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Updates from week commencing 14 December 2020

Read all the updates and what we've been working on during the Coronavirus outbreak.

Sunday 20 December 2020

18:50

 

Tier four restrictions and impact on dentistry

 

The Government announced on Saturday that London and large parts of the South East of England would move into a new tier four with additional restrictions. The Government confirmed that dental services would remain open:

 

“The majority of public services will continue and you will be able to leave home to visit them. These include the NHS and medical services like GPs and dentists. We are supporting the NHS to carry out urgent and non-urgent services safely, and it is vital anyone who thinks they need any kind of medical care comes forward and seeks help.”

 

On the back of the announcement, we have again approached NHS England to urge them to reconsider their intended approach for NHS contracts in the final quarter of the current financial year. We have argued that whist dental services will appropriately remain open, the Government advice to reduce contact and travel will inevitably impact patient behaviour across all parts of the UK. It is not the right time to reintroduce stretching targets which force NHS practices into seeking ever higher numbers of UDAs, given the constraints that will apply.

 


 

Friday 18 December 2020

16:48

 

Video roundup

 

As 2020 draws to a close, we have yet more news and updates to share with you. Here's my roundup of the latest news affecting dentistry across the UK.

 

Useful links:

UDA targets

 

Brexit

 

Northern Ireland

 

Scotland

 

 


 

16:46

 

Website availability this weekend

 

Due to essential maintenance work, bda.org will be offline from 22:00 on Saturday (19 December) until mid morning on Sunday (20 December).

 

If you need access to any files, please download them before this period. Online booking of events will not be available. The library online catalogue and the CPD Hub are not affected, and both will be accessible during the work.

 

We apologise for the inconvenience.

 


 

16:15

 

Racism in dentistry: measuring the scale of the problem

 

In order to combat the issues around racism in dentistry, we first need to understand the scale of the problem.

 

In her new blog, Shareena Illyas, chair our new Equality, Diversity and Inclusion committee, explains why our new survey on racism is an essential step towards tackling racism and discrimination in dentistry.

 

“Our intention is to try and capture interpersonal racism from microaggressions right through to physical abuse, as well as those instances where biases in decision-making mean that people are treated unfairly because of their ethnicity, skin colour, accent or religion”.

 

Read Shareena Ilyas’ blog - Racism in dentistry: Measuring the scale of the problem.

 


16:10

 

What are the rules around travel and quarantine?

 

Members have been getting in touch to ask us about oversea travel during the Christmas period and the subsequential quarantine period.

 

Our advice team have put together a video covering the essential details that you need to know.

 

Watch Essential Advice: Staff members and quarantine .

 


 

14:54

 

England: Targets to push NHS dentistry to the brink

 

With only a couple of weeks until the start of the new year, NHS England have yet to confirm the final contractual arrangements for quarter four.

 

With such significant changes to consider, NHS England should have given practices detailed guidance in good time. In the absence of that clear guidance, and in light of today's coverage, we have chosen to share what we expect the position to be from 1 January 2021.

 

We are doing what we can to help advise the profession and have compiled a comprehensive summary for members . We are also hosting a webinar for members on Tuesday 22 December, from 13:00 - 14:00, to hear about the background to the negotiations with NHS England. We’ll also examine the practical implications for practice owners and associate, and answer your questions.

 

Whilst this is all still subject to confirmation, we expect that we will see a return to measurement by Units of Dental Activity, with a target of achieving 45% of pro-rata UDAs for the quarter, to achieve 100% of contract value. That would be, in effect, 11.25% of annual UDAs delivered across three months. For orthodontics, the UOA target is likely to be even more stretching at 70% of UOAs to achieve full contract recognition for the quarter. These are measures for the fourth quarter only and do not impact the arrangements for the first three quarters of the year.

 

If practices fall short of delivering 45% of their UDAs, we expect there to be a buffer zone in which UDAs will be recognised in proportion. So if 90% of the 45% target is achieved (40.5% of pro-rata UDAs), then 90% of UDAs for the quarter would be paid. If practices deliver 80% of the 45% UDA target, they would be paid 80% of their UDAs for the quarter. That means in effect an important threshold of 36% of pro-rata UDAs (36% being 80% of 45%).

 

However, if practices fall below 80% of the target, then we expect UDAs to be paid only on the basis that they are delivered, rather than at the enhanced rate. For example, if a practice was to reach 32% of pro-rata UDAs, they would only receive credit for the UDAs delivered on a 1:1 basis, which would represent 8% of their annual UDA total (32% delivered during one quarter of the year).

