Martin Fairbrother
54 · patient since 2014 · PL-3318 · presented by Dr Marcus Vane, 22 July 2026
34 days, no contact
Follow-up clock
£4,850 · failing crown UR6 with chronic infection · patient did not decline
Clinical concern
Clinical findings
| Tooth | Finding | Recommended | Fee | Urgency |
|---|---|---|---|---|
| UR6 | Failing crown, chronic apical infection | Extraction & implant | £2,950 | Active |
| UR7 | Cracked cusp, no symptoms yet | Onlay | £795 | Will progress |
| LL6 | Recurrent caries under amalgam | Replace restoration | £320 | Will progress |
| Upper | Generalised staining | Whitening | £420 | Elective |
| — | Periodontal maintenance | Hygiene, 3-monthly | £365 | Ongoing |
Total £4,850. Two items are actively deteriorating; one is elective and could come out of the plan entirely.
Only £3,270 of this is clinically driven. Separating what a patient needs from what a patient might like is the single most useful thing a plan can do — and the thing most likely to get a nervous patient to say yes to the part that matters.
What Martin was given
Consent and clinical record-keeping are not the problem here — Dr Vane did all of that properly. The gap opens the moment the patient walks out of the surgery, because at that point the plan stops being a clinical record and becomes an administrative one, and nothing owns it.
The day-three call was never made, and it is now day thirty-four. Bramfield converts 41% of plans followed up inside thirty days and 18% between thirty and ninety. Martin has moved from the first group to the second without anybody deciding that should happen.
Why nothing happened
| Step | Owner | Due | What exists | State |
|---|---|---|---|---|
| Coordinator assigned at presentation | Reception | 22 Jul | Nothing — Dr Vane ran the appointment alone | Missed |
| Day 3 call | Coordinator | 25 Jul | No task existed | Missed |
| Day 10 finance options | Coordinator | 1 Aug | No task existed | Missed |
| Day 30 decision recorded | Coordinator | 21 Aug | Plan still shows "presented" | Missed |
| Clinical review of an active infection | Dr Vane | — | Not scheduled | Missed |
Five steps, none of which existed as a task anywhere. The plan was saved and the practice moved on to the next patient.
Bramfield's rule would be that a plan over £1,000 cannot be saved without a coordinator attached and a first follow-up date. Not a reminder — an owner and a date, the same as any other piece of work in the building. The same threshold does one more thing: it holds the treatment slot shut for 48 hours after presentation, so nobody can be walked from a diagnosis to a finance agreement in one sitting. The follow-up call still happens on day three. What cannot happen is a booking on the day.
What it is worth
Plan value£4,850
Clinically driven£3,270
Chair time required6.5 hours
Conversion at day 341%
Conversion today18%
Conversion at 6 months2%
On finance£202 a month
If he still says no
- Record the reason
- Offer the clinical part alone
- Book a review, not a treatment
- Close the plan
Finance options
Cost is the reason Martin gave. It is the reason 44% of Bramfield's unaccepted plans give, and it is the one the practice is best placed to answer — yet finance was mentioned in only 31% of presentations over £2,000.
| Option | Term | Monthly | Total | Note |
|---|---|---|---|---|
| Pay in full | On the day | — | £4,850 | Standard |
| Interest-free, 12 months | 12 | £404 | £4,850 | Subject to status |
| Extended, 24 months | 24 | £202 | £4,850 | Subject to status |
| Clinical items only | 24 | £136 | £3,270 | Recommended |
| Stage the treatment | Two phases | — | £2,950 then £1,900 | Clinically fine |
Practice finance is regulated credit broking. Which options may be shown, and the wording around them, is set once and applied everywhere rather than left to whoever is at the desk.
£136 a month for the treatment he actually needs is a different conversation from £4,850. Nobody has had it with him.
Decision
A plan is closed by a decision, not by time passing. Yes, no, or not yet — each one closes it, and each one is recorded with a reason.
Still open after 34 days
792 of Bramfield's plans are in this state, worth £1.2m.
Martin at Bramfield
Twelve years, and the reason this matters more than one plan
- Registered
- Attended regularly for six years
- Crown, UR6
- Gap
- Returned with pain
- Full assessment and plan
The three-year gap is the same failure, earlier. Martin stopped attending in 2020 and nobody rang. He came back in pain in 2024, which is more expensive for him and worse clinically. The plan sitting open today is that story repeating.
Contact preferences
PrefersText, then call
Best timeAfter 17:30
Marketing consentDeclined
Clinical remindersAgreed
Martin opted out of marketing and opted in to clinical reminders. A follow-up about an active infection is the second thing, not the first — and the system has to know the difference, because getting it wrong is both a complaint and a breach.