Last updated: May 2026 | Author: The Business Acquisitions Group
“Private practices are always worth more than NHS practices.” You will hear this repeated in dental M&A circles as though it were settled fact. It is not — or at least, not in the way that is usually meant.
Private dental practices do attract higher EBITDA multiples than NHS-only practices. But the multiple is only one part of the valuation equation. The absolute sale price depends on the EBITDA itself, and a well-run, high-UDA-value NHS practice can achieve a higher total sale price than a small, principal-dependent private practice on the same normalised EBITDA.
This article explains how NHS and private dental practices are actually valued, what drives the difference in multiples, and how to think about your own practice.
The Two Valuation Approaches
NHS and Mixed Practices: Two Methods Combined
For practices with NHS income, buyers and lenders often use two complementary approaches:
1. Goodwill multiple on NHS contract income
The NHS contract has a guaranteed income value — annual NHS income × a goodwill multiple. The goodwill multiple reflects the quality and stability of the contract:
- High-value UDA contracts (£35+/UDA), clean delivery record, stable ICB relationship: 70–90p goodwill per £1 of annual contract
- Lower-value UDA contracts, some under-delivery, or ICB uncertainty: 50–70p goodwill per £1
A practice with a £600,000 annual NHS contract and a 80p goodwill multiple achieves £480,000 in NHS goodwill — before any value is applied to private income or tangible assets.
2. EBITDA multiple on total normalised profit
For mixed practices with significant private income, buyers increasingly apply an EBITDA multiple to the whole normalised profit figure, treating the NHS and private income together:
- NHS-dominant (80%+ NHS): 4–6× normalised EBITDA
- Balanced mixed (50/50): 5–7× normalised EBITDA
- Private-dominant (70%+ private): 6–8× normalised EBITDA
Private Practices: EBITDA Multiple Only
Private practices are valued on a single metric: normalised EBITDA × multiple.
The range is 6–10× normalised EBITDA, driven by:
- Whether revenue is principal-dependent or built into an associate team
- Specialty services (implants, orthodontics, cosmetic dentistry add value)
- Location, patient demographic, and review profile
- Whether there is a stable, contracted associate base
Why Private Practices Command Higher Multiples
Private practice income has characteristics that NHS income does not:
No contract renewal risk. Private practices have no equivalent of the ICB relationship — there is no government body that can vary, claw back, or not renew the income. This absence of counterparty risk is reflected in the multiple.
Upside potential. Private practices can grow revenue by adding treatments, growing the patient base, or adding associates — without a contractual ceiling. NHS practices are limited to their contracted UDA allocation.
Broader buyer pool. Private practices attract a wider range of acquirers including individual dentists (principal positions), premium DSOs, and international dental groups. NHS practices are more dependent on buyers with NHS Performer credentials and NHS experience.
No novation complexity. Private practice sales do not require NHS contract novation (a 3–6 month regulatory process). This speeds up completion and reduces transaction risk for buyers.
When NHS Practices Achieve Higher Absolute Prices
Here is the important nuance: a higher multiple does not automatically produce a higher total price. The price is multiple × EBITDA. If the EBITDA is higher, the total price is higher even on a lower multiple.
Example A: Large NHS practice
- Normalised EBITDA: £300,000
- Multiple: 5.5×
- Sale price: £1,650,000
Example B: Small private practice
- Normalised EBITDA: £120,000
- Multiple: 7×
- Sale price: £840,000
The NHS practice achieves nearly twice the price despite a lower multiple — because the underlying profitability is higher.
The UDA value factor. NHS contract income is not homogeneous. UDA values range from approximately £28/UDA (lower-value ICB areas) to £38/UDA (high-value areas). A practice in a high-UDA-value area with a large allocation has substantial NHS goodwill value that a lower-UDA practice simply does not.
The stability factor. For buyers who want a stable, predictable income base, a well-run NHS practice with a decade of consistent delivery and a clean ICB relationship is a genuinely attractive asset. The NHS income is contractually guaranteed and inflation-linked — that reliability has value, particularly for buyers financing with debt.
