Friday 19 June 2020
20:30
Weekly roundup
Here's my weekly roundup of the 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:
Petition
Advice on NHS and pay
PPE and Fit-testing
Mental wellbeing
Legal webinar
19:00
Wales: Red alert to be lifted on Monday
The CDO Wales, Dr Colette Bridgman, confirmed today that the Welsh Government will be
lifting the red alert in dentistry from Monday 22 June. This corresponds to the First Minister's announcement earlier in the day that there will be an easing of lockdown measures from this coming Monday.
In this phase, dental practices will able to provide more care and treatment for patients. However, practices will need to make sure that measures are in place to ensure a safe environment for staff and patients. Social distancing and infection control measures will mean that fewer patients can be seen, so dental teams are being asked to prioritise those who need more urgent care.
Dental practices who are ready to do so can treat more patients ahead of the earlier planned date of 1 July.
16:24
Respirators in dentistry: practical guidance and face fit-testing
Last week's
webinar on the use of respirators in dentistry is now available to view online. Login to our iLearn platform to view this live recording.
Ross Clark, Head of Occupational Hygiene at the Institute of Occupational Medicine, will help you understand the following:
- What respirators you should select
- Where you can get them
- What face fit-testing involves
- How to wear a respirator and manage its use.
15:00
PPE and fit-testing: what you need to know
Dentists have two important challenges in terms of PPE and COVID-19. The first is sourcing the right equipment. The second is getting it correctly fitted.
In his blog, Tarik Shembesh, a dentist who is leading the fit-testing program in London's urgent dental centres, shares
10 things you need to know about fit-testing PPE and the dental practice.
14:45
Webinar: Legal review of members' business interruption policies
We held a webinar on Wednesday, covering the legal issues that are common to more than two-dozen business interruption policies that have been reviewed by Brown Rudnick LLP.
Members who were unable to attend can now
watch the webinar.
Ravi Nayer, a partner at Brown Rudnick LLP, provided members with:
- An overview of the review undertaken by Brown Rudnick LLP
- An explanation of the key legal issues identified by the review
- The important considerations and possible next steps for BDA members in light of the FCA test case
- Guidance on the role and benefit of any class action for dentists
13:55
England: Latest version of the return to face-to-face care toolkit is available
The
latest version includes updates on face masks for all staff, ventilation measures, fit-testing and cover from BDA Indemnity, and clarity on fallow time after AGPs. There is a paucity of evidence upon which the time of 60 minutes has been arrived at. Many countries either have no fallow time for AGPs or a very short period. We are pressing government agencies and other organisations to provide the evidence for this guidance as it has a significant impact on the delivery of care to patient, access to dental services and the viability of dental practices in the high street.
10:57
Northern Ireland: An independent legal position on restrictions on private practice
Members have raised questions about the extent to which the current restrictions apply to private dentistry, so we’ve taken legal advice on private practitioners’ ability to treat patients.
We requested legal clarity from the Acting Chief Dental Officer and RQIA on a number of occasions, but we felt the responses required further clarification.
The Department of Health’s desired single speed approach is to avoid mixed messages on the return of dentistry to the public, resulting in one set of rules for Health Service, and another for private dentistry. However, whereas there is a contractual relationship for Health Service dentistry, the position for private dentistry has been less obvious.
Our legal advice for members
makes that position clear.
We have advised throughout this period that, as ever, all professionals should work in a way which ensures the health, safety and wellbeing of their patients and colleagues and should only provide treatment where it is safe for them to do so. The process of assessing whether it is safe will have to be determined by dentists and their team and involve carrying out the necessary risk assessments having regard to relevant guidance issued by professional bodies, the Department of Health, the RQIA and any other statutory bodies.
You can find guidance and templates on assessing risk in
our toolkit. While the document is currently for England-based members who returned to face-to-face care two weeks ago, the corresponding templates and CPD will assist members in Northern Ireland. Importantly, dentists will also want to ensure that their indemnity provider is content with the scope of any care provided.
Finally, in his letter issued to GDPs yesterday, the Acting CDO has now provided dates for moving to Phase 2 and 3 of the GDS re-establishment plan, including a fast-track date of 1 July where practitioners can meet the necessary standards to safely offer AGPs and non-urgent/routine care. Additional details on compliance are to be provided in the coming days.
10:10
Death in service benefits in England
NHS England and NHS Improvements have published guidance for claimants and employers in regard to death in service. This scheme is separate to the one for those enrolled in the NHS Pension.
All staff employed by dental practices, including dental nurses and cleaners are eligible. Individuals are required to have been performing their duties 14 days before the start of their coronavirus symptoms and the coronavirus disease must wholly or mainly be the cause of death.
Contact the helpline on 0300 330 3331 for more information.
