Friday 5 June 2020
Here's my weekly roundup of the five major things that happened this week in relation to the COVID-19 pandemic and UK dentistry. I hope you find it useful.
Useful links from the video:
BBC News at One: Not all dental practices can re-open on 8 June
BBC News at One interviewed our Vice Chair, Eddie Crouch on the issues dentists are facing in trying to return to face-to- face care on Monday.
Watch from 17:12 (available until 13:30 tomorrow)
Scotland: PPE supplies for dental practices
NHS National Services Scotland (NSS) has provided an update on PPE supplies for dental practices.
NSS National Procurement is working with NHS Boards across Scotland to deliver PPE for onward distribution (by Boards) to all dental practices. Allocation to NHS Boards will be based on the number of
practices in each Board area.
National Procurement has today distributed more than 3 million individual items of PPE to dental practices – these supplies are currently en route to all 14 territorial boards for onward distribution to over 1,100 dental practices throughout Scotland.
The challenges of re-opening on June 8
"If footballers can be tested twice a week then why can't we as healthcare workers?"
Mixed-practice owner Anne Grew writes about the challenges she faces in trying to ensure safety for her staff and patients when they re-open for face-to-face care on June 8.
Anne's blog: Re-opening a dental practice after lockdown
Scotland: Guidance for reopening private practices
Wholly private practices in Scotland may now open to treat patients.
The National Clinical Director and CDO issued a joint letter to private practices earlier this week and Healthcare Improvement Scotland (which is responsible for inspecting private practices) has issued guidance on reopening. The guidance stresses the importance of patient and staff safety, and of not contributing to an increase in the R number.
Regarding AGPs, it states: "Dental practices where the use of AGPs are needed as part of urgent or essential care must submit revised risk assessments and operating procedures to HIS before restarting these procedures".
Of the 1,000 dental practices in Scotland, only 23 are wholly private. The CDO is set to issue a letter setting out a timeframe for reopening NHS and mixed practices.
Updated edition of toolkit for returning to face-to-face care launched
You can now download the
updated edition of our toolkit for returning to face-to-face care. While primarily meant to support dentists in England as they prepare to re-open from 8 June, it also contains advice and support that’s applicable across the UK.
New content includes:
- Respiratory protective equipment, RPE (p30)
- Types of respirator; What is adequate and suitable?; The limitations of RPE; What to look for in fit-testers; Selecting the right mask; FFP2 or FFP3?
- PPE fit-testing (p32)
- Dental aerosol contamination reach (p36)
Updated content includes:
- Closing dates for the furloughed workers scheme (p20)
- Cleaning down of surfaces and floors (p28)
- Associate relationships (p21-22)
Our aim is to support you in the practical application of the widely agreed measures, so you can return to face-to-face care with confidence. We will continue to update this toolkit as more information becomes available.
New Standard Operating Procedures for England
Standard Operating Procedures (SOPs) have been published in England.
- Transition to Recovery: A phased transition for dental practices towards the resumption of the full range of dental provision
- Urgent Dental Centres (UDCs): Guidance and SOP for the provision of urgent dental care in primary care dental settings and designated urgent dental care provider sites.
BBC News on dentists returning to face-to-face care
Last night BBC London featured a segment on the issue of PPE supply in regard to dental practices in England opening on 8 June.
Watch from 4:45 (available until 22.50 tonight).
Thursday 4 June 2020
New guidance from The Dental Schools Council
The Dental Schools Council has published a new guide:
COVID-19 – returning to student-led dental clinical treatments which provides recommendations on risk mitigation based on currently-available evidence. The guide, which will be updated regularly, complements
our own new toolkit and we were pleased to contribute to its development.
Northern Ireland: Clarity sought on PPE and financial support
Richard Graham, Chair of Northern Ireland Dental Practice Committee, has written to the Health Minister Robin Swann to seek
clarity on issues relating to the phased return of the GDS as outlined by the Acting CDO earlier this week.
Clarity is being sought on whether the Department of Health will give practitioners access to a central supply of PPE, if financial supports will continue for so long as they are needed and whether there will be a reduction of the abatement on FSS payments as costs increase alongside an increase of face-to-face care. The plight of private practice has also been emphasised to the Minister.
BDA Good Practice members: Returning to face-to-face care
Good Practice members (currently England only) may now complete our
returning to face-to-face care assessment to receive a certificate to indicate Good Practice compliance. We hope to expand this to include the devolved nations soon.
Not a Good Practice Scheme member? Find out more about the
Good Practice certification today.