What Drives Multiple Within Each Category
For NHS and Mixed Practices
Higher multiple factors:
- High UDA value (£35+/UDA)
- 3+ years of consistent delivery at or near contracted allocation
- Clean ICB relationship with no outstanding clawback or performance correspondence
- Increasing private income as a proportion of total revenue
- Associate-generated (not principal-dependent) private income
- Good or Outstanding CQC rating
Lower multiple factors:
- Under-delivery in the UDA delivery record (buyers discount the income to delivered levels)
- Low UDA value
- Outstanding ICB correspondence or clawback risk
- High principal dependency across both NHS and private income
- Short remaining lease term
For Private Practices
Higher multiple factors:
- Revenue built into the associate team, not dependent on the selling principal
- Specialty services with meaningful contribution to income
- Established brand, strong Google reviews, loyal patient base
- Premium location with affluent patient demographic
- Contracted associate base with written agreements
Lower multiple factors:
- Revenue highly concentrated in principal’s personal clinical income
- Earn-out structures become likely as buyers price key-person risk
- No specialty services
- Principal-specific patient relationships
The Mixed Practice Advantage
Many dental practice sales advisers argue that well-balanced mixed practices — those with a meaningful NHS contract providing a reliable income floor alongside genuine private revenue generating higher margins — are among the most attractive acquisitions in the current market.
The NHS income provides lender security (banks and dental lenders are comfortable with NHS contract-backed income as collateral). The private income provides margin and growth potential. The combination can attract both individual buyers (who value the NHS stability) and DSOs (who value the private growth story).
For more on mixed practice valuations specifically, see our guide on selling a mixed NHS and private dental practice.
What Actually Determines Your Practice’s Value
The most accurate answer to “is NHS or private worth more?” is: it depends on the specific EBITDA and the specific multiple — and the multiple is determined by where your practice sits on each of the factors above.
A dentist with a £200,000 normalised EBITDA private practice on a 7× multiple achieves £1.4 million. A dentist with a £300,000 normalised EBITDA mixed practice on a 6× multiple achieves £1.8 million. The NHS/private classification tells you the starting point for the multiple range, but the final number is driven by the quality of what you’ve built.
The right starting point is a confidential valuation from a specialist dental practice broker — one that knows both the NHS buyer market and the private acquisition market, and can position your practice accurately against both.
Get a free confidential dental practice valuation →
For a full breakdown of typical sale price ranges, see how much does a dental practice sell for in the UK?
Frequently Asked Questions
Are private dental practices worth more than NHS practices?
Private practices typically achieve higher EBITDA multiples (6–10× vs 4–6× for NHS-only practices) — but the absolute sale price depends on the underlying normalised EBITDA. A large, well-run NHS practice with high UDA values and a clean delivery record can achieve a higher total price than a small, principal-dependent private practice, because the EBITDA itself is larger.
What is the typical EBITDA multiple for an NHS dental practice?
NHS-only practices: 4–6× normalised EBITDA. Mixed NHS/private practices: 5–8×, depending on how dominant the private income is. The multiple reflects both the income quality (NHS income is stable but has a contractual ceiling and renewal risk; private income has growth potential but is less certain) and the buyer demand for each type.
What makes an NHS dental practice more valuable?
The three most important factors are: UDA value (higher UDA value per contract = higher goodwill value), delivery track record (consistent delivery at contracted allocation with no clawback), and private income proportion (the more private income alongside the NHS contract, the higher the EBITDA multiple that applies).
Does NHS contract novation affect the sale price?
The novation process does not directly affect the headline price, but it affects who can buy and the transaction timeline (3–6 months). It also means there is contract uncertainty during the process that buyers price in through their offer structure. For detail, see our guide on NHS contract novation when selling a dental practice.
For a free, confidential assessment of your practice value, request a dental practice valuation from our specialist team.