Friday 18 September 2020
Dental sector added to Mischon de Reya's group action against insurer
The Insurance Times reports that the law firm Mischon de Reya has added the dental sector to its group action against the insurer QBE. The group action relates to the insurer's failure to honour business interruption insurance, as a consequence of the COVID crisis. As a result of the favourable test case ruling this week, MIschon de Reya is encouraging dental practices to join its group action. In April a number of dentists threatened to sue insurers over the insurers refusing to pay out on business interruption insurance, due to the COVID pandemic. In June, the British Dental Association turned to the FCA to ask that the specific plight of dentists be considered in relation to business interruption insurance.
NHS dentists are reminded of their obligations
Several news bulletins on BBC Radio Essex yesterday headlined with concerns that some dental patients seeking NHS care were being told that they couldn't have this because it went against 'safety guidance' but their dentists were willing to provide treatments privately. The local dental committee in Essex was quoted as condemning this practice, while BDA vice chair, Eddie Crouch said this was unacceptable. Eddie said that the BDA had written to all its members reminding them of their obligations.
BBC Radio Essex, 17/09/2020, 12h; 13h; 14h; 16h, 17 hrs. Not available on BBC Sounds
Thursday 17 September
BBC Essex talks dentistry and explores why some people are not getting NHS care
David Monk devoted the first 45 minutes of his mid-morning programme today on BBC Radio Essex to people’s difficulties in accessing NHS dentistry. We know that dentists are really having a hard time and are desperately trying to catch up on the backlog, the presenter said, but he was receiving calls and texts from listeners who told him that the treatments they were used COVID. This included a call from a woman who said that a filling had fallen out of her tooth two days after lockdown and was offered an NHS appointment in July. She subsequently received a call from her dentist who said the appointment was no longer available but he could see her privately the next day. During this visit she was told that if she hadn’t attended when she did that her tooth would have split. The filling, she said, cost £250 and she had other treatments which amounted to £540. She said she was fortunate because she could afford to pay but felt sorry for others who couldn’t.
The dental segment included a text from an anonymous private dentist and interviews with BDA vice chair, Eddie Crouch and chair of Local Dental Committee in Essex, Tony Clough. The practitioner said that private dentists hadn’t received any funding and explained that the NHS guidance stipulated that priority has to be given to patients requiring urgent care and emergencies first.
Eddie expressed sympathy for patients having to wait a long time to get their dental problems treated, and said most dentists were working flat out to get through the backlog. Eddie outlined the support provided to NHS dentists to help them get through the pandemic and said the BDA had written to all members to say what this entailed. He said he was very disappointed to hear where dentists weren’t adhering to this, and was unequivocal in his condemnation of the practice.
Tony Clough echoed many of the views expressed by Eddie, and said his LDC was aware of the issues raised in the programme and took the matter very seriously. He said that dentists had led on the provision of urgent care during lockdown and it wasn’t going to allow a few to damage the profession’s reputation. He said the LDC had already approached practices directly where they heard this was the case and warned that financial penalties could ensue. He told listeners that if they had concerns raised in the programme that they could contact the LDC directly and they would approach the practice concerned.
BBC Radio Essex, Dave Monk, 17/09/2020, starting at 10.25. This is not yet available on BBC Sounds
Russ Ladwa inaugurated as BDA's 134th President
Russ Ladwa, who has held many of the leading roles in UK dentistry, has today taken office as the 134th President of the British Dental Association. A former Dean of the Faculty of General Dental Practitioners, he has chaired both the Federation of London Local Dental Committees and the Dental Vocational Training Authority, and was a board member of the odontology section of the Royal Society of Medicine before being made its president. In 2012, having been a life-long member of the BDA, Russ was elected to its board, serving until 2019. Russ qualified as a dentist from the London Hospital Medical College in 1975. He returned from a short spell as a civilian dentist in the US Army to work as an associate in an NHS practice in West London in 1977, buying the practice shortly thereafter. In the 1980s Russ was involved in establishing the Asian Odontology Group and was a founding member of the Association of Dental Implantology. In 1990, he was one of the first London GDPs appointed as a Postgraduate Dental Tutor, a position he held for 23 years. Russ Ladwa said: "Clearly the Coronavirus pandemic will inevitably loom large over my presidency. So, I am heartened the BDA has stepped up and shown real leadership when it hasn't always been forthcoming from the authorities. This challenge, huge as it is, will dominate, but not define my term of office.”
Wednesday 16 September
Dentists warn tooth extraction surgery backlog is a 'national scandal'
In a letter to Health Secretary Matt Hancock, the British Dental Association said yesterday that waiting times were a "national scandal" and likely to soar as a result of the pandemic. It called for an urgent action plan to tackle the growing backlog. Charlotte Waite, chair of the BDA's England Community Dental Services Committee, said: "The hundreds of extractions that took place every day in hospitals ended with lockdown, but demand hasn't gone anywhere. "Stretched services are now struggling to meet the backlog, while tens of thousands of vulnerable adults and young children wait in pain. We need a plan and full disclosure on the true scale of a problem that is already a national scandal." The Express explained that extractions are often performed under general anaesthetic for children and vulnerable adults, including those with learning disabilities. The letter, also signed by charity Mencap, told how some children waiting more than a year needed multiple courses of antibiotics to fight infections. It said: "A whole year in pain with trouble eating, speaking and sleeping is unacceptable for anyone, let alone our most vulnerable patients - and this is set to get worse."