09:05
Petition to extend business rates relief to dentists
With practices struggling to keep afloat we have launched a petition calling on government to extend the COVID-19 business rates relief to healthcare providers. This is part of our on-going campaign for private practices to receive fair and equitable financial support during this crisis.
Only 8% of practices in England reported that they were confident in maintaining their financial sustainability prior to June 8. Many practices continue to struggle despite re-opening, a situation which is completely untenable.
Sign the petition today
Thursday 18 June 2020
18:25
Northern Ireland: Clarification on timescales and hope for PPE
Dentists in Northern Ireland will be allowed to provide non-urgent care from 29 June, while aerosol-generating procedures (AGPs) will be permitted when phase three commences on the 20 July. A fast-track option of 1 July will be made available to practices able to demonstrate they can safely offer AGPs and non-urgent/routine care. This is part of the new timetable for restoring high street dentistry in Northern Ireland that was announced by the Department of Health today.
In his letter, the CDO has also recognised the importance of PPE in restoring dental services, adding: "I am working alongside officials in the Department to agree how we will provide PPE support to you in the context of the broader re-build programme and management of the Pandemic".
In a press release issued today, the HSCB went a step further: "One of the key elements necessary to allow practices to move to phases 2 and 3 is the availability of suitable PPE. In recognition of this, the Department of Health will support dentists in restoring services by providing help with PPE supplies".
Encouraging progress has been made, but we will continue to press for the detail in relation to PPE, and of course, on future financial supports which are essential to keep practices afloat throughout this road to recovery.
We will continue to monitor the situation and update you on all progress.
17:02
Three things you can do for your mental wellbeing
BDA president Roz McMullan supported front line staff in a Northern Ireland hospital during the early weeks of the COVID-19 outbreak. Here
she reflects on the increasing levels of stress dentists are under and looks at three strategies for mitigating it.
If you want to hear more from Roz on this topic, register for her webinar:
Understanding your wellbeing in a COVID-19 world on Thursday 25 June at 19:30-20:30.
16:20
Completion of NHS England Workforce Data Collection Forms
Many members have contacted us to ask about the Compass Workforce Data Collection Forms that need to be submitted by Friday, 19 June 2020. We know that many members are concerned about how this information will be used, especially in relation to those who do work in mixed practices, but not on NHS patients. We share many of those concerns. We have asked NHS England for more information, but we are unlikely to get the information before the forms have to be submitted.
We also understand that some members have had difficulty with the BSA call centre in relation to the form.
Like many of our members, we have reservations about how this information is going to be used, and whether the information will be as useful as it could have been had dentists been able to get better help. That said, we know that this information will allow NHS England to evidence how important continued NHS contract payments were to ensure members of the dental team were able to help in the wider COVID-19 emergency.
15:48
Scotland: Dental practices to reopen from 22 June
The
CDO has written to dental practitioners today to say that practices can reopen for urgent care using non-aerosol generating procedures (AGPs) from Monday 22 June. This follows the First Minister’s announcement this afternoon about Phase 2 for easing the lockdown across Scotland.
We have responded to the news with a
press release on the financial pressures facing practices and a
blog from SDPC Chair David McColl on the plans for reopening and our concerns for dentists.
We met with the CDO and Scottish Government yesterday to discuss our concerns, including financial support, risk assessment, and extending key worker status to dentists and their teams. We will continue to liaise with the Scottish Government and to raise dentists’ concerns as we move towards Phase 3.
15:35
Updates from across the UK
We have updates from around the country on the case we're making to government, new dates for reopening practices, and how expansion of care will be delivered:
-
England: We presented evidence to Parliament's Health and Social Care Committee on the impact of the pandemic on dentistry. Here's a summary of the case our Chair, Mick Armstrong, made on bringing dentistry back from the brink.
-
Wales: As face-to-face clinical care looks set to expand in Wales, National Director of BDA Wales Caroline Seddon, outlines how we are campaigning on your behalf.
-
Scotland: Now that a reopening date has been confirmed, the chair of the SDPC outlines the challenges facing dentists as practices prepare to reopen in Scotland.
13:30
England: Making your voice heard
As part of our ongoing campaign to make sure your voice is heard, Mick Armstrong, Chair of BDA Board, spoke for you and the profession to the Parliament's Health and Social Care (HSC) Committee on Tuesday.
We know that the effects on general practice – both NHS and private - has been devastating and is possibly existential. The HSC Committee has been tasked with looking at the impact of the pandemic on England's healthcare services.
The case he presented covered both pandemic-specific issues and some that predate the current crisis, such as oral health inequalities and rock-bottom morale.
Find out more about
what he said on behalf of the profession.
13:25
PPE and fit-testing: what you need to know
Dentists have two important challenges in terms of PPE and COVID-19. The first is sourcing the right equipment. The second is getting it correctly fitted.