 

In effect, for the last quarter if a practice reaches the threshold of 36% pro-rata UDA delivery, we expect each UDA delivered to be worth 2.2 UDAs. If the practice fails to reach 36% of pro-rata UDAs, each UDA is likely to be worth one UDA. A similar approach is likely to apply to orthodontic delivery in relation to the 70% target.

 

We have been in discussions for months with NHS England about the approach and have argued persistently that these targets are inappropriate and will cause financial difficulties for some practices.

 

We have also been clear with NHS England that these targets are not right for patient care. The return to UDAs and the level of the target will encourage practices to concentrate on delivering UDAs rather than meeting the urgent care needs which persist in many areas.

 

This is a crucial step backwards for practices already struggling to stay afloat. Find out more, in this blog from Chair of our GDP Committee, Dave Cottam.

 


 

14:35

 

Webinar: New UDA targets - What you need to know

 

Members: Join our webinar on Tuesday 22 December, from 13:00 - 14:00, to hear about the background to the negotiations with NHS England. We’ll also examine the practical implications for practice owners and associate, and answer your questions.

 

The number of attendees for this live session is limited to 1,000 registrants. Should you miss out on a ‘seat’ for the live session we’ll be sharing a recording shortly afterwards. CPD will not apply for the session and certificates will not be issued.

 

Register here

 


 

Thursday 17 December 2020

16:02

 

Matt Hancock challenged in Parliament over activity targets for dentistry

 

In the House of Commons today Judith Cummins MP, Vice-Chair of the All-Party Parliamentary Group on Dentistry and Oral Health to which we provide secretariat, challenged the Secretary of State for Health and Social Care over the expected imposition of activity targets on NHS practices.

 

Hours before Parliament broke up for Christmas - making it impossible for MPs to fully scrutinise the Government’s decision - Ms Cummins called a return to activity targets “shocking and unacceptable”. She urged Matt Hancock to reverse the decision, stressing the majority of practices would struggle to hit the new target and warning a return to UDAs in the middle of a pandemic “could lead to the demise of NHS dentistry as we know it”.

 

In his response, Mr Hancock claimed the agreement has been reached jointly with the profession, something we strongly dispute. We have refused to sign up to the deal which we consider unachievable for the majority of practices and potentially unsafe in the face of surging COVID rates.

 

We have voiced our concerns about this issue to Parliamentarians and the press. We continue to push for new contractual arrangements for the next financial year which are fair, sustainable and move away from the discredited UDAs.

 


 

15:57

 

Working in Northern Ireland, but living elsewhere?

 

Health and Social Care in Northern Ireland has many staff that cross the border into Northern Ireland to work, referred to in law as frontier workers. After 31 December 2020, many will need a Frontier Worker permit to maintain citizen's rights (ie. to work, rent, access benefits and services etc). Please note, this scheme will close on 31 July 2021.

 

Irish citizens do not need to apply for a Frontier Worker permit, but may need documentation to prove they were working in NI prior to 31 December 2020. For further information on Brexit, dentistry and Northern Ireland please see our Brexit page.

 


 

15:28

 

GDC report on impact of COVID-19

 

Today, the General Dental Council (GDC) have published a report on the Impact of COVID-19 on Dental Professionals. It highlights the following findings:

 

  • The financial impact on dental practices and professionals has been severe. The continuing need for infection control measures will continue to constrain capacity and limit the pace of recovery.
  • Most dental professionals felt confident to do their job safely, but there are concerns about the consistency and timing of guidance issued during the height of the pandemic.
  • Access to dental care has been severely affected and is likely to continue to be for some time. Dental professionals are uncertain about their ability to meet demand.
  • Dental professionals expect some groups of patients to be affected more severely than others, including those particularly vulnerable to infection, older people and people unable to afford dental treatment.
  • Dental professionals think funding models and regulatory approaches need to evolve.

 


 

15:05

 

Furlough and loan scheme extended

 

Chancellor Rishi Sunak has today confirmed an extension to the furlough scheme, which will now run until the end of April next year. This means the government will continue to pay 80% of the wages of workers who have been furloughed.

 

Mr Sunak also confirmed he would be extending the government-guaranteed COVID-19 business loan schemes until the end of March. These changes come in the run-up to the next Budget, which the chancellor confirmed would take place on 3 March 2021.

