Friday 17 July 2020
Here's my weekly round-up of the major things that happened this week in relation to the COVID-19 pandemic and UK dentistry. I hope you find it useful.
Fallow time report to take weeks
Fallow time is an issue at the forefront of dentists’ minds right now, due to the direct financial impact it has and confusion regarding the effectiveness of the mitigation technologies available. The Scottish Dental Clinical Effectiveness Programme (SDCEP) group on aerosols had a further meeting today looking into the issue.
As part of this process, they’re looking at the latest research and working with experts on: microbiology, particulate measuring devices, and the air flow and mitigation measures in place worldwide. Professor Jan Clarkson has today made clear that this is likely to take time yet:
“We are well aware of the financial impact of fallow time, the potential cost of mitigation technology and the potentially misleading claims over its effectiveness. However, there is no blueprint for this. It will be the best review there can be, given the lack of evidence on viral load and infectivity, but it’s going to be four/five weeks minimum before publication."
Northern Ireland: Welcome U-turn on UDCs
Following the pressure we’ve applied in recent days, including Richard Graham’s appearances on the Nolan Show today and yesterday, we’re pleased to see a significant U-turn by the Health and Social Care Board on UDCs. This was clarified in
a letter from Chief Dental Officer, Michael Donaldson this morning.
We’re also expecting a further communication on fit-testing later today, we will keep you updated.
Wales: Russell Gidney on BBC Radio Wales
Dentist, Russell Gidney who runs the Beaufort Park Dental Surgery in Chepstow, South Wales appeared on BBC Radio Wales yesterday, taking listeners' calls on the current challenges dentistry faces in Wales.
Listen to Russell on
BBC Radio Wales' afternoon show with Eleri Sion (starts at 1hr 10mins).
CDS conference and AGM postponed until 2021
The 2020 Annual Presidential and Scientific Meeting of the our Community Dental Services Group, has now been rescheduled to October 2021. Due to the pandemic and strict social distancing measures required, we felt it would not be fair to ask speakers and delegates to attend this year.
President Elect, Josie Lemon, will now host the conference at Windsor Racecourse on Thursday 30 September - Friday 1 October 2021. Topics are expected to include: autism, learning disabilities, epilepsy and mental health. In the meantime, the current President, Gill Greenwood, has agreed to extend her term of office to cover these contingency plans.
This change of plans means that the AGM will also be cancelled for 2020. However, if anyone is interested in joining the committee or would like to know what vacancies are currently available within the CDS Group Management Committee, please do get in touch:
Wales: Health Improvement Wales update on ACORN
Health Improvement Wales have issued a new series of
FAQs to help practices complete the Assessment of Clinical Oral Risks and Need (ACORN).
There are 15 FAQs in total, including:
- What is ACORN?
- Do I operate under high amber or low amber?
- Why do dental teams have to risk and needs assessments (ACORN) for urgent care?
- Does using the ACORN toolkit mean I will be part of the GDS reform programme?
- Can I refuse to do ACORN as part dental recovery plan?
Armed Forces dentistry and COVID-19
Two Air Force dentists recently gave us an insight into
the impact of COVID-19 on military dentistry in the UK. Wing Commander Penny Hartley-Green, Senior Dental Officer Royal Air Force, and Dr Brent Weller, Civilian Dental Practitioner in Defence Primary Healthcare, shared how the service and their roles have been affected by the pandemic.
Dr Brent Weller said: “Before March, I was in semi-retirement, only working 2.5 days a week. But when asked to come back and work full-time again, I agreed. Having served in the first Gulf War, I understood when there was a need to put national priorities ahead of personal ones.”
Thursday 16 July 2020
Northern Ireland: NIDPC Chair on The Nolan Show
Richard Graham, Chair, Northern Ireland Dental Practice Committee, appeared on Stephen Nolan's eponymous BBC Radio Ulster The Nolan Show today to discuss our concerns regarding the financial situation facing dentists in Northern Ireland.
Listen to Richard Graham on the Nolan show (starts at 29:30).
Scotland: We need better engagement with Scottish Government
We have written to the Chief Dental Officer expressing our dissatisfaction over the lack of engagement and negotiation with the Scottish Dental Practice Committee over recent developments with the phased return to dentistry. SDPC and the wider BDA are keen to contribute positively and constructively, and the Committee requires sufficient time to consider any proposals fully to allow an informed discussion and to give SDPC its place as the formal negotiating body on behalf of GDPs.
Wales: Funding questions for the CDO
This week we are pushing for
answers from the Welsh Government on funding for AGPs and the disparity between the abatement figures in England and Wales.
We argue that 100% of the NHS contract value is needed to enable the GDS to provide AGPs at a time when many are already operating at a loss. We are also raising concerns over the differences between the abatements in England and Wales.
We’re hoping for clear answers from the Chief Dental Officer on these and related issues. We continue to campaign on behalf of your practice.