British Dental Conference and Dentistry Show postponed again
The British Dental Conference and Dentistry Show has been officially postponed once again. The planned date of the next conference is now 21-22 May 2021. Further details can be found on the
show website. For queries relating to the show, please
contact the organisers CloserStill Media.
Standard Operating Procedures published
The Office of the Chief Dental Officer England has released the much anticipated
Standard Operating Procedures for the 'transition to recovery'.
The SOP aims to cover a phased transition for dental practices towards the resumption of a full range of dental provision.
Perspectives on re-opening from around the country
We’re working to support and inform dentists across the UK, as restrictions on dentistry are lifted at different rates across the four nations. Here are some voices from around the country, reflecting on the challenges dentists face:
England: Anne Grew, a mixed practice owner from North London, tells us why re-opening a dental practice after lockdown poses serious challenges
Northern Ireland: Tristen Kelso reflects on the challenges of returning to face-to-face care and the burning questions facing dentistry in Northern Ireland
Wales: Paul Jones tells us how de-escalation plans impact private practices in Wales and highlights members’ voices at this critical time.
Wales: CDO's message to private practices
Dr Colette Bridgman, Chief Dental Officer Wales,
has acknowledged the pressures placed on private practices in Wales at this time, as she looks ahead to when current restrictions will lift she has said: "The treatment you can offer is currently limited to non-AGPs and urgent care... these cautious but necessary steps will continue to have a financial impact on private practitioners, but we are making progress to a return to service."
She also encourages private practices to use this time and the guidance available to prepare for re-opening and to avail of free access to the
Attend Anywhere software, purchased by the Welsh Government for dentists in Wales to hold remote consultations.
Dental practices in England obtaining PPE
NHS England and the Office of the CDO announced last week that, from 8 June, practice can open to resume face-to-face care if they have appropriate social distancing and other safety measures in place.
The Office of the CDO has indicated today that PPE for dentists will be available from dental wholesalers for practices to purchase from 5 June. They have confirmed that this will include equipment necessary for aerosol generating procedures (AGPs) including gowns or coveralls, and FFP2 respirator masks.
The HSE website has advice and
training materials on fit testing respirator masks.
We have been advised that practitioners and staff involved in conducting AGPs can also book free fit test training via an independent Respiratory Protective Equipment (RPE) fit testing company. If you are experiencing fit testing issues, a helpline is available from 08.00–20:00 seven days per week on 07947 968972 or 07947 968922. We understand that bookings for online training courses for fit-testing will also be available via these phonelines (subject to availability). We understand that these phone lines have been very busy and members are having some difficulty getting through.
Wednesday 3 June 2020
Helping you prepare for a return to face-to-face care
More than 8,000 members have already downloaded our
toolkit on returning to face-to-face care, as dentists in England prepare to open from 8 June.
Our toolkit aims to help teams implement the changes needed to gear up to providing appropriate treatments at appropriate times. It provides practical advice on every step of the process, including advice on:
- Infection control, cleaning and PPE
- How best to communicate the changes to patients
- Employee management and training
- NHS contractual arrangements.
Our aim is to support you in the practical application of widely agreed measures, so you can return to face-to-face care with confidence. We also contributed to the FGDP (UK)’s work, so you will see similarities and alignment between the two pieces.
NHS test and trace resources published
NHS test and trace service aims to ensure that anyone who develops symptoms of coronavirus (COVID-19) can quickly be tested to find out if they have the virus, to trace close recent contacts of anyone who tests positive for coronavirus and, if necessary, notifies them that they must self-isolate at home to help stop the spread of the virus. It is hoped that this service will allow us to trace the spread of the virus and isolate new infections and play a vital role in giving us early warning if the virus is increasing again, locally or nationally. Dental teams returning to their practices may wish to contribute to these efforts by displaying these
test and trace posters just released.
Scotland: NHS practices will not open on 8 June
Tom Ferris, Chief Dental Officer, Scotland has informed us that dental practices in Scotland will not reopen to NHS patients from next Monday (8 June) as had been widely trailed. This is to allow enough time for practices and NHS Boards to make the necessary preparations, as well as finalise the funding model and secure sufficient PPE. The reopening date is subject to further internal Scottish Government discussions, but will be some time this month. We expect the CDO will send a letter to the profession this week with an update on the indicative timescale for reopening.
In the meantime, practices should be using the
SDCEP return to practice guidance to prepare for reopening later this month. We have also issued a
returning to face-to-face care toolkit (available to members) with practical advice on returning to practice. Although largely England-focused, it provides useful guidance that complements the SDCEP publication.
