Updates from week commencing 12 July 2021

Friday 16 July 2021

13:17

Confidential counselling and emotional support

Would you like some support? We provide all members with access to Health Assured, a comprehensive confidential service designed to help you deal with personal and professional problems that could be affecting your home life or work life, health, and general wellbeing.

Members can access the helpline 24/7, 365 days a year. Support includes:

• Unlimited access to counselling for emotional problems and a pathway to structured telephone counselling for you or your dependents and for you face-to-face counselling sessions at your convenience.
• Legal information: Advice on issues that cause anxiety or distress such as debt management, accountancy, lawsuits, consumer disputes, property or neighbour disputes.
• Bereavement support: Qualified and experienced counsellors who can help with grief and related stress plus a team of legal advisors to help with legal issues.
• CBT online: We recognise the value of self-help tools in dealing with a range of issues, which is why we have a range of Cognitive Behavioural Therapy self-help modules, informative factsheets and invaluable advice videos from leading qualified counsellors.

11:56

Recruitment and the right to work in the UK: BDA advice

Many practices employ staff from within the European Economic Area (“EEA”). Until now, freedom of movement has meant that establishing the right to work for this group of individuals has been reasonably straight forward for employers.

However, people from within the European Economic Area (except Irish citizens) now need to provide proof of their immigration status to show their right to work in the UK.

Practice owners must now establish whether a candidate has the right to work in the UK before employing them, to avoid a civil penalty or, where an individual is knowingly or reasonably believed to be employed without immigration permission, criminal liability.

To find out what you need to know, members can access our advice on recruitment, Right to Work checks and correct HR procedures.

09:17

MPs raise dentists’ concerns in Parliament

Three MPs spoke up for dentistry during Wednesday’s debate on the new Health and Care Bill in the House of Commons, after we worked to brief Parliamentarians on the importance of our having a voice on the new Integrated Care Boards. With the crisis of poor NHS dental access reaching breaking point from Cornwall to Cumbria, it is unfathomable that the boards responsible for commissioning local services may be devoid of the expertise of dentists.

During the debate, former minister Steve Brine MP echoed our call for dentistry representation on Integrated Care Boards, and also supported the measures to increase water fluoridation. Clive Lewis MP felt that the Bill in its current form does little to address the problems with NHS dental access. Finally, Peter Aldous MP once again demonstrated his support for the dental workforce and called for increased investment to enable greater dental access – as well as lending his weight to the call for dentists to be represented on Integrated Care Boards.

We are already dissecting the finer points of the Bill in great detail, prior to committee stage in September. In this way we will be able to provide targeted briefings to MPs and Peers that will address both the interests of our members and the ongoing fight for improved oral health across both England (to which this Bill specifically relates) and indeed the wider UK. We will keep you up to date.

Thursday 15 July 2021

15:07

Scotland: Calling for clarity

After the CDO's letter to the profession last week, our members raised a number of concerns about the review of infection prevention and control guidance currently underway.

Some commented the letter was premature for primary care dentistry, as the recent revisions only apply to those working in a hospital dental setting at this stage. Many were unaware of the recent revisions and asked where this information had been initially announced. Some were unclear on the specifics of the information and what impact this would have on them.

This feedback clearly shows that clarity from the Scottish Government is required including dentistry-specific, evidence-based guidance to allow dentists to work safely. We have collated your feedback and submitted it to the Scottish Government for comment. We will keep you updated with our progress.

14:03

England: Face coverings must still be worn in healthcare settings

Following our recent message to the Prime Minister, England's Chief Nursing Officer Ruth May has now clarified that face coverings must still be worn in healthcare settings: "Face coverings and social distancing measures will remain in place across healthcare settings so that the most vulnerable people can continue to safely attend hospital, their GP surgery, pharmacy or any other healthcare settings for advice, care and treatment. And it is important for the public to continue to play their part when visiting NHS and care settings to help protect our staff and patients, particularly those who may be more vulnerable to infections."

