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Updates from week commencing 17 August 2020

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

Friday 21 August 2020



England: Updated travel advice for dentists and their teams


The list of countries exempted from quarantine will change again this weekend.


Dentists and their teams should take note that travellers returning from the following countries will no longer exempt from self-isolation requirements after 04:00 on Saturday 22 August: Austria, Croatia and Trinidad and Tobago.


Whereas, Portugal will be added to the list of counties exempt from quarantine requirements from 04:00 Saturday 22 August.


We recommend you review this list in full, if either you or your team are planning to travel outside of the UK.





Public Health England scrapped: What next for oral health?


This week the Government announced its decision to replace Public Health England with the National Institute for Health Protection (NIHP). England’s pandemic response is understood to be the reason for this change and the NIHP’s mission is to protect people from threats to public health.
Is the abolition of PHE a threat to oral health? That’s the question Dr Robert Witton, Chair of the Dental Public Health Committee, tackles in his recent blog. In it he discusses what these changes might mean for dentistry and calls for oral health not to be considered an optional extra.





Decision pending on business interruption cover


The High Court hearing on business interruption insurance concluded on 30 July, but a judgment is not expected until later in the year due to the huge amount of material under review, the possible impact of the decision and complexity of the arguments.


Much of the legal argument has centred on causation and the requirement for the loss suffered by the insured to have been caused by the "insured event" (for example the occurrence of a notifiable disease within a 25 mile radius of a premises).


The insurers said that, regardless of the events insured against, no policy was ever designed to provide cover for a national pandemic, and as a result of the national lockdown, businesses would have suffered losses anyway. However, the FCA argued that the national lockdown only occurred because of each and every individual case of COVID-19, which can each properly be described as a cause of the insured's losses.


We know that this is an important issue for many dentists and we will update you when we know more.



Thursday 20 August 2020



England: Cap lifted on admissions to dental schools


The Government and higher education sector in England have together agreed that all students who achieved the required grades will be offered a place at their first-choice university. It has been decided to honour all offers to students who meet their conditions this coming year wherever possible, or if maximum capacity is reached to offer an alternative course or a deferred place.


To support this commitment, the Government has lifted the cap on domestic dentistry, medicine, veterinary science and undergraduate teacher training places. Additional teaching grant funding will also be provided to increase capacity in medical, nursing, STEM and other high-cost subjects which are vital to the country’s social needs and economy. However, it remains unclear how this will impact the number of admissions to dental schools this year.





Important clarification: Dentists and contact tracing


A recent update to COVID-19 guidance on the management of health and social care settings has clarified the position of dentists regarding the Test and Trace programme.


If dentists are providing direct care to a patient with COVID-19 and are wearing the correct PPE in accordance with the current IPC guidance, they are not considered a contact for the purposes of contact tracing and isolation, and are not required to self-isolate for 14 days. We welcome the clarity that this provides dentists across the country.





Northern Ireland: New condition attached to FSS scheme


Yesterday, the Department of Health wrote to all NI GDPs announcing the inclusion of an additional condition in the August-September Financial Support Scheme. As part of the usual application process, GDPs will be asked whether they have provided treatments involving AGPs to all categories of GDS patients. Only those that have will receive FSS payments with the 20% abatement removed. The Department’s intention is to ensure that registered Health Service patients are not being denied access to treatments involving AGPs.


We believe the current Financial Support Scheme should continue - with no abatement and amended eligibility rules to allow excluded GDPs access to funding - until better information is available regarding fallow time/PPE and the risk of a second wave of COVID cases recedes. We will continue to fight hard on your behalf.





Northern Ireland: Inspections to go ahead


In recent discussions with RQIA regarding the resumption of on-site inspections, we stressed the need for a sensible and light-touch approach at this difficult time. We’re frustrated to see RQIA take on board few dentists’ concerns.


RQIA are insisting that ‘on-site’ inspections for the first tranche of inspections will go ahead, despite our warnings, however they’re adamant that mitigating measures will be put in place. The inspector will wear appropriate PPE, keep a two metre distance from GDP staff and talk to each member of staff for no longer than 15 minutes. Practices selected for inspection will also receive a supportive telephone call with an inspector a month in advance of an inspection taking place, and around flexibility to set a mutually convenient date for inspections.


More details can be found in this RQIA letter. If practice owners affected have any concerns about the practicalities of the proposed inspection, or believe RQIA inspectors are not following the arrangements set out in the letter, then please share those concerns with RQIA Senior Inspector Jo Browne on 028 9536 1887.





Wales: CDO says contract value abatement last quarter stands


The Chief Dental Officer (CDO) has responded to the concerns we’ve raised regarding the higher rate of GDS NHS contract value abatement in Wales.