We are having ongoing discussions with the Scottish Government around the funding model (including financial support for mixed practices), PPE availability, and extending ‘key worker’ status to dental staff. We will keep you updated on progress.
Wholly private dental practices in Scotland have been advised that they can now reopen, but have been reminded that the safety of staff and patients is paramount. We understand that Healthcare Improvement Scotland will be issuing guidance this week and will keep you updated.
Scotland: Assurance about the NHS financial support payments
Scottish Dental Practice Committee representatives have spoken with NHS Practitioner Services Division (PSD) to peer review their process for calculating the financial support payments to individual practitioners. We know that PSD have received several hundred queries from dentists about the Scottish Government’s NHS funding package and how it relates to their individual circumstances. Most of these related to maternity issues or where practitioners had changed list numbers during the test period.
After PSD explained their methodology, we randomly selected some anonymised examples and PSD explained the payment calculation for each example. SDPC representatives were satisfied that the PSD approach was fair and transparent, and commended PSD on their efforts to address dentists’ queries.
If you have questions about these payments, we recommend you see
the latest FAQ. We believe that they will update them as more information becomes available.
Tuesday 2 June 2020
Public Health England report on COVID-19 disparities in risks and outcomes
Public Health England report on COVID-19: review of disparities in risks and outcomes highlights the deeply concerning disproportionate risks faced by colleagues from black, Asian and minority ethnic communities. We hope to see a clear Government action plan in response to the report.
BAME communities represent around 28% of the dentist population in the UK and as dentistry begins to return to face-to-face care, the associated risks will be at the forefront of the profession's minds. We have today produced
a toolkit on returning to work which highlights that organisations should support sensitive and comprehensive conversations with BAME staff, recognising the long-standing context of the poorer experience of BAME individuals in all parts of healthcare. Any underlying health conditions that may increase the risks in undertaking frontline roles should be identified and acted upon.
NHS England/CDO Standard operating procedure
We had been anticipating a new SOP for England in the early part of this week around the transition to dental recovery, following last week’s announcement of a return to face-to-face practice.
We know that work has been ongoing to develop the SOP but once again, its publication has not happened in a timely way. As we have seen consistently throughout the pandemic, it has taken too long to get important information out of NHS England.
We have expressed our frustration that, with the short time frame for practices to prepare, it is simply unacceptable for dentists at this point to lack this important guidance.
We will of course update you when we hear more.
Northern Ireland: Phased return for dental services outlined
The Acting Chief Dental Officer, Michael Donaldson, has issued
a letter to all General Dental Practitioners on the re-establishment of dental services in Northern Ireland. The letter outlines three phases of re-establishment and indicates that guidance for practitioners on re-establishment will be issued in the coming days.
On 8 June restrictions will not be lifted in Northern Ireland, but all practices will return to face-to-face urgent care. This will help maximise the number of patients with urgent care needs being seen. Practices will not be able to offer non-urgent care until phase two and there is no date set yet for when this second phase will begin. We will update you as soon as information becomes available.
Members: Returning to face-to-face care toolkit launches today
We have produced a
toolkit for returning to face-to-face care to support you and your team to resume practising as safely and efficiently as possible.
This toolkit will provide members with the best possible advice on every stage of the process, so you can re-open with confidence.
This version is for practices in England. Other documents for the devolved nations will follow. We will keep this toolkit updated as new guidance and advice comes to light. Download it today to make sure you're prepared for the challenges ahead.
Business Interruption: FCA to move on legal test case
We have received news that the Financial Conduct Authority (FCA) has identified representative samples of business interruption insurance policy wordings to be examined in a legal test case.
The BDA was the first trade union or professional body to directly engage with the FCA following the failure of most polices to pay out for losses incurred during the pandemic. While we welcome the news, we have expressed concern that the FCA's ‘one size fits all’ approach will fail to address the specific needs of our members.
While dentists in England can resume face-to-face patient care from 8 June, it follows 10 weeks of lockdown during which many practices have seen cashflow fall to zero.
We have also expressed concern that levels of capacity – owing to social distancing and infection control procedures – will be a fraction of pre-pandemic levels. Practices also face shortages and higher costs for vital personal protective equipment (PPE) with a consequential impact on revenue.
Our Chair Mick Armstrong has said: “This move looks like positive news for many businesses facing crippling losses during lockdown. The issues we have identified with our legal team remain and continue to affect our members' ability to claim under policies. To that end, the FCA still has many questions to answer."