This provides much needed clarity for our members. Chair of the BDA, Eddie Crouch, has made clear: "When visiting a dentist face coverings, social distancing and hand washing remain fundamentals not optional extras. Wider changes that take place on Monday will have no impact on how the public should approach accessing our services."

12:11

Behind the headlines on the expansion of the sugar tax

We have backed new recommendations for a sugar and salt tax on unhealthy food, which would direct some of the revenues to help get fresh fruit and vegetables to low-income families. The move would build on the success of the sugar levy, which prompted a fall in sales of high-tier sugary drinks – those containing more than 8g of sugar per 100ml – of 44% in its first year.

Tooth decay has been the number one reason for hospital admissions among young children in the UK, with the burden hitting those in the most deprived communities the hardest. As BDA Health and Science Chair Mick Armstrong has said: “Ministers are making the right noises on prevention but need to take a joined-up approach. If the government is serious about tackling preventable disease it must build on the ambition set out in this strategy.”

That’s why, we are calling for sustained government action to tackle diet-related disease, like tooth decay, as an integral part of ongoing work to confront obesity. We have also joined with the National Education Union and their No Child Left Behind campaign in calling on the Prime Minister to extend school meals so no child is left hungry this summer.

11:50

New GDC Chair, a chance to turn the page

The General Dental Council (GDC) have this morning announced the appointment of Baron Harris of Haringey ("Lord Toby Harris") as new Chair of Council, and Angie Heilmann MBE, who joins as a registrant Council Member. Both will take up their new posts on 1 October 2021, when the current Chair Dr William Moyes and Council Member Catherine Brady leave office.

Lord Toby Harris currently chairs the National Preparedness Commission and has previously chaired several public sector bodies, including the first Chair of the Metropolitan Police Authority (MPA). He also spent 12 years leading the Association of Community Health Councils, representing the interests of the public in the NHS.

In response to Baron Harris' appointment, BDA Chair Eddie Crouch has said: "We are disappointed that the GDC has again chosen not to select a dentist as Chair. This would have been an important step to rebuild trust with this profession. However, a new face offers an opportunity to turn the page. We send our congratulations to Baron Harris and offer our commitment to work with him and his team to secure the cost-effective, right-touch regulation dentistry desperately needs."

09:04

Advice on COVID-19: Updates to our FAQs

Designed to give you and your practice the advice you need, our COVID FAQs are frequently updated with the latest information. Members’ most frequently asked questions currently include:

• Should I use the NHS COVID-19 app?
• Should my practice use lateral flow tests?
• Must patients wear face coverings?
• If I'm vaccinated, is full PPE essential?
• Is the COVID-19 vaccination mandatory?

Wednesday 14 July 2021

16:12

Challenging plans for inaccurate, unethical dental checks on migrants

We have urged Home Secretary Priti Patel to think again on plans to introduce dental checks to establish the age of Channel migrants. Dental X-rays are not an accurate method for assessing age.

Furthermore, it is inappropriate and unethical to take radiographs of people when there is no health benefit for them. X-rays taken for a clinically justified reason must not be used for another purpose without the patient's informed consent and must be carried out without coercion and in full knowledge of how the radiograph will be used and by whom.

The new Nationality and Borders Bill, tabled last week and currently undergoing its second reading, will give the Home Secretary the power to introduce methods of assessing age via regulation. “This is a retrograde step from Priti Patel,” BDA Chair Eddie Crouch has said, “in 2016 the Home Office ruled out dental checks for migrants, which we considered inaccurate, inappropriate and unethical.”

13:59

England: Primary care must get seat at the table on commissioning

We have joined with partners across primary care to ensure dentists, pharmacists, opticians and audiologists have a proper voice on Integrated Care Boards (ICBs), which are set to be handed responsibility for commissioning decisions.