Last month, we’d pointed out that dentists in Wales had been doing more but being paid less, as practices in Wales remained open during the red alert phase to see some patients face-to-face, and yet the 20% abatement of the ACV of the GDS contract in Wales for April, May and June was significantly greater than the equivalent in England which was nearly 4% less (3.75%).


The CDO has now confirmed that there is no room to revisit this abatement figure at present. However, we will build on the progress we’ve made in recent months, and continue to campaign on your behalf.



Wednesday 19 August 2020



Northern Ireland: Health minister warns of new restrictions

Northern Ireland's Health Minister, Robin Swann, has said he will be recommending COVID-19 restrictions to the Executive to curb the increasing spread of the disease. This comes as 34 new COVID-19 cases were confirmed in Northern Ireland by the Department of Health.

Mr Swann said he will recommend restrictions when ministers meet on Thursday, which may include reducing the number of people who can meet in a household. We do not believe these restrictions will further impact dentistry in Northern Ireland. However, we will keep you updated with any developments.





Scotland: Financial support announced for Vocational Dental Practitioners (VDPs)


We're pleased to see the Scottish Government take note of the concerns we raised on behalf of Vocational Dental Practitioners (VDPs), and welcome their decision to provide additional financial support for VDPs moving to associate position, and for vocational trainers.


Last week, we raised concerns about the funding package available to VDPs in Scotland and the financial consequences they faced should they move to an associate position at the end of their VDP year in August 2020. We've now been informed that they will announce revised financial support measures for completing VDPs moving to their first associate position (replacing an outgoing associate) next week.


In these circumstances VDPs may now receive either the value of the VDP salary, or 80% of the monthly average of their item of service payments for the period August 2019 to February 2020 inclusive, whichever is greater. These young dentists are the future of the profession and we're pleased to see our work help alleviate some of the financial stress they're under.





Scotland: Concerns over PPE supplies for dental practices


We are concerned that much of the “enhanced” PPE provided to NHS dentists in Scotland has passed its expiry date (some equipment is from as far back as 2012) which may present significant risks to patients, dentists and their teams.

Since dental practices reopened in June, the Scottish Government and NHS National Services Scotland have been supplying a limited amount of PPE to allow practices to treat NHS patients. Dentists have been able to provide AGPs to NHS patients requiring urgent care since last Monday (17 August). These reports of expired PPE are therefore of immediate concern, for both staff and patient safety.

We've raised the matter with NSS and are seeking formal certification – or some other evidence – that the expired PPE has been appropriately revalidated.





Stress: Is there a burgeoning mental health crisis?
It may be a long time before we see the real mental health impacts of this pandemic. But since the end of lockdown, there’s been a rise in the requests for mental health support to the Dentists’ Health Support Programme (DHSP).


Rory O’Connor, Coordinator of the DHSP, has reflected on the mental health challenges facing dentists during this new normal. He writes on the need to exercise empathy and maintain your professionalism during this crisis, explains what warning signs you should look out for and why they're forecasting an increase in requests for support this winter.





Wales: Risk assessment tool for healthcare workers


The Welsh government has produced a risk assessment tool to help people working in the NHS and Social Care. It is designed to help you see if you’re at higher risk of developing more serious symptoms, if you come into contact with the COVID-19 virus. Dentists and their teams may find it useful to consider their own personal risk factors for COVID-19 and to review the suggestions provided on how to stay safe.



Tuesday 18 August 2020



National Institute for Health Protection to be set up


This morning Health Secretary Matt Hancock has confirmed Public Health England (PHE) will be replaced by a new body focused on preparing for external threats like pandemics.


Baroness Dido Harding, who runs NHS Test and Trace in England, will be the interim chief of the new National Institute for Health Protection (NIHP). Its mission is to protect the UK from external threats to health including infectious diseases and biological weapons. It will operate at a national level but work with local public health directors and devolved nation Chief Medical Officers. Its three focus areas will be:


  • Response – the operational response to COVID, alongside vaccine development 
  • Resilience and preparedness – to develop standing capacity for fast action at scale 
  • Culture – harness academic expertise and private capacity; be outward-looking, non-hierarchical, remove silos and bureaucracy.


In his speech, Mr Hancock confirmed little about the non-pandemic related roles of PHE, but said that function will be embedded across government, NHS, primary care and local area teams. We understand that consultations will take place over the next few months, during which Michael Brodie will take on the role of interim CEO of PHE.


We will work to make sure the voice of dentists and dentistry is heard throughout this process.





Admissions to dental schools in 2020


The Medical and Dental Schools Councils have issued a statement about admissions to medical and dental schools in 2020. It recognises that students hoping to begin studying dentistry are in a uniquely difficult situation.


In it they warn that not all applicants who now meet the conditions of their offer will be able to start medical or dental school in 2020. They note that their ability to increase the number of places available is limited by specialist facilities for subjects such as anatomy, clinical placement opportunities and numbers of dental chairs, particularly in the latter years of the course. But saying that they are working with the Department of Education and the Department of Health and Social Care to see what funding solutions can be put in place to facilitate any additional places.





