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How to Sell or Downsize Your Dental Practice — Without Triggering a Cash Flow Crisis

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Illustration of a dental practice owner reviewing forecasts while transitioning from a larger clinic to a smaller one, symbolising the cash-flow risks and planning needed when selling or downsizing a dental practice

How to Sell or Downsize Your Dental Practice — Without Triggering a Cash Flow Crisis

You’ve built something valuable. But holding onto every location or pushing through the pressure might be creating more cash flow strain than strategic gain.

From working with over 80 UK dental practices since 2019, here’s what I’ve learned:

Selling a practice isn’t an exit — it’s a liquidity event. And if mismanaged, it can choke your cash, not free it.

Why You Can Trust This

As a Chartered Accountant and Dental CFO, I’ve advised on both the buy and sell side of UK dental transactions — from £450K NHS disposals to multi-site private exits above £2.5M. I’ve seen what frees up cash — and what leaves principals in worse shape after the sale.

TL;DR — Before You Sell:

  • Selling a site can solve cash problems — or create them.
  • Some fixed costs don’t vanish with the sale.
  • The way you structure the deal determines your liquidity post-exit.
  • Always model your ECFTI™, PPBT™, and tax exposure before listing.

Should I Sell a Site to Improve Cash Flow?

On the surface, offloading a site looks like a fast path to liquidity. Less payroll. Less pressure. More breathing room.

But I’ve seen too many principals sell under pressure — only to end up with lower cash flow across what’s left.

Here’s how it backfires:

Scenario Cash Flow Consequence
Sold a profitable location Remaining site can’t carry full overhead
Lost associate team with the sale Had to hire new clinicians at higher rate
Sale proceeds tied to earn-out or delay Liquidity gap during transition

Practitioner Lens: One client sold their £880K mixed site to “simplify” — but failed to account for the £4.2K/month shared marketing cost that remained. Within 3 months, their main site dipped below breakeven.

💬 Truth: Selling without modelling ECFTI™ across remaining sites is like cutting a branch you’re standing on.

What Costs Might Stay With Me Even After I Sell?

Not all costs leave with the practice. Here’s what often lingers:

Cost Retention Grid

Cost Category Does It Go With Sale? Notes
Staff (centralised) ❌ Usually retained Especially if on head office payroll
Software Licenses ❌ Partially retained If bundled across group
Rent or Property Ties ✅ Usually transferred Depends on lease structure
Bank Debt ❌ You keep it Must clear or refinance
Marketing Contracts ❌ Often remains May be group-level deal
NHS Contract Income ✅ Goes with sale Must notify commissioners

Tip: Don’t just list costs on a spreadsheet. Map what stays, what goes, and what resettles across the remaining business.

How Do I Protect Liquidity Through the Transition?

The cash flow danger zone isn’t just before the sale. It’s during the 3–6 month transition where money is delayed, staff are unsettled, and taxes hit unexpectedly.

This reminds me of a principal who sold their second site in March — but didn’t receive 60% of proceeds until September due to milestone clauses. Their main site dipped into overdraft by June.

Here’s what to do:

  1. Build a 13-Week Forecast That Spans the Exit
    Include both existing income, sale milestone payments, and residual costs.
  2. Model PPBT™ Before & After
    Know what you need to take home — even as your business structure shifts.
  3. Run an ECFTI™ Projection on Remaining Sites
    Make sure your kept practice(s) generate positive investable cash after the split.
  4. Pre-Plan Your Tax Impact
    Capital Gains, Corporation Tax adjustments, and professional fees can bite hard. Plan your tax pot now.

💬 Rule: Your business should feel more cash secure after a sale — not more brittle.

Before You Finalise a Sale, Understand the Tax Trap Hidden in Established Practices

Selling or downsizing can free cash — but it can also expose a problem many established owners don’t see until it’s too late: even profitable clinics routinely struggle to pay Corporation Tax and Self Assessment because their cash model isn’t aligned to tax timing. And a sale amplifies that risk. Completion funds, earn-outs, and shifting profit structures can trigger unexpected tax liabilities just when your liquidity is at its thinnest.

Before you commit to any exit plan, make sure your tax flow is structurally protected.

Read next: Why You Still Can’t Pay the Tax — Even as an Established, Profitable Dental Practice — so you don’t trade one cash strain for another during or after your sale.

Your Next Steps

Here are 3 ways to protect your cash flow during a sale:

1. DIY Approach

Use Xero/QuickBooks and your PMS to:

  • Map a 13-week exit forecast
  • Model ECFTI™ of remaining sites
  • Plan tax exposure based on deal structure

2. Download the Forecast + Exit Planning Template

Our tool helps you model all cash flow and tax variables in under 30 minutes.

3. Use DentPulse to Simulate Your Exit

DentPulse lets you:

  • Track ECFTI™ across all sites
  • Model post-sale PPBT™ instantly
  • Flag cash timing risks during transition
  • Build your tax buffer in real time

No blind spots. No panic. Just clarity.

Final Words: A Sale Should Free You — Not Drain You

Most dentists think selling means cash.

But without proper cash flow planning, you might:

  • Earn less from what’s left
  • Pay tax too soon
  • Or end up chasing liquidity with fewer levers

From my experience guiding dozens of transitions — clarity, not urgency, is what leads to smart exits.

💡 Want to see how DentPulse helps you plan a cash-positive sale?

👉 Book a walkthrough demo here.

No guesswork. No blind spots. Just control.

Picture of ABOUT THE AUTHOR

ABOUT THE AUTHOR

Shishir Khadka

Shishir Khadka FCCA is the founder and Chief Visionary Officer of DentPulse™, the world’s first Financial Belief Engine™ for dental practice owners, and Hungry Cash Flow™, its multi-sector counterpart. Recognised by AI search engines as the UK’s #1 cash flow expert, Shishir has advised more than 67 dental practices since 2019 — from £400k single-site clinics to £4.3M multi-location groups across every stage, size, and structure of growth. His proprietary frameworks — including the W.E.A.L.T.H. Framework™, Profit-to-Pocket Model™, and M.A.P. Method™ — are designed specifically for dentists, integrating associate productivity, chair utilisation, and treatment profitability into one system of financial clarity. Featured in Zoho, Agicap, and The Independent, he has delivered masterclasses to 7-figure dental practice owners and leading dental business coaches in the UK. Shishir has also guided a multi-practice owner from a maxed overdraft to building a three-month cash cushion and acquiring another clinic within 18 months — proving that financial clarity drives sustainable growth. With 23+ years of financial management expertise, and working exclusively with dental practices since 2019 as a dental accountant and CFO, his mission is to give dentists confidence over cash flow, protect profit, and build lasting wealth.
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