 


 

11:55

 

Rollout of lateral flow testing in primary care

 

All primary care contractors in England have been contacted by the NHS this week regarding lateral flow antigen testing kits for staff.

 

Lateral flow antigen testing will now be rolled out to asymptomatic patient-facing staff delivering NHS services across all four primary care contractor groups (Medical, Dental, Optometry, and Community Pharmacy) in England.

 

Lateral flow antigen testing, in conjunction with PCR testing, aims to reduce further transmission and enhance the resilience of NHS services, by improving virus detection. Patient-facing staff will be asked to test twice-weekly using self-administered nasal swabbing and report their results through an online platform. Any positive lateral flow antigen tests will need to be followed up by a confirmatory PCR test.

 

Primary care contractors will be sent information on how to obtain the kits as well as an invitation to order lateral flow testing devices directly from Primary Care Services England (PCSE), who will be managing the ordering and delivery process.

 

The final closing date for orders across all contractors will be Wednesday 30 December.

 


 

11:40

 

Scotland: Re-routing low level concerns to be handled locally

 

We welcome new arrangements for the re-routing for low level concerns that do not meet the threshold for fitness to practice, to be handled locally by Health Boards and practices.

 

From 1 January 2021, this new system will apply to concerns raised about dentists who provide or assist with the provision of General Dental Services, in NHS or mixed private/NHS practices in relation to NHS dental care.

 

The Scottish Dental Practice Committee has been campaigning for this for some years.

 


 

08:15

 

England: Targets to push NHS dentistry to the brink

 

With only a couple of weeks until the start of the new year, NHS England have yet to confirm the final contractual arrangements for quarter four.

 

With such significant changes to consider, NHS England should have given practices detailed guidance in good time. In the absence of that clear guidance, and in light of today's coverage, we have chosen to share what we expect the position to be from 1 January 2021.

 

We are doing what we can to help advise the profession and have compiled a comprehensive summary for members .

 

Whilst this is all still subject to confirmation, we expect that we will see a return to measurement by Units of Dental Activity, with a target of achieving 45% of pro-rata UDAs for the quarter, to achieve 100% of contract value. That would be, in effect, 11.25% of annual UDAs delivered across three months. For orthodontics, the UOA target is likely to be even more stretching at 70% of UOAs to achieve full contract recognition for the quarter. These are measures for the fourth quarter only and do not impact the arrangements for the first three quarters of the year.

 

If practices fall short of delivering 45% of their UDAs, we expect there to be a buffer zone in which UDAs will be recognised in proportion. So if 90% of the 45% target is achieved (40.5% of pro-rata UDAs), then 90% of UDAs for the quarter would be paid. If practices deliver 80% of the 45% UDA target, they would be paid 80% of their UDAs for the quarter. That means in effect an important threshold of 36% of pro-rata UDAs (36% being 80% of 45%).

 

However, if practices fall below 80% of the target, then we expect UDAs to be paid only on the basis that they are delivered, rather than at the enhanced rate. For example, if a practice was to reach 32% of pro-rata UDAs, they would only receive credit for the UDAs delivered on a 1:1 basis, which would represent 8% of their annual UDA total (32% delivered during one quarter of the year).

 

In effect, for the last quarter if a practice reaches the threshold of 36% pro-rata UDA delivery, we expect each UDA delivered to be worth 2.2 UDAs. If the practice fails to reach 36% of pro-rata UDAs, each UDA is likely to be worth one UDA. A similar approach is likely to apply to orthodontic delivery in relation to the 70% target.

 

We have been in discussions for months with NHS England about the approach and have argued persistently that these targets are inappropriate and will cause financial difficulties for some practices.

 

We have also been clear with NHS England that these targets are not right for patient care. The return to UDAs and the level of the target will encourage practices to concentrate on delivering UDAs rather than meeting the urgent care needs which persist in many areas.

 

This is a crucial step backwards for practices already struggling to stay afloat. Find out more, in this blog from Chair of our GDP Committee, Dave Cottam.

 


 

Wednesday 16 December 2020

16:40

 

Travel and self-isolation: What you need to know

 

If you are planning to travel abroad, our advice is to check whether you are returning from one of the countries which are exempt from the quarantine guidelines. Northern Ireland and Wales currently follow the same guidelines as England. If you are in Scotland, please refer to the specific advice from the Scottish Government.