The Health and Care Bill currently before Parliament would shift the responsibility for managing the contracts for primary NHS services, including general practice, general dental practice, community pharmacy and primary optometry services from NHS England to ICBs. Partners warn current draft legislation risks leaving around 190,000 non-medical primary care professionals working in the NHS in England shut out of representation on the boards. Together we are pressing for change as the Bill heads for Second Reading in Parliament.

As it stands, the Bill only dictates that each ICB includes a member nominated by General Practice, with no insight from any of the other primary care professions. This is despite GPs accounting for only about a third of the primary care workforce in England.

BDA Chair Eddie Crouch said: “General practice simply cannot be expected to effectively represent the views, perspectives and distinct challenges facing colleagues in the wider NHS.  …The crucial contribution non-medical primary care professionals make to the local health and care systems must be recognised and reflected at every level of the NHS, including within Integrated Care Boards.”

11:42

England: Call for mask wearing to continue in healthcare settings

Today we have written a letter to Prime Minister Boris Johnson, along with the Royal Pharmaceutical Society in England (RPS), the British Medical Association and Royal College of Nursing, calling for face masks to be mandatory in healthcare settings.

From 19 July it will no longer be mandatory for the public to wear face coverings when visiting a pharmacy, dentist, hospital, shop or other establishment in England. We have called for mandatory use of face masks, social distancing and regular handwashing to stay in place in all healthcare settings past 19 July. We also want to see the use of appropriate respiratory protection for staff in health and care settings continue, alongside improvements in ventilation wherever possible.

BDA Chair Eddie Crouch said: “No health professional should be left struggling to manage patient expectations come Monday. After all the mixed messages we need government to be crystal clear that face coverings will remain in place to protect the public and staff.”

11:19

England: NHS focus group on dental system reform

As part of their work for the next stage of dental system reform, NHS England and NHS Improvement have asked dental professionals and commissioners to take part in an up-coming focus group. Would you like to join up?

If you'd like to get involved in a dental system reform focus group as a provider, complete this expression of interest form by 11:59pm on Sunday 18 July. Please note, this form has to be completed in one sitting, but you can read a copy of the questions in advance.

09:03

England: Revised guidance on phased courses of treatment

The Office of the Chief Dental Officer (OCDO) for England has issued a revised note for the avoidance of doubt on phased courses of treatment.

The guidance has been updated to incorporate further information about prevention and how the guidance can apply to the treatment of periodontal disease. The note sets out when it may be appropriate to phase treatment over up to three courses of treatment and the processes that should be followed to do so.

Tuesday 13 July 2021

14:09

Scotland: Details of ventilation funding for NHS practices

The Scottish Government have outlined further details of ventilation funding available to NHS dental practices. To apply, practices need to complete a form via their NHS Board and only claims occurred during 1 April 2020 to 31 March 2022 will be accepted.

In response to our queries on the draft proposals, the Scottish Government also provided clarity on a number of points:

• Ventilation standards are defined as 10 air changes per hour.
• HEPA filters are not recommended as a universal mitigating solution, however, they might be used as a short-term mitigating solution where other ventilation solutions are not available.
• The figure of £1,500 per surgery was based on the results of a survey which indicated that existing investment has commonly ranged between £500 and £2000, and showed that among those who had previously carried out an upgrade, the most common category for intended future spending is '£1001 - £2000' (40%).
• The Scottish Government will make a contribution to the costs of the initial equipment only, like the funding model for disinfectors and defibrillators.
• Funding will not cover waiting rooms.

We welcome this clarification from the Scottish Government, as we continue to campaign on this vital issue on behalf of all dentists in Scotland.

11:03

Scotland: Locum dentists now qualify for £500 COVID payment

Following the First Minister’s announcement in November, the Scottish Government issued guidance to GDPs explaining how to receive the £500 one-off COVID payment. Until today, locum dentists were unable to have a claim made on their behalf by a single appropriate service provider. As of last week, locums can also claim this bonus. We welcome this addition which ensures locum dentists working in Scotland are acknowledged for their efforts.