Supporting dentists and their teams


Our new PPE course has now supported over 7,000 dentists and DCPs to use PPE with confidence in the dental practice. The course provides clarity on the PPE required for AGPs during the COVID-19 pandemic and how to correctly don and doff PPE.


Here’s what attendees have said:


“This course was wonderful. Now I'm not afraid to go back to work because I know what to expect. Thank you very much.”


“Very comprehensive & informative, thank you!”


“This course is an excellent training module. It’s very clear and easy to follow. It’s been recommended to all the team by the IPC lead.”




Last chance to nominate NHS staff for new award


Do you know NHS staff members, carers and volunteers that have gone above and beyond? Nominate them for the NHS Parliamentary award today!


These awards were launched by NHS England and NHS Improvements to celebrate NHS staff, carers and volunteers. Send your completed nomination forms today and then follow up with your MP before Tuesday 1 September to make sure they have submitted it.



Monday 17 August 2020




England: PPE portal for NHS practices


NHS practices in England should expect to receive an email by Friday 21 August inviting you to register with the PPE Portal. This is an online platform delivered through a partnership between the Department of Health and Social Care and the NHS. It is set up to supply PPE, free of charge, to health and social care providers.


The intention is that practices use their usual suppliers for routine orders, but to give them access to these supplies in emergency situations. If you have any questions, please contact the PPE Portal Customer Service team on 0800 876 6802.





Oral health of COVID-19 patients explored


A recent contribution to the International Journal of Infectious Diseases explores whether oral mucosal lesions in a COVID-19 patient are new signs of the disease or secondary manifestations. It calls for dentists to be included in the intensive care unit multi-professional team to improve oral health in critical patients. It argues that this is important, not only in COVID-19 patients, but also, to contribute to evidence-based decision-making in managing infectious diseases.





Support for NHS dentists and their teams


Many NHS staff are facing significant stresses due to the current climate of increasing pressures on healthcare systems. That's why, a confidential staff support line has been set up for NHS staff. It is operated by the Samaritans and free to access seven days a week.


Dentists and their teams can reach out for confidential support by calling 0300 131 7000 (07:00-23:00) or for bereavement support by calling 0300 303 4434 (08:00-20:00). To find out more about the resources available to you and for access to wellbeing apps, guides and virtual common rooms, see the NHS People website.





England: Dental health must not be overlooked in public health shakeup


We are asking for clarity on public health provision, after this weekend's announcement that Public Health England is to be replaced. We have written to the Secretary of State for Health and Social Care Matt Hancock to stress that oral health inequalities will likely widen as a result of the COVID-19 pandemic.


We've made clear our concerns over the potential loss or disruption to priority work areas in dental public health, including the generation of tools and guidance for local authorities, commissioners and practitioners, epidemiology, and providing leadership and co-ordination covering key groups from young children to vulnerable older people and policy areas including sugar reduction.


Chair of the BDA Board, Mick Armstrong, has said: “Effective management of the pandemic response is a clear national priority. But meaningfully protecting the public long-term hinges on an effective approach to public health, in which oral health is not an optional extra.”





England: Weekly COVID-19 figures by local authority  


On Friday Public Health England published its weekly surveillance summary of COVID-19 in England. Looking at data from 3 – 9 August, it shows that 5,401 cases were reported and increases in activity were seen in the North West, Yorkshire and Humber and the East Midlands in particular.


At a local authority level, incidence was highest in Oldham, followed by Blackburn with Darwen which continues to decrease.


We believe that NHS England will soon produce new Standard Operating Procedures (SOPs) to clarify how dentistry should operate during local lockdowns and to cover proper procedures for managing patients who are shielding. We will update you as soon as we have more information.




Second self-employed support grant capped at £50,000


A second Self-Employment Income Support Scheme has now been made available. To be eligible for it, more than half of your income needs to come from self-employment. You must also have had a trading profit less than £50,000 in 2018-19, or an average trading profit of less than £50,000 from 2016-17, 2017-18 and 2018-19.


Many self-employed dentists do not fall into this category. If you do, you may be eligible to a grant covering 70% of the applicant's average monthly trading profits. You will need to confirm your business has been affected by the virus on or after 14 July, but you do not need to have taken the first grant to be eligible for the second.





Updated travel advice for dentists and their teams


Further amendments were made to list of countries exempted from quarantine this weekend. Dentists and their teams should take note that travellers returning from the following countries are now no longer exempt from self-isolation requirements: Aruba, France, Malta, Monaco and the Netherlands. The Turks and Caicos Islands were also removed from the exempt list, making them the first British overseas territory to require quarantine on arrival in the UK.