 

If the country you or your staff have travelled from is not on the exempt list, you will need to self-isolate for 10 days on your return. However, you can now take a test (five days after leaving a non-listed country) to see if you can stop self-isolating sooner:

 

  • If you get a negative test result, you did not have the virus when the test was done. If you are self-isolating as an international arrival, you may stop self-isolating.
  • If you get a positive test result, you had the virus when the test was done. If you have no symptoms of coronavirus, you must self-isolate for 10 days from your test date. If you have symptoms of coronavirus, you must self-isolate for 10 days from the day your symptoms started, if earlier than when you took your test. People you live with or are travelling with should also self-isolate for 14 days from the day you took the test.
  • If your coronavirus test result is unclear, you must, by law, continue self-isolating for the remainder of your self-isolation period. If you want to shorten your self-isolation period, you will need to take another test.

For more information, please see our FAQs.

 


 

14:20

 

Northern Ireland: Financial Support Scheme update

 

Details of the extension of the Financial Support Scheme (FSS) until the end of the financial year have been shared with GDPs in Northern Ireland.

 

An additional £5m for the GDS budget will enable patient contributions to continue until the end of the year. There will be no abatement applied, on condition that 15% Item of Service activity is reached, starting from the January-February payment cycle. A sliding scale of abatement will be applied where activity levels are lower than 15%.

 


 

11:19

 

Contact tracing and self-isolation


You must self-isolate when told to do so by NHS Test and Trace personnel or a medical professional.


If you have no symptoms, but you have been told to self-isolate by Test and Trace, you should do so for ten days.


If you have COVID-19 symptoms and are told to self-isolate, you should do so for either ten days starting from the day after the day you got symptoms, or for ten days from four days before you had the test, whichever is longer.

 

If Test and Trace tell you that you were in close contact with someone who has since tested positive for COVID, you will be told to isolate for ten days starting with the day after the last day you came into close contact with the positive person. A close contact is defined as:

 

  • Having face-to-face contact with someone at a distance of less than 1 metre
  • Spending more than 15 minutes within 2 metres of an individual
  • Travelling in a car or other small vehicle with an individual
  • Or in close proximity to an individual on an aeroplane.

For more information on contact tracing and self-isolation, see government guidance or our FAQs.

 


 

09:31

 

Have you applied to the EU Settlement Scheme?

 

The Government has set up the EU Settlement Scheme for EU/EEA nationals living in the UK. Any dentists or staff members who are EU/EEA nationals need to apply to the scheme before 30 June 2021 in order to remain in the UK without the need for future visa status, unless they have obtained citizenship or are citizens of the Republic of Ireland.

 

This includes individuals who have previously applied for residency in the UK; their status will be converted to the new scheme, but they must apply. From 1 January 2021, the UK Government intends to treat newly arrived EU citizens the same as citizens from elsewhere, requiring them to comply with a new points-based system. If you are an EU/EEA national already living in the UK, make sure you are signed up to the EU Settlement Scheme.

 


 

Tuesday 15 December 2020

17:13

 

Lateral flow antigen testing in primary care

 

All primary care contractors in England will be contacted by the NHS this week regarding lateral flow antigen testing kits for staff.

 

Lateral flow antigen testing will now be rolled out to asymptomatic patient-facing staff delivering NHS services across all four primary care contractor groups (Medical, Dental, Optometry, and Community Pharmacy) in England.

 

Lateral flow antigen testing, in conjunction with PCR testing, aims to reduce further transmission and enhance the resilience of NHS services, by improving virus detection. Patient-facing staff will be asked to test twice-weekly using self-administered nasal swabbing and report their results through an online platform. Any positive lateral flow antigen tests will need to be followed up by a confirmatory PCR test.

 

Primary care contractors will be sent information on how to obtain the kits as well as an invitation to order lateral flow testing devices directly from Primary Care Services England (PCSE), who will be managing the ordering and delivery process.

 

The final closing date for orders across all contractors will be Wednesday 30 December.

 


 

16:12

 

Mental health and the pandemic

 

The festive season can be a stressful time for many. If you would like some support in combatting this stress and supporting your mental health, know that there are many options available to you. Dentists can contact the Dentists' Health Support Programme or review the list of services available across the country on our stress page.

 

Members also have access to Health Assured, a confidential service designed to help you deal with problems that affect life, health and general wellbeing. For access to confidential counselling and emotional support, call their helpline 24/7, 365 days a year on 0800 030 5182.

