of some of the most common types.

Here are some examples of deal structures Sell all of the practice ownership and receive proportion of the total sale amount up front (usually 50 to 80 %). The remaining amount (usually the remaining 20 to 50%) is called the earn-out. Earn-out is usually associated with the following tie-ins:

•R equirement to stay working in the practice to be a part of the transition process of moving the practice from your ownership to the ownership of the new buyer. This tie-in period is usually 3 - 5 years. The longer you are tied-in the more the risk is spread between you and the new owner. This could lead to a higher value being paid by the buyer for the practice.

• Requirement to achieve certain ‘targets. These could be minimal or onerous so need to be considered as part of the overall price paid for the practice. These goals could be in the form of:

■ Achieving a turnover target.

■ Achieving profit targets.

■ Growing aspects of the practice eg. revenue streams, services etc.

• Occasionally, practices with a high growth potential, the seller may be included in the ‘upside’ of the practice growth.

This is most often the case with sellers who are 10+ years away from retirement and who still want to pursue business growth.

This upside could be structured as a share of the profits, based on turnover or profit growth.

Sell all of practice ownership and walk away on day one. This is usually the case for practices sold to an independent buyer.

These tend to be dental practices that have less than 3 surgeries, with turnover less than £750,000 and a selling price below £1M. There are some scenarios though where a corporate or multisite owner will let the owner walk away on day one with all the proceeds paid up front.

• Sell a proportion of practice ownership (10% up to 80%) and cooperate with the new co-owner in building the business.

The new co-owner will bring skills, experience, knowledge or investment which will help the practice grow and develop further.

• I f you are selling a practice with other partners in the business, it is possible to negotiate a different deal for different partners in the business. This is usually the case when partners are of different generations and have differing ambitions and retirement plans.

Intricacies of each deal and each practice sale are different so while these are some of the more common deal structures on the market there are also others. Whenever you decide it is time to think about retirement, and this could be in your 20s, 30s, 40s or 50s it is never too late to ensure that your practice is professionally valued using evidence-based valuations.

MediEstates have been valuing practices for over a decade and the information from each transaction is part of the data used to value future transactions. As the largest dental practice broker in the UK market, we have our finger on the pulse and ensure you benefit from this experience. If you would like to find out more about any aspect of future planning, retirement sale or exiting your practice please get in touch with our experienced team.

10

FINANCE

Impact of an additional surgery

By Kimberley Parker We hope that you and your teams are well, we send our very best wishes.

Throughout this edition of Business In Focus, we have been providing you insight to help grow your business and increase revenue. One way to evolve your business and vision is through the addition of a surgery.

This is incredibly relevant during these extraordinary times as this permits greater capability to move between surgeries when implementing fallow time. Not only will this benefit the practice from the outset, it will also prepare the practice as the business grows with room to expand into another surgery without limitations. The result is the ability to truly meet your patients needs with the availability of additional sessions whilst enabling you to maximise on chair time. With increased diary availability based on the additional surgery, there is opportunity to profit from increased revenue, ebita and subsequently, the practice value.

Refinancing – cash flow & business growth

Have you considered refinancing your existing practice finance loan? Now may be a great time to review! The banks appetite is still fully present and this is reflected in the low rates that we have received for our clients on refinance deals - as low as 1.5% above base. A review has multiple benefits, freeing up cash flow, aiding growth, maximising on profitability whilst ensuring that you have the most competitive deal available to you. You may also be considering extending your practice portfolio and so a refinance could support the purchase of your next dental practice.

We provide a tailored and personal service in order to source the very best deals, suited to your business plans. Please don’t hesitate to contact us on this today.

SPEAK TO OUR EXPERT FINANCIAL TEAM TODAY 01332 321702

Annual Investment Allowance - Extension

Furthermore, whilst investing in your additional surgery, you will also benefit from the extension of the Annual Investment Allowance (AIA). The government announced that they will not revert back to an allowance of £200,000 from January 1st as initially planned and in support of businesses, will extend the £1,000,000 allowance through to December 31st 2021. This enhanced tax relief is welcomed news for businesses such as your own whereby this current period has allowed time for planning for investment and growth.

mediholdings.co.uk 01332 609318 contact@mediholdings.co.uk

HSMH001-01-21

Speak to our expert financial team today 01332 321702