In his blog, Tarik Shembesh, a dentist who is leading the fit-testing program in London's urgent dental centres, shares
10 things you need to know about fit-testing PPE and the dental practice.
Wednesday 17 June 2020
16:00
Wales: What BDA Wales is doing for you
National Director of BDA Wales, Caroline Seddon, has outlined how we are campaigning on your behalf as face-to-face clinical care looks set to expand in Wales.
Find out more about what we are doing for dentists in Wales, as we:
- Push for an expansion of care to include AGPs
- Lobby government to support private practice
- Urge for an increase in NHS contract value for dentists
- Help shape a new model for NHS dentistry.
15:30
Up-coming webinar: Stress and COVID-19
With so many dental practitioners facing severe financial problems, times have never been tougher. While we lobby governments on your behalf, we also urge you to also consider your mental wellbeing at this difficult time.
We invite you to register for our
Understanding your wellbeing in a COVID-19 world webinar, which will see BDA President Roz McMullan looking at stress and mental wellbeing (1 hour CPD). Roz worked to support the mental wellbeing of frontline healthcare after the outbreak of the crisis and looks forward to share stress mitigation strategies with you.
Taking place on Thursday 25 June at 19:30-20:30, it will help you to:
- Understand signs and symptoms of stress and burnout
- Explore the prevalence of stress in dentistry and what we know about COVID-19 and well-being
- Gain knowledge of psychological effects on healthcare staff when experiencing a pandemic
- Be aware of evidence-based prevention and coping strategies during a pandemic
- Be aware of signposting for people experiencing stress and burnout and gain knowledge of the organisations available for support.
14:01
England: Confirmation from NHS England on payments
We have received confirmation from NHS England on a number of issues related to the payment of associates and employed staff.
For clarity on issues related to NHS associates and sick pay, pay during self-isolation, pay during continued redeployment, see
our financial impact page.
For advice on the rights of employed NHS staff, see
question 21 on our FAQ page.
13:50
Respirators in dentistry: practical guidance and face fit-testing
Last week's webinar on the use of respirators in dentistry is now available to view online. Login to our iLearn platform to view this live recording.
Ross Clark, Head of Occupational Hygiene at the Institute of Occupational Medicine, will help you understand the following:
- What respirators you should select
- Where you can get them
- What face fit-testing involves
- How to wear a respirator and manage its use.
12:30
Petition to extend business rates relief to dentists
With practices struggling to keep afloat we have launched a petition calling on government to extend the COVID-19 business rates relief to healthcare providers. This is part of our on-going campaign for private practices to receive fair and equitable financial support during this crisis.
Only 8% of practices in England reported that they were confident in maintaining their financial sustainability prior to June 8. Many practices continue to struggle despite re-opening, a situation which is completely untenable.
Sign the petition today.
09:00
England: Making your voice heard
As part of our on-going campaign to make sure your voice is heard, Mick Armstrong, Chair of BDA Board, spoke for you and the profession to the Parliament's Health and Social Care (HSC) Committee yesterday.
We know that the effects on general practice – both NHS and private - has been devastating and is possibly existential. The HSC Committee has been tasked with looking at the impact of the pandemic on England's healthcare services.
The case he presented covered both pandemic-specific issues and some that predate the current crisis, such as oral health inequalities and rock-bottom morale.
Find out more about what he said on behalf of the profession.
Tuesday 16 June 2020
Northern Ireland: Making the case for dentistry
Today Caroline Lappin, Chair of the Northern Ireland Council, has
written to the Department of Health and Social Care to make the case for dentistry in Northern Ireland. Specifically to argue that the Acting Chief Dental Officer, Michael Donaldson, should have a seat on the Management Board being set up to plan the recovery of HSC services. This board is currently comprised of senior DoH, HSC Trust, HSC Board officials. In the letter we make a strong case for dentistry's inclusion and highlight other important matters relating to dentistry and oral health in Northern Ireland.
11:50
Face coverings in primary care
We are aware of some confusion caused by last week's letter from NHS England regarding the wearing of face coverings by dental practice and other primary care staff when not in PPE.
We have sought clarity from NHSE as to whether the face covering requirement applies at all times or only when social distancing cannot otherwise be maintained, and will update you as soon as we have a response.
11:00
Wales: LDC Conference
Many of you will have seen the recent announcement that the upcoming LDC conference is being held electronically on Saturday 25 July 2020. This comes at a vital time for dentistry across all countries of the UK.
The motions generated at LDC Conference will set the policy direction for Welsh GDPC over the coming year across a wide range of topics. We are all aware of the challenges that we are facing at the moment at this unprecedented time and this conference represents a great opportunity to have the LDC voices heard.
Motions are coordinated by individual LDCs, and will need to be submitted by LDCs by July 1 2020. The conference website has a helpful
guide to submitting motions which I would encourage you to read. There are a limited number of places available to each LDC which will be arranged on a local level.