 


 

14:19

 

Supporting your recovery after COVID-19

 

Dentists and dental teams across the country are grappling with the effects of COVID-19. The NHS has provided resources for those who are recovering from COVID-19, to support those coming to terms with the impact the virus can have on the body and mind. If you have been diagnosed with COVID-19, Your COVID Recovery should help you to understand what you might expect as part of your recovery.

 

If you have completely recovered from COVID-19, you may wish to donate blood plasma to those who continue to fight the disease. See our blog on plasma donation to learn more about this life saving work.

 


 

08:25

 

England: PPE Portal order limits increased over Christmas

 

The Department of Health and Social Care PPE Portal will be operational over Christmas. Their delivery partners, Royal Mail and their Pallet Carrier, will not be delivering on Christmas Day and Boxing Day.

 

However, orders made during this time should still be delivered within 5 days. To make allowance for any potential disruptions or increased need, DHSC have increased order limits by 25% for all providers, as of Tuesday 8 December, and until at least 4 January.

 

You're encouraged to call the customer service team on 0800 876 6802 if you have any questions about using the PPE portal. The team is available from 7am to 7pm, 7 days a week, to help resolve your queries. Or see the latest PPE Portal guidance, detailing order limits for the different types and sizes of provider.

 


 

Monday 14 December 2020

17:44

 

Brexit and Northern Ireland: Some dental practices now need HTA licences

 

The Human Tissue Authority (HTA) have informed us that some dental practices in Northern Ireland will need to apply for a licence before the end of the Transition Period.

 

Any dental practices in Northern Ireland that receives human tissues, cells or acellular bone products from suppliers in GB will require an import licence from the HTA from 1 January 2021 in order to continue. These licences are for regulatory purposes and are not required by customs or at the border.

 

The HTA intends to contact these establishments in the coming days to discuss whether they will be affected by the changes, and to help them apply for a licence if needed. They plan to issue fixed-term licences in the first instance to ensure that they can continue to import human tissues and cells from GB as needed.

 

We understand that these licences will be free of charge and the application process itself will be a pared-back version of the standard licence application process.

 


 

15:54

 

England: No further restrictions to dental services

 

London will be put into England’s highest tier of coronavirus restrictions from 00:01 on Wednesday, MPs have been told. It’s important to note however that, although London and parts of Essex and Hertfordshire will enter tier three, dental practices will remain open and there will no change in terms of access for patients. Dentists should continue to follow guidance and let their patients know that appointments will continue as planned.

 


 

15:03

 

Brexit and dentistry: Medicines supply continuity

 

The NHS has sent a letter to NHS organisations on the issue of medicines supply ahead of the end of the transition period on 31 December. It covers trader readiness and buffer stocks, regulation and shortage management of medicines. We note that it is not deemed necessary for local providers, whether in hospitals or primary care, to stockpile medicines or for clinicians to write longer prescriptions for patients. For more information on Brexit and dentistry see our Brexit page.

 


 

12:30

 

Brexit and Northern Ireland: Dental practices need an XI EORI number

 

At an EU Transition stakeholder event hosted by the Department of Health last night, we were informed that many dentists in Northern Ireland will need to apply for an XI EORI number. If your practice does any low-level trade with GB, such as sending impressions to labs in Scotland, you need to prepare for the post-transition period by:

 

We recommend you move quickly to do this to avoid encountering delays, as enrolment will be handled manually from 14 December. To get an EORI number that starts with XI, you must already have an EORI number that starts with GB. If you do not have one, apply for an EORI number that starts with GB as soon as possible.

 

See the NI Customs and Trade Academy for more information, or take a look at our Brexit section for more on Brexit and dentistry.

 


 

10:32

 

Brexit and dentistry: The transition period ends soon

 

The UK left the European Union on 31 January 2020 and entered an 11-month transition period during which it continued to follow existing arrangements while negotiating a future free trade deal and wider relationship. This transition period comes to an end at 11pm on 31 December 2020.

 

From that moment on, EU legislative arrangements currently in place for movement of goods, people and services will no longer apply to the UK, and access to, and inclusion in EU regulatory and support systems will also cease.

 

The changes will apply differently to Great Britain (England, Wales and Scotland) and to Northern Ireland, because the Withdrawal Agreement’s Northern Ireland Protocol will see certain EU arrangements and legislative requirements continue to apply in Northern Ireland.

 

For more information on how this is likely to affect dentistry see our Brexit page on:

 

  • Workforce and recognition of qualifications
  • Immigration arrangements
  • Medicines and medical devices
  • Northern Ireland
  • Data sharing and data protection
  • Research and development.