Wednesday 15 July 2020
Scotland: More funding needed as dentistry enters phase three
As dentistry in Scotland moved to phase 3 of reopening this week,
we have urged the Scottish Government to look again at the financial support available to dentists.
We have welcomed the additional funding outlined in
the letter from the Chief Dental Officer last week – an extra 30% to the General Dental Practice Allowance and a 30% increase to the GDPA cap. However, we argue that this support did not go far enough.
We will continue to meet with the Chief Dental Officer and Scottish Government regularly to make the case for dentists and dentistry in Scotland.
Letter to the PM: Obesity treatment and prevention
Yesterday, we co-signed
a letter urging the Prime Minister to take urgent action on obesity treatment and prevention. We believe that a robust and joined-up policy package is required, if the Prime Minister’s new obesity plan is to be effective and change the health trajectory of future generations.
There has never been a more important time to tackle these issues. Living with obesity worsens the health outcomes for COVID-19 and increases the risk of developing type 2 diabetes, cardiovascular disease and thirteen types of cancer. That’s why,
we will continue to campaign on the elements of the government’s Childhood Obesity Plan which relate to improving oral health.
Northern Ireland: Call for dentists to write to MLAs
We are urging members in Northern Ireland to add your voice to our campaign for funding, by sharing your story of how COVID-19 has affected your practice.
Please write to your MLA and urge them to contact the First and Deputy First Minister on your behalf.
To do this, all you need to do is enter your postcode below. The names of your MLAs will be provided. You can then select to send them an email.
We continue to call for urgent action to ensure
dedicated financial support for mixed/private-orientated and NHS practices is achieved across Northern Ireland. In
a letter written yesterday, we urged the First Minister and Deputy First Minister to address the issue, as to date individual Ministers have failed to provide an adequate response.
The lack of any meaningful support for mixed/private dentistry is particularly alarming and wholly unacceptable. We are also pressing for additional funds to be committed to the GDS budget, and no abatement to be applied, to reflect sky-rocketing costs.
Share your story and together we can make a difference.
England: Our work on abatement and NHS contracts
Reflecting on the confirmation from NHS England this week that the final abatement figure is 16.75%, Dave Cottam outlines how
our work has helped confirm a reasonable abatement figure and a clearer contract structure for dentists.
“We finally had confirmation this week from NHS England of the abatement figures for 1 April to 8 June... It was a long road to get to this figure. We’ve had hours of discussions, meeting (virtually) two-to-three times each week in which we persisted to put forward the case for the profession. We urged NHS England to lower the abatement and to finally make longer term NHS contractual arrangements fit for purpose... It’s taken far too long to get here, but in the end, it feels like a fair number.”
For more information on contracts and abatement our
financial impact page.
Scotland: Increased pressure on UDCCs during phase three
Stuart Fullerton, an associate dentist based near Glasgow, discusses the increasing pressure on urgent dental care centres (UDCCs) as lockdown lifts in Scotland:
“From this week, pressure on the centres is likely to grow as the number of referrals from practices increases and some redeployed GDPs return to their practices... I worry that there is a real risk that UDCCs reach breaking point, as the backlog of vulnerable patients continues to grow.”
Tuesday 14 July 2020
Risk assessment guidance: consent and note-taking
The latest edition of our COVID-19
risk assessment guidance for members
includes issues of consent and the importance of note-taking. This is an important addition as your records are the only sure method of demonstrating the consent process, which will inevitably evolve over the period you are treating the patient. Download this updated guidance for members today.
England: Further clarification of contract and abatement issues
Following discussions with NHS England, we now have
further clarification on key issues such as abatement reconciliation, the definition of patient activity and staffing assurances, including:
- The abatement for the period between 1 April and 7 June will be enacted through reconciliation over the period to 31 March 2021. We expect it to be reclaimed by commissioners gradually over the second half of the financial year.
- The definition of patient care for calculating levels of activity will include all clinical contact that dentists or dental care professionals have with patients either face to face, by telephone or video consultation.
- Staffing assurance requirements apply to all individuals whether directly employed, employed as a locum or engaged through a contract for provision of service on any basis. It applies not just to dentists and dental hygienists, but also dental therapists, dental nurses, non-clinical and administrative staff.
what you need to know about abatement.
Webinars on key COVID-19 topics
We’ve held a number of webinars to support members during this difficult time. Don’t miss out, login to watch the recordings today.
On PPE, respirators and fit testing:
Stress and coping strategies:
Business interruption insurance:
England: What you need to know about abatement
Yesterday NHS England and the Chief Dental Officer England published a letter setting out key NHS contractual issues going back to the period of lockdown and those applying in the current face-to-face period since 8 June.
Abatement, to be applied to most contracts from 1 April up until 8 June, will be 16.75%. For practices that have operated as urgent care centres during that period, there will be no abatement for the time they have been providing urgent care. For the period from 8 June onwards, when practices have begun to provide face-to-face care again, 100% of contract value will be paid, with no abatement.
what you need to know about abatement.