LDC emails across Wales are as follows:
If you are not involved already, please use this chance to get involved with your LDC and put your stamp on how dentistry moves forward.
10:00
Hunt pledges to reopen dentistry inquiry following BDA evidence
Health and Social Care Committee Chair Jeremy Hunt has promised to reopen to inquiry into dentistry that was abruptly closed by December’s snap General Election.
His pledge followed
oral evidence from the British Dental Association.
BDA Chair Mick Armstrong told the committee the effects of the pandemic on oral health have been “catastrophic”.
“Dentistry was not in a great place when we started. We’ve got access problems which have been raised in both Houses, and also in the previous Health Select Committee, with widening inequalities, rock-bottom morale and retention problems, so the pandemic has just made that that much worse,” he said.
“The effects on general practice, NHS and private, has been devastating and is probably existential. The effect on oral health has been catastrophic.”
The BDA Chair who works as a frontline clinician in West Yorkshire, told MPs: “We’ve cancelled eight million courses of treatment nationally.
“Our practice alone has cancelled 6,000 appointments and we will be cancelling another 3,000 until September just to deal with the urgent case backlog.
“So 12,000 dentist practices in the country have been effectively replaced by 500 urgent care centres, they’ve done a sterling job in treating the most urgent, but it’s clearly no replacement.”
Monday 15 June 2020
17:15
Scotland: Latest update on reopening dental practices
The Scottish Government has issued
some further details on the plans to reopen practices to NHS patients later this month. This follows the CDO’s letter of 8 June. The date for reopening will be confirmed following the Scottish Government’s next 3-weekly lockdown review on 18 June. This latest memorandum reiterates that practices should use the SDCEP guidance, and work with their NHS Boards, to prepare for reopening.
The Scottish Government has also issued an
interim Statement of Dental Remuneration (SDR) which practices should use on reopening. This revised SDR is to record activity only; there will be no patient charges for the time being, and the NHS financial support package will remain in place. We pressed the Scottish Government to include a code for the use of translators in the SDR as this is a major commitment for some practices. They decided not to, which we see as a missed opportunity.
We are meeting with the CDO and Scottish Government officials on Wednesday to discuss various issues regarding the phased return to practice. We will update you as soon as possible.
12:00
The FCA to consider plight of dentists
We have made a formal request to the Financial Conduct Authority (FCA) to consider to the challenges facing the dental sector before the FCA takes forward a test case on insurers’ non-payment of business interruption claims.
The FCA has previously stated that most policies with basic cover would not cover COVID-19. However it is now seeking "legal clarity" on business interruption insurance in an attempt to provide greater clarity for businesses and insurers.
We have
instructed law firm Brown Rudnick LLP to review the wide range of business interruption policies held by our members and provide tailored legal advice for the dental sector. We have also set out in detail to the FCA, the issues faced by the profession and have asked them to adequately reflect these in its own legal challenge.
We advise members to await the outcome of the FCA process before considering whether to pursue class action litigation. This would be premature at this stage and will not help to solve the cash crisis that members are facing now.
Brown Rudnick will be joining us to host a
members-only webinar on Wednesday (17 June) for dentists to discuss the review conducted by Brown Rudnick, our letter to the FCA and what next steps are likely to look like.
09:28
Changes made to DFT assessment
Health Education England (HEE) and deaneries are making changes to the final review of competence progression (FRCP) this year to allow for the issues for training caused by COVID-19. By now you should have heard from your aligned HEE office. NHS Education for Scotland also have indicated modifications to the process. We believe that process changes are still under discussion in Northern Ireland and Wales.
You should be aware that HEE has changed the final list of minimum requirements for Outcome 6 and introduced a new Outcome 6C designed to enable dentists to gain further experience in any competencies not fully demonstrated during Dental Foundation Training (DFT). This will be an individualised process of support after leaving DFT, while working in the NHS General or Personal Dental Services (GDS or PDS) or in Dental Core Training.
HEE’s
guidance outlines the process, which is intended as a pragmatic solution to the disruption of training in the last few months. We have asked for clarity on the practicalities of the approach, such as the timelines, the suitability of posts to comply and the issues around moving between UK countries. We will update you once we have more information.
The timelines for the FRCP process have also moved to the end of July/beginning of August and you should receive further information on this from HEE.
For more information see
our FAQs.
08:55
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08:40
CQC launches emergency support framework
The Care Quality Commission has
emailed dental providers in England to thank them for their service in response to the COVID-19 crisis and to launch the new emergency support framework (ESF).
The ESF is a tool that supports conversations between inspectors and providers and designed to help communicate the specific stresses and challenges that providers are facing, and to understand where people may be at the greatest risk of unsafe care.
ESF will start to be implemented across dental services from today. You can find out more on the
CQC website.