09:22

England: Win for common sense in NHS dental contract case

NHS Resolution has directed NHS England to apply its discretion during the year-end reconciliation process to ensure a fair and proportionate outcome, in a recent tribunal.

The applicant and GDS Contract holder in question had fallen short of their annual UDA target by 30 UDAs using the most favourable of NHS England's reconciliations methodologies for the contract year 2019-2020. Whilst NHS England had set out ways of calculating a fair practice UDA figure for March 2020, the most favourable way brought about mitigation of just one UDA.

NHS Resolution noted in a message to Local Area Teams that a "fair, sensible and proportionate approach should be taken, and one where the application of common sense should take precedence." NHS England has been directed to look again at its decision and to exercise discretion to give an increased UDA total for the March UDAs. Additionally, NHS Resolution stated that the breach notice which had been served was not appropriate and should be reconsidered.

We are pleased with this decision coming from NHS Resolution and it tells NHS England to use its discretion to make sure that its policies do not cause unfair outcomes.

If you think your contract should have been reconciled differently last year to ensure a fair and common sense outcome from the reconciliation process then, like our member, consider an appeal. BDA Expert and Extra members can contact advisory services for help with their applications. Call 020 7935 0875 or email advice.enquiries@bda.org.

Monday 12 July 2021

17:33

England: How can dentistry "learn to live" with COVID?

Dentistry needs help if we're going to "learn to live with COVID-19". Shawn Charlwood, Chair General Dental Practice Committee, today outlines why we need a clear plan from government and real support, on everything from patient access to workforce sustainability:

• Read: Can dentistry learn to live with COVID?

16:24

The Prime Minister's confirmation earlier this week that there will be a relaxation of general pandemic restrictions in England from 19 July has raised many questions from members about how this will impact on dental practices. The simple answer at the moment is we don't know, for now however, current IPC guidance remains in place. We have been pressing for clarity from NHS England this week but there is no indication that there will be any immediate change in the Standard Operating Procedure.

Dentists and their teams are asking whether they can or should insist on the continued use of face coverings, and whether they should persist with social distancing. We are awaiting further Government guidance next week, with the Secretary of State for Health so far having told parliament that it would make sense for guidelines such as the two metre rule to continue in "some specific settings", including medical environments. We will continue to update our FAQs when we receive further news.

In the meantime, the Scottish CDO confirmed yesterday that there would be a review of the overarching UK infection prevention and control guidance with an associated consultation in August with revised recommendations published in September 2021. This will include a revision of the dental specific appendix in line with the revised general IPC document. There will also be a risk assessment template for dental practices to support the implementation of any new guidance.

14:19

In a recent blog Shareena Ilyas, Co-Chair of the BDA Equality, Diversity, and Inclusion Committee, explored the issue of unfair COVID-19 payments for dentists taking maternity leave.

• Read: Fair COVID payments for maternity leave dentists

11:18

Scotland: Impact of pandemic on dentists' mental health

A research report on the impact of the pandemic on dentists' mental health in Scotland contains some concerning results:

• 27% of survey respondents reported significant depressive symptomology
• 55% of primary care staff rated themselves as emotionally exhausted.

Earlier this year we worked with the Scottish Government to produce a summary of mental health and wellbeing resources for dental teams. We hope this to be a useful resource for dealing with the problem, however the primary focus must be on prevention.

NHS Education for Scotland (NES) has stated that it will incorporate dentists' mental health in its future work, including follow-up studies. We have contacted NES to discuss how we could contribute to this important issue.

9:51

Dental system reform: NHS focus group

The following message is from NHS England and NHS Improvement.

As part of their work for the next stage of dental system reform, NHS England - Dental contract reform want to hear from dental professionals and commissioners.

If you'd like to participate in a dental system reform focus group as a provider, you will need to complete the expression of interest form by 11:59pm on Sunday 18 July.

The expression of interest online survey has to be completed in one sitting. To read a copy of the questions in advance, see the expression of interest survey PDF.