£1.2m of treatment was diagnosed last year and never mentioned again.
Bramfield presented 1,940 treatment plans worth £3.1m and patients accepted £1.9m of it. The other 792 plans — £1.2m — were diagnosed by a clinician, explained to the patient, and then left, because “I’ll have a think about it” is not a status that anything tracks. 578 of those patients were never contacted about it again. Private dentistry is a business where the diagnosis is the easy part, and the software either owns what happens next or nothing does.
We built the screens that make it stop — every one of them live and clickable below. Then we build the same for your practice, with no commitment: the screens your team would use, in your language and your brand, linked up so you can walk your own process through them. Open it, show your team — if it's a fit, we'll make a detailed, priced proposal.
Bramfield Dental & Aesthetics does not exist. We cannot show live client systems, so this study is built around a fictional practice — invented business, invented clinicians, invented patients, invented figures. What is not invented is the work: the treatment plan lifecycle, the governance regime, the two recall cycles and the failure modes are all real, and the screens are genuine working pages rather than pictures of pages. Every mockup on this page opens and responds to clicks.
What this is not: a practice management system. It does not chart teeth, hold clinical records, run the front-desk diary or file claims, and it is not something you would rip your PMS out for. Displacing one of those is a far larger undertaking than this. Your practice management system, your imaging and your accounts all stay exactly where they are.
What it is: the layer none of them owns — the plan that was diagnosed and never mentioned again, the recall that quietly lapsed, the clinician whose acceptance rate has been sliding for two quarters, and the evidence a governance visit asks for. Where a tool already does its job, we integrate with it rather than replace it.
On scope: Bramfield is a local private practice serving its own community — two sites, patients who live nearby, and treatment delivered over months. It is deliberately not a medical tourism operation, which is a different business with a different problem. Bramfield is set in England, which matters: clinician registration is UK-wide but the inspectorate is not, and a practice in Wales, Scotland or Northern Ireland answers to a different one. The specifics of registration, prescribing and consent also change — in a real build all of that is configuration, not code, and nothing here is advice.
A practice that is very good at the clinical half and has no system for the other one
Bramfield runs two practices in Cheshire — mostly private dentistry, with a facial aesthetics clinic that has grown into a fifth of the revenue. Nine dentists, three hygienists, two aesthetic practitioners, 6,800 patients. The dentistry is excellent. What happens between a patient being told what they need and that treatment being booked is held together by the memory of whoever was in the room.
- Practices
- 2
- Active patients
- 6,800
- Clinicians
- 14
- Treatment coordinators
- 4
- Revenue
- £4.9m
- Aesthetics share
- 19%
- Plans presented, 12 months
- 1,940
- Value presented
- £3.1m
- Value accepted
- £1.9m
- Chair utilisation
- 78%
- Recalls overdue
- 2,410
- Lost appointments a year
- 1,842
Eight failures, and what each one actually costs
Every one of these has a clinical face and a commercial one, and the clinical face is the more uncomfortable of the two. A plan nobody followed up is not only revenue — it is a diagnosed problem getting worse in somebody’s mouth.
A plan is closed by a decision, not by time passing
One idea holds this together. A treatment plan over £1,000 cannot be saved without a named owner and a first follow-up date — not a reminder, an owner, the same as any other piece of work in the building. It cannot be closed without a decision: yes, no, or not yet, each with a reason. That single rule is what turns £1.2m of forgotten plans into a worklist.
Everything else reads from it. The diary knows which waiting patients could fill today’s cancellation. The recall engine knows which patients are on a clinical reminder and which need marketing consent. The governance register applies the same expiry logic to certificates that the plan applies to follow-ups.
One thing this is not: a system for pressuring patients. A patient who understands a plan and declines it is a good outcome and closes it cleanly. What it counts is decisions recorded, not treatment sold — which is both the ethical position and, as it happens, the one that produces better numbers.
Seven screens follow. Each one opens as a real page — click through them.
Seven screens. Every one of them real.
No screenshots, no slideware — each screen below is a working page, rendered live in its frame. Click a frame or its link to open the full screen in a new tab and use it.
Today
The morning view for a principal or practice manager: outstanding treatment by age, chair utilisation against target, follow-up rates by clinician, and a list of what a person should actually do before six o’clock — ordered by clinical consequence first and money second.
Treatment plan & follow-up clock
The screen this study is built around. A £4,850 plan presented thirty-four days ago to a patient who did not say no — he said he needed to think about the cost, and nobody ever mentioned that it could be paid monthly.
Five follow-up steps, none of which existed as a task anywhere. The plan separates what is clinically driven from what is elective, prices the consequence of the delay using the practice’s own conversion rates, and shows the same failure repeating: this patient stopped attending for three years in 2020 and nobody rang then either.
Outstanding treatment
£1.2m of diagnosed treatment sitting unbooked, and the honest number underneath it: £312,000 is what the pot is actually worth once you apply the practice’s own conversion by age. Quoting the £1.2m is how software gets sold; quoting the £312,000 is how it gets kept.
More than half the plans have no recorded reason at all. The smallest group — forty-four patients stalled by anxiety, twenty-one of them clinically active and left for five months — is the one to fix first.
The book
Four and a half hours of empty chair today, forty-one patients on the standby list who would come at short notice, and 214 patients with treatment already diagnosed and waiting for a slot. Three lists that live in three places.
