A guest blog from our partners Medical Defence Shield
- By Sam Shah, specialist dental surgeon, medico-legal advisor and solicitor
For dentists, hygienists and dental therapists, an associate agreement is not just paperwork. It is the document that usually decides what happens to your income, your patients, your notice, your records and your options if the relationship with the practice breaks down. In recent cases, unclear or one sided agreements have led to disputes over withheld money, restrictive clauses, changing working patterns and uncertainty about self-employment status.
A well drafted agreement protects both sides. It gives the practice structure and certainty, but it also gives the clinician clarity about what they are agreeing to and what the practice can and cannot do. Without that clarity, disagreements can become expensive very quickly.
Retention and withheld funds
One of the most common issues is the practice withholding money at the end of the relationship. Sometimes this is called retention. Sometimes it is said to cover remedial work, failed treatment, patient complaints, lab bills, recruitment costs or other losses.
The problem is that practices do not automatically have a right to hold back money just because they say they are worried about future costs. In one recent matter, £2,500 was withheld and said to be held for 12 months, even though there was a strong argument that the retention arrangement was not actually agreed in the contract. In another contract review, there were concerns about wide deduction and retention clauses that were heavily weighted in favour of the practice.
That is why the agreement needs to say clearly:
- whether retention is allowed at all
- how much can be retained
- for how long
- for what specific reasons
- what evidence the practice must provide before keeping or deducting money
If funds are withheld without a contractual right, ask for a written breakdown, supporting evidence and a copy of the clause relied upon. If there is no clear clause, or the deduction goes beyond what the contract allows, the practice may be acting unlawfully and the money can be challenged formally.
Non-compete clauses
Many agreements contain post-termination restrictions. These can include non-compete clauses, non-solicitation clauses and restrictions on treating former patients after leaving. Some protection for a practice may be reasonable, but many clauses go further than they should and can seriously affect your ability to work.
Recent contract reviews identified broad non-compete and non-solicitation provisions as major risk areas, particularly where they were paired with immediate termination rights or unilateral variation clauses. The key question is whether the restriction is proportionate. A clause should not be so wide that it effectively stops a clinician earning a living in their local area.
Before signing, check the radius, the time limit and exactly what conduct is restricted. A fair clause should be narrow, clear and justifiable. For example, in the UK it’s unlikely that 5 miles over 3 years would be reasonable in most cases!
Self-employment issues
Many clinicians are described in their agreements as self-employed, but calling someone self-employed does not settle the issue on its own. The real question is how the relationship works in practice.
Problems arise where a contract says self-employed but gives the practice extensive control, fixed obligations and broad rights that look more like employment. Recent advice has highlighted concerns around IR35 or employment status indemnities, where the associate could be asked to carry the risk if HMRC later says the arrangement was not genuinely self-employed.
Self-employment wording should be consistent with the practical reality. If the practice controls your hours tightly, dictates changes without agreement, or includes clauses that shift tax risk unfairly onto you, that should be reviewed carefully before signing.
Data controllership
Data protection is often overlooked in dental contracts, but it matters. Recent contract reviews raised important questions about whether the practice is the data controller and whether the associate is acting only as a processor for practice data.
That may sound technical, but it has practical consequences. It can affect where patient information is stored, whether records can be used on personal devices, what happens after a data breach and who is legally responsible for certain decisions about patient information. If these provisions are unclear, both the practice and the clinician may be exposed.
Every agreement should say clearly who is responsible for what. If it does not, that is a sign the contract needs attention before it is signed.
Sponsored workers
Those working under a sponsorship certificate need to be especially careful. Contract terms about hours, pay, notice and role description can have immigration consequences as well as contractual ones.
If the agreement does not match the sponsored role properly, or if the practice changes hours or income in a way that affects the sponsored arrangement, the risks are much more serious. There can also be disputes where a practice tries to recover sponsorship related costs from the clinician without a clear contractual basis, even though those costs may be general practice costs rather than properly recoverable personal liabilities.
If you are sponsored, do not assume that a verbal reassurance is enough. Make sure the contract reflects the actual arrangement and get advice promptly if the practice tries to vary the terms.
Do not copy contracts
A major warning for practices and clinicians alike: do not copy and reproduce contracts from other providers, from another practice, or from the BDA unless you have permission to do so. Using someone else’s contract wording without proper authority can create legal and ethical problems, and copied terms are often badly suited to the actual working arrangement in any event. A contract should be properly authorised, properly adapted and properly reviewed for the specific practice and clinician.
Final point
Good agreements prevent bad disputes. They reduce the risk of arguments over money, restrictions, records, status and notice, and they make it far easier to resolve problems if they arise. If you need advice on an existing dispute or would like an associate agreement or contract reviewed before signing, contact the team for tailored advice and contract review support.