Ravi Nayer, partner at law firm Brown Rudnick has commented: “Today's announcement continues to make clear that there can be no one size fits all court decision and, importantly, gives zero comfort on the question of whether challenges affecting certain businesses in the healthcare sector will be taken into account by the court.”
Your voice matters: Impact of COVID-19 on dentistry
You are invited to take part in
a survey by the School of Dentistry in the University of Leeds aims to capture how COVID-19 has impacted dentists in primary care in the UK. It is part of a wider study organised by the World Health Organisation (WHO) which is asking similar questions of dentists all around the world. It should take ten minutes to complete and all submissions are anonymous.
Monday 1 June 2020
Guide for returning to work published by FGDP
The Faculty of General Dental Practice has today published a guide on returning to work, called
the Implications of COVID-19 for the safe management of general dental practice. We were pleased to contribute to the development of this guide and urge you to review it.
We will be publishing our own comprehensive toolkit for returning to face-to-face practice tomorrow. This will contain additional and complementary practical advice for members. Our aim is to ensure dentists can return to work as safely and efficiently as possible.
Tomorrow’s webinar on COVID-19 and dentistry
We have partnered with the Royal Society of Medicine to bring you a
webinar on COVID-19’s challenges for the dental profession. Taking place tomorrow at 17.00-18.00, it will:
- Review the current knowledge of the viral load in the oral cavity
- Address the future challenges of appropriate PPE for the dental team
- Consider the challenges for general dental practice
- Provide one hour of CPD.
Speakers will include:
- Ms Deborah Bomfim, President, Odontology Section, Royal Society of Medicine
- Dr Barry Quinn, Faculty of Dentistry, Oral and Cranio-facial Sciences, King's College London
- Professor Stephen Challacombe, Martin Rushton Professor of Oral Medicine, King's College London
- Professor Paul Coulthard, Dean, Dentistry and Institute Director, Institute of Dentistry, Queen Mary University of London
- Mick Armstrong, Chair, British Dental Association.
Register before 14.00 tomorrow to secure your place.
Survey: Is your practice ready for 8 June?
We are surveying dental practice owners in England to investigate what challenges you are experiencing in getting ready for the potential resumption of face-to-face patient care from 8 June.
survey should take no more than 5-10 minutes to complete and will help us make the case to Government on what is needed to get back to providing effective and safe patient care.
NHS England contract arrangements to remain unchanged
Last week NHS England and the CDO for England, Sara Hurley confirmed that the temporary NHS contract arrangements, which include monthly payments to practices equivalent to 1/12th of the annual contract value, would continue.
In a letter on 28 May it was confirmed that these payments will remain unchanged, subject to variable costs abatement. Contract holders should also assume that current conditions, for example paying associates, continue until you hear otherwise.
We are in on-going discussions with NHS England regarding how the contacts will be introduced for the rest of the 2020-21 financial year. In the meantime, practices should be reassured that their contract values will continue to be paid from 8 June and that these payments will not depend upon any specific level of care at that time or delivery of Units of Dental Activity (UDAs).
The NHS England letter also made clear that resumption of the full range of routine dental care would be risk-managed by the individual practice, who can decide whether or not to include aerosol-generating procedures (AGPs). That decision will reflect specific circumstances including practices being able to adopt the appropriate infection control and PPE requirements.
NHS England regional teams have been asked to work with local providers to agree the ongoing provision of urgent dental centres (UDCs). This will include support for practices unable to perform AGPs and assistance with any local dental access issues.
BDA Benevolent Fund webinar on finances and COVID-19
The BDA Benevolent Fund invite you to
sign up for their up-coming webinar on financial advice. This free one hour webinar will take place this Thursday, 4 June, at 16.00. It aims to highlight the support that is available to dentists and dental students and provide you with tools to help you manage your personal finances during this difficult time. It will cover:
- State Benefits
- Self-employed support
- Credit cards and loans
- Pensions, investments and insurances
- General money-saving tips.
England: Important advice to be published for dentists
Dentists and their teams in England will be working frantically this week to decide when they can open for face-to-face treatment and what care they are able to provide. We anticipate the publication of three important pieces of advice and guidance to help in that decision-making either today or in the early part of the week:
- Guidance from NHS England and the Office of the Chief Dental Officer, including a new Standard Operating Procedure
- Implications of COVID-19 for the safe management of general dental practice: a practical guide from the Faculty of General Dental Practice
- The BDA’s own COVID-19 special guidance on returning to routine care
We will update you as and when these are published.