Underneath, why the chair sits empty across a year: 518 patients simply did not turn up, against a practice that sends one reminder and never asks for a reply.
Recalls
Two entirely different cycles running side by side. A dental recall is a clinical reminder on a six-to-twelve month interval. An aesthetics top-up is a commercial approach about an elective treatment on a three-to-four month cycle, and it needs marketing consent.
Running the second under the rules of the first is how a practice ends up with a complaint it cannot defend — so the system holds the distinction rather than leaving it to whoever runs the list.
Clinical governance
An aesthetics clinic bolted onto a dental practice inherits two regulatory worlds at once. The dentistry is inspected and the clinicians are registered; the aesthetics side turns on who prescribed, whether that prescriber saw the patient in person — a prescription for an injectable cannot be written remotely — and whether the practitioner was inside their competence.
One clinician’s mandatory medical emergencies training lapsed in August and he has treated patients on eleven days since. Nobody knew, because the certificate is a PDF in a shared folder — the same failure as the treatment plans, wearing a different hat. Eleven days of treating patients without it is the kind of finding an inspection does not let go of.
The screen also carries the complication protocol: the routes a patient can use to report pain or a colour change after an injectable, and where each one has to land. It is the only queue in the practice that is not allowed to be a queue.
Patient portal
A second audience, and a nervous one. The same plan in plain English — what is wrong, what would be done, what it costs, and which parts are genuinely optional. It separates the £3,270 that is clinically driven from the £4,850 total, and shows the monthly figure that nobody mentioned in July.
It also says the thing a practice rarely puts in writing: you are under no obligation to have any of this, and if you would rather do nothing we will book a review instead.
The plan first, because it is the thing with a patient behind it
Four phases of two weeks each — eight weeks end to end. The treatment plan and its follow-up clock go live first, because 184 of those stalled plans belong to patients with an active clinical problem. Each phase ends with something the team actually uses, not a demo.
Discovery & data
Weeks 1–2.
- Migrate patients, plans and clinical notes
- Fee structures and finance options
- Recall intervals and consent basis per patient
- Agree what closes a plan
Plans & follow-up
Weeks 3–4.
- Treatment plan with owner and follow-up dates
- A cooling-off window before high-value treatment can be booked
- Clinical urgency separated from elective
- Finance options built into presentation
- Outstanding treatment worklist
Diary & recalls
Weeks 5–6.
- Day book with gap and standby matching
- Confirm-don’t-remind appointment messaging, classified as administrative
- Clinical recall and aesthetics cycles, kept separate
- Anxiety flags that change how booking works
Governance & rollout
Weeks 7–8.
- Clinician registration checked against the public register weekly
- Aesthetics prescribing, consent and photographs
- Complication protocol that escalates instead of queueing
- Audit scheduling with named owners
- Patient portal, one practice first
Eight weeks is possible because most of it already exists. The patient and case records, document handling, expiry tracking, escalation rules, the SMS and email engagement engine and the portal are running in production across six sectors already. What actually gets built for a practice is the sector core: the treatment plan structure, the clinical-versus-elective split, the two recall bases, and the governance register. That is the part this study is about, and it is the part we would spend the eight weeks getting right.
What is real here, and what is not
Real
- The treatment plan lifecycle, and the fact that most plans stall for reasons nobody records
- The governance regime — registration, indemnity, mandatory training, audits, and the separate questions the aesthetics side raises about prescribing and consent
- That a clinical recall and a cosmetic top-up rest on different lawful bases, and that an appointment confirmation stops being administrative the moment it carries an offer
- The two recall cycles and the different legal bases they sit on
- The failure modes. All eight are drawn from how practices actually run
- The screens themselves: working HTML, not images, built the way we build the real thing
Not real
- Bramfield Dental & Aesthetics, its clinicians and its patients. All invented
- Every figure on every screen, including the conversion-by-age curve — that is Bramfield’s fictional data, not published research
- Any claimed outcome. We have deliberately not put a saving or a return on this page, because we would be making it up
- Any resemblance to a client. We do not show live client systems, which is precisely why this study exists
The engine underneath is already in production
The difficult parts of this system exist and run today — they are just doing it for other sectors. Live platforms, with the same client and case records, document handling, approval limits, escalation rules and portal at the centre of each:
- Medical tourism
- Student management
- Retrofit & remediation
- Financial brokerage
- Property management
That is why the working mockup is a realistic offer: we are not sketching a new product to sell you, we are showing you what the existing one would look like with your stages, your language and your brand on it — before any build begins.
We would rather show you your own screens
This took a fictional practice and made its process visible. The same exercise works better with a real one — your treatments, your language, your brand — and it costs you nothing to find out whether it is worth building.
A conversation about your treatments, your clinicians and where the money leaks.
A working mockup of your own process — clickable, in your language and your brand.
Click through it with your team. If it's a fit, we'll come back with a detailed, priced proposal. If not, we part on good terms.
Ready to see your own screens running like this?
Tell us how your practice actually runs — your treatments, your recalls, your clinicians, where the money leaks — and we'll show you how we'd build it. If it's a fit, we build your screens. No commitment — and a detailed, priced proposal only if you ask for one.
What happens next
- We reply within one working day — a person who has read your note, not a bot.
- If it's a fit, we build your mockup — the screens above, re-skinned to your process and your brand.
- You click through it before anyone commits — if it earns the build, we talk about that.
Every enquiry is confidential — we never share your details, and we never put client work on a website.
Thank You!
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