Monday 13 July 2020
NHS England finally confirms abatement figure and sets out key NHS contractual issues
Today NHS England and the Chief Dental Officer England published a
letter setting out key NHS contractual issues going back to the period of lockdown and those applying in the current face-to-face period since 8 June. This letter has been published after extensive discussions between the BDA and NHS England.
The letter says that the abatement to be applied to most contracts from 1 April up until 8 June will be 16.75%. This figure is based on an approximate assessment of variable costs that will not have been incurred when practices were closed to face-to-face care (such as laboratory costs and materials).
For practices that have operated as urgent care centres during that period, there will be no abatement for the time they have been providing urgent care. That different approach recognises the extra costs for UDCs, on set-up, protective equipment and potentially staffing.
For the period from 8 June onwards, when practices have begun to provide face-to-face care again, 100% of contract value will be paid, with no abatement. This recognises the additional costs of providing care during the current period, again for example in terms of PPE. Practices are expected now to be making all possible efforts to be delivering as comprehensive a service as possible to patients.
Practices will not be measured on the delivery of Units of Dental Activity during this period. However specific assurances will be requested that individual practices are open for face-to-face care, are adhering to contractual hours with reasonable staffing levels for NHS services in place and are performing the ‘highest possible levels of activity’, with no undue priority being given to private activity over NHS activity.
Practices will need to deliver at least 20% of usual volumes of patient care activity to receive their full contract value. Importantly, we have agreed with NHS England that the definition of patient care activity includes all clinical contact that dentists or dental care professionals have with patients either face to face, by telephone or video consultation counted by the BSA via completed courses of treatment or via the COVID-19 triage portal.
The period to be assessed will be all clinical contact that dentists or dental care professionals have with patients either face to face, by telephone or video consultation from 20 July to 16 September 2020. This will be compared to the number of courses of treatment only, provided by the contractor in the equivalent period in 2019. Remote advice and care is included in the calculation for 2020 but not for the equivalent period in 2019. If practices are unable to meet the 20% threshold, then they will be required to revert to payment based on UDAs.
This above arrangement is temporary and we are working with NHS England to establish a revised mechanism for the later part of this financial year as activity gradually increases.
Since 25 March, there have been conditions attached to practices continuing to be paid. Included in those has been a requirement on practices to ensure that all staff, including associates, non-clinical and others, continue to be paid at previous levels. This continues to be a requirement now. All practices will be asked to provide assurance over their continued engagement of staff, and to give an explicit declaration that they have not gained any windfall profits.
Alarmingly high COVID-19 death rates among UK health workers
The UK has seen one of the
highest numbers of COVID-19 health worker deaths in the world, according to a new report by Amnesty International. They report that more than 540 health and social care workers have died in England and Wales. Russia is the only country with higher reported health worker deaths.
With the proper application of safe systems and equipment, no worker should die of work-acquired COVID-19. Since the early days of this pandemic, we have stood with the
Society of Occupational Medicine (SOM),
the BMA and The Doctors’ Association in calling for zero work-related deaths from COVID-19. We are saddened and frustrated that government inaction has caused so much avoidable death to our colleagues across the health and social care sector.
Scotland: What you need to know about returning to dentistry
Today sees an expansion of dental care in Scotland, as we move into phase 3 of Scotland's reopening plan. If you’ve not yet read last week’s
letter from the Chief Dental Officer and the
memorandum to dentists issued by the Scottish Government with further details about Phase 3 of the return to dentistry from 13 July, we urge you to do so.
The Memorandum includes information on: preparation of surgeries; aerosol-generating procedures; PPE; financial support; the revised Statement of Dental Remuneration (which will be issued separately); and closing courses of treatment.
We have also adapted our
toolkit for returning to work for members in Scotland. It is designed to complement the SDCEP guidance, download it for practical advice on various issues, including indemnity, employment relations, and staff terms and conditions.
Northern Ireland: PPE deliveries delayed
Deliveries of the centrally-procured PPE promised to practices in Northern Ireland on 2 July have been delayed. Chief Dental Officer, Michael Donaldson, has written to practices to clarify that these deliveries will take place from 20 July.
If you are expecting a delivery, look out for an email this week with details of your PPE delivery day. We understand that these delivery slots are fixed and not subject to change. The CDO has therefore asked that you ensure someone at the practice can accept the delivery on that day.
Take our short survey (closes today)
Our new survey sets out to identify the pressure on all practices, including those with mixed and private income streams.
Jason Wong, the new Deputy Chief Dental Officer for England is leading a group looking at these issues, with input from all four nations and a range of dental organisations.
We’re surveying dentists to inform the group’s recommendations. It’s only open until next Monday, so please take five minutes to
complete this short survey today.