Children are waiting up to a year to have rotting teeth pulled due to Covid-19 delays
The Telegraph reports that tens of thousands of vulnerable adults and young children are "waiting in pain" for treatment, highlighted by the BDA in an open letter, signed by a range of stakeholders, to Health Secretary Matt Hancock. "Significant" waiting times for extractions have resulted in children requiring "multiple courses of antibiotics" to fight infections, the group warned in a letter to the Health Secretary. Data gathered by the BDA from across England suggests many community and hospital dental services are yet to resume extractions, which are performed under general anaesthetic after they were paused at the beginning of lockdown. Up to 50,000 elective procedures were postponed for under 18s between March and May, according to official statistics, and tooth decay remains the "number one reason" for admission among young children, the BDA said. Official targets for extractions vary between one month and 18 weeks, but due to "high demand and underinvestment" waiting times longer than a year were occurring before the pandemic and are now "expected to surge", it added. The BDA has called for an "urgent action plan", and the publication of an internal Public Health England review into the "true scale" of extractions under general anaesthetic, which is believed to be "significantly understated".
"We have raised this issue repeatedly with NHS England," the letter reads. "Meanwhile the situation has continued to get worse, so we are asking you to step in to resolve this problem as a matter of urgency." Charlotte Waite, Chair of the BDA's England Community Dental Services Committee said the demand "hasn't gone anywhere" despite lockdown. "Increasingly stretched services are now struggling to meet the backlog, while tens of thousands of vulnerable adults and young children wait in pain," she said.
BDA estimates that around 10 million people will not have had a routine dental check-up by end of this year
Phil Upton's breakfast programme on BBC Radio Coventry and Warwickshire also highlighted BDA's concern about how long patients are having to wait to get a dental appointment. In an interview, BDA vice chair, Eddie Crouch said the trade union estimated that by the end of this year around 10 million people will have missed out on having a routine dental check-up. Commenting on NHS guidance on fallow time, Eddie noted that obviously, as profession, we want to operate safely, but we're one of the few countries in the world that has an hour's 'down time' between coming out of a procedure and seeing the next patient. He said dentists want the science on fallow time to be reviewed because if it allow dentists to see patients on a more frequent basis, this will improve the service for patients.
Dentist Hani Mostafa also spoke on the programme and said he now sees around eight patients a day, compared to between16 and 30 patients a day before the pandemic. He said he runs a mixed practice and has 'installed certain measures to reduce fallow time'. However, he said there was a 'disparate culture within dentistry' between the NHS and private care and said the NHS had strict guidance [on fallow] to follow. He said that some patients were forced to seek private care.
BBC Radio Coventry and Warwickshire listen from 01:49:28
Tuesday 15 September 2020
Unions alarmed over lack of consultation on PHE abolition
Eleven unions, including the BDA, have written to Matt Hancock expressing their alarm over plans to abolish Public Health England (PHE), the
Health Service Journal reports. The signatories to the letter (BDA, BMA, RCN, Federation of Clinical Scientists, Chartered Society of Physiotherapy, Prospect, Unison, Unite, PCS, FDA and Managers in Partnership), seek assurance that there will be no compulsory redundancies for workers in PHE. They warn that abolishing PHE and creating the new body could distract from vital pandemic work. They urge the health secretary "to ensure that we have an adequately resourced national public health system (including laboratories) with sufficient capacity, resilience and access to data, research and analysis over the long-term to address all domains of public health effectively." The unions have also sought a "binding commitment" to the independence of the National Institute for Health Protection and acknowledgement that strategic public health functions should be the responsibility of publicly accountable bodies. They say the government needs to address the issues we are raising comprehensively and urgently, and in a way that reassures both the staff directly affected, and all of us in the country, since we rely on their invaluable work. "We are alarmed by the creation of the National Institute for Health Protection without properly consulting expert staff and without a clear plan for the future of large swathes of PHE," the unions said.
In August, Hancock announced PHE would close in April 2021. Its health protection functions would be rolled into the NIHP, along with NHS Test and Trace and government's Joint Biosecurity Centre. A new public health agency could be formed to take on PHE's health improvement and prevention functions, or they could be moved into other organisations, such as local government — which houses most local public health — or NHS England. Proposals so far suggest the body will be part of the Department of Health and Social Care, rather than an independent agency, according to the HSJ. A Department of Health and Social Care spokesman said: "We will be consulting with staff and engaging with an external stakeholder advisory group on where Public Health England's health improvement functions would be best placed in order to continue supporting the UK's public health system and helping people live longer, healthier and happier lives."
