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Show Notes

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Twenty dental practices sounds like a headline, but the real story is the unglamorous set of decisions that make scale possible. Dr. Ashkan Pitchforth joins us to explain how a UK dentist goes from a first acquisition to a multi-site dental group, without relying on hype or shortcuts. We talk candidly about the early trade-offs: keeping cash inside the business, living modestly, and staying focused on solutions instead of getting stuck on problems. 

A big part of the conversation is dental practice finance. Ash breaks down how he used rapid performance improvement to release equity, what happens when a bank says no, and why switching lenders can unlock growth when covenants and leverage limits tighten. We also dig into how banking changes once you move past roughly 12 to 15 sites, where you start needing corporate-level structure: CFO thinking, forecasting, HR processes and clean compliance that protects you from nasty surprises later. 

Then we get into what many owners overlook: the NHS as a strategic advantage when you understand it properly. Ash shares his acquisition criteria centred on NHS contracts and predictable monthly income to ensure debt serviceability. He explains how he learned the rules well enough to move contracts and win tenders, including the humility of stepping into an NHS dental adviser role to learn how commissioners think. Finally, we tackle recruitment and retention, and the therapist-first direct access skill mix model that flips the usual approach so dentists do higher-end work and therapists handle the routine flow, creating a steadier, more satisfying system for the whole team.

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