Monday 14 September 2020
If we’re not seeing the same number of patients as before, more will lose teeth that may have been possible to save through no fault of patients nor of dental practices
Last Saturday, the 6.30pm news bulletin on BBC 1 Wales highlighted that it could be next year before the backlog of dental cases could be treated. The segment also featured a warning from BDA chair of the Welsh general dental committee, Tom Bysouth, that many of Wales’ 500 dental surgeries were facing the threat of redundancies or even closure. The presenter added that the British Dental Association has called for support for dental practices.
Commenting on worst case scenario for the patients, Tom said if we are not seeing the same number of patients, then we’re not fixing the same number of teeth, and that means patients potentially losing teeth that may have been possible to have saved through no fault of patients nor of dental practice. It’s just an unfortunate set of circumstances that have led to that. Furthermore, it impacts on the sustainability of dental practices. The BDA’s concerns were also highlighted on news bulletins on BBC Radio Wales.
BBC 1 Wales, Wales Today; 12/09/2020, Unavailable on BBC Sounds
Many of Wales’ 500 dental surgeries are facing the threat of redundancies or even closure
The chair of BDA’s Welsh general practitioners committee, Tom Bysouth, told the
BBC that dentists are "firefighting" to deal with a "huge backlog" and will not catch up until 2021. “If we were acting in normal circumstances, it would take at least another six months," he said. "We're prioritising the more urgent care - but as an example, I took four people off our fillings list yesterday, and put three on. If it stays the same, it won't be in 2020 we catch up, but 2021. We are chasing the tail." Tom is also concerned that, with people not having routine check-ups, signs of mouth cancer may be missed and fillings will get worse, making teeth irreparable. "Before lockdown, a typical practice with three dentists would see around 60 to 80 people a day, but that dramatically reduced over lockdown in order to comply with social distancing measures," he said. Some had been seeing as few as 10 a day when they reopened because of Welsh Government rules around ventilating surgeries. But new guidelines that came into effect in August meant a new patient can now be seen every 20 minutes not every hour, greatly increasing the number.
The BDA estimates during lockdown patients seen on the NHS fell by as much as 98% and with practices paid for each one treated, for many this makes it "impossible to stay afloat" without help. "NHS practices have been offered support," a spokeswoman said. "But most practices are mixed - doing both private and NHS work. There's been no meaningful help for private practice. If these practices fail, their patients have nowhere to go."
Tom warned that many of Wales' 500 surgeries were facing the threat of redundancies or even closure. However, with government financial support only available for NHS work, he believed those that did less of it were in a "precarious" position. He said: "There is a risk some may have to close, let staff go or reduce their hours. Like any business model, it needs to be viable. They are as vulnerable as any business. "People already face a 90-minute round trip in parts of Wales and 15% of practices are taking on new patients. And this was pre-Covid." The BBC also reported that the BDA called for a rates holidays for private dentists, the same enjoyed by other businesses and said the end of the furlough scheme would be a "a major challenge" for them as they are operate at "a fraction of capacity".
We need downtime to be reduced for practices to be viable and to provide a better service for patients
During an interview with Danny Kelly on BBC Radio West Midlands, BDA vice chair, Eddie Crouch said that at least 10 million check-ups have been lost since February. He said he was hopeful that research into the ‘downtime’ for aerosol generating procedures would show that this could be reduced. “We need this for dental practices to be viable and to provide a better service for patients,” Eddie said. When asked whether people were taking better care of their teeth knowing they can’t get a dental appointment, Eddie said the picture was mixed, with some people eating more sugary snacks. In winding up the discussion, the presenter commended Eddie for his ‘gorgeous smile’ and for ‘having some of the best teeth in the west midlands’!
BBC Radio WM, Danny Kelly, 11/09/2020, 12.43; unavailable on BBC Sounds
Scotland: consultants could demand extra payments to put their lives on the line in intensive care units this winter if Covid-19 cases spiral
The Herald Scotland reports Lewis Morrison, chairman of the British Medical Association (BMA) Scotland, said a failure by the Scottish Government to reward consultants for going “above and beyond” contracted hours during the pandemic had created ill-feeling amongst staff, many of whom have put themselves and their families at risk to care for the most seriously ill patients. With cases of the virus reaching a four-month high, Mr Morrison said there has been little chance of the “rest and recuperation” that was talked about by Government leaders in early July when cases of the virus were low. Health Secretary Jeane Freeman announced in July that NHS medical and dental workers would be awarded a 2.8% increase in their annual pay rise, in common with those across the rest of the UK. However, the chairman said there is a “real frustration” that after four months of lobbying, the Government did not agree a separate, national deal to recognise extra hours and changes in working practices and blamed the “tired narrative” that senior doctors are already overpaid for the decision. In his speech to the BMA’s first virtual Annual Representatives Meeting, the chairman also said the pandemic could finally force a debate on what the NHS can realistically expect to deliver going forward and how treatments are prioritised.