Updates from week commencing 20 April 2020

Friday 24 April 2020

20:45

Friday wrap up: What happened this week

Here's my weekly round up of the major news in dentistry in response to the COVID-19 pandemic and how we're campaigning on your behalf. We hope you find it useful.

Useful links mentioned in the video:

• Eddie Crouch on BBC Today Listen in from 45mins 10 sec
• Senior community dentist Charlotte Waite on PPE in urgent dental centres
• Associate Olivia O'Neill-Dunne on the risk of ignoring private dentists
• Send in your questions for our webinar
• Our pay dispute resolution service
  

NIPDC presses for financial resolutions for practitioners 

The Northern Ireland dental practice committee (NIDPC) met today to address pressing financial issues for dentists in relation to the current COVID-19 crisis. 

Such issues included shortfalls in the Financial Support Service (FSS) payments for practitioners who have been on maternity leave during the reference period. The anxiety for those affected has been exacerbated by the lack of communication from the Department of Health (DOH).  

 
Consequently we will be engaging with HSCB/DoH and the Business Services Organisation (BSO) early next week to press for an urgent response to these issues and we expect to see some movement - particularly on the maternity issue. Thanks to you, our members, concerns have been raised with the NI Assembly Health Committee and they are now advocating to the Minister on your behalf. Along with the UK-wide BDA lobbying efforts we are seeking an equitable financial solution for private practitioners was .  

Finally, we will be impressing upon the Minister to instruct officials to urgently issue backpay owing to practitioners from the DDRB 2019/20 pay uplift, which would provide much needed breathing space at this time.  

18:35

Addressing the current situation for associates

This morning our GDPC associates group met and addressed concerns regarding the financial circumstances associates are facing as a result of the COVID-19 pandemic.

The issue of associates’ NHS pay and how it is being determined was raised, as was the uncertainty around the NHS contractual situation for the rest of the financial year. Solely or mostly private associates find themselves in a very challenging position. We are encouraged by the recent support from MPs and hope that the Chancellor will be pressed to act to safeguard incomes and the future of many practices.

Urgent dental centres was also addressed as was the clear issues regarding appropriate PPE supply - particularly the high failure rates for FFP3 masks, where they are available.

There was lengthy discussion of the future for dentistry and associateships. While much is still unclear, it is likely that there will be significant changes to dentists' professional lives, both in terms of clinical practice and finances. This crisis and the slow return to a new normal have only underscored the inappropriateness of UDAs and the need for an NHS contract that prioritises patient and dentist safety and care, not activity.

There is likely to be a debate within the profession about the relative benefits of employment and self-employment and we intend to lead that conversation.

15:55

New toolkit  for primary care dental services in Wales

An updated and user-friendly guidance on primary care dental services in Wales had been published. The guidance now concludes with reference to a potential lifting of the country's lockdown.
 
On page 21 it states: "Planning for de-escalation (RED alert phase to heightened AMBER phase) of the pandemic plan for dentistry is already under consideration and will be available in preparation for lock-down relaxation. In addition, regard is also being given to challenges facing dental services going forward".

15:40

Risk assessment guidance updated

We have updated our COVID-19 risk assessment guidance for members with additional recommendations on record keeping for NHS practices and triaging before referral or treatment.

It is likely this guidance will change often so please keep an eye for new versions.

13:35

COVID-19 testing for essential workers

The government has confirmed that it is rolling out testing to all essential workers in England who have virus symptoms.

Tests can be booked via an online portal. The government website confirms that “all NHS and social care staff” are included within the definition of essential worker and can access the system.

Dentists and their teams are included, as confirmed to us today during our meeting with Health Minister, Jo Churchill. We have asked that those groups are explicitly included on the list to avoid any chance of uncertainty.

12:20

International Workers’ Memorial Day

Tuesday 28 April is International Workers’ Memorial Day. This year, the need to commemorate the untimely passing of working people, particularly in the NHS family but also in wider society, feels more pertinent than ever. No one is immune from the ongoing challenges we are all facing, and many are paying the ultimate price.

As part of this, a minute’s silence is planned for 11am. Dentists may wish to join this act of commemoration.  #IWMD20 

Thursday 23 April 2020

17:26

Private practices: How to get an NHS email account

It's now more important than ever for private practices to have access to an NHS email account. Without one, it will make it much harder for you to be able to make referrals to UDCs and issue prescriptions.

To access an NHS.net account, private practices need to register and answer 14 questions on data management and security. We have produced a guide for members in private practice on how best to answer these questions.

According to NHS Digital wait time to apply for and get an account is approx. 10 days at present.

15:15

BDA Benevolent Fund supporting dentists in crisis

Ros Keeton, Chair of the BDA Benevolent Fund, has written to members reflecting on the impact of the pandemic. "For some dentists, practical issues around personal finance have been the greatest worry," she says. "In three weeks we received the same number of applications as we normally see in six months. We've been working non‐stop to help dental students, dentists and their families as quickly as possible."

Find out more about the work of the Benevolent Fund during COVID-19. Or sign up to attend their live webinar on 'How to spend less and start saving' at 18:00 this evening.

Campaign for PPE continues

We continue to lobby for appropriate PPE to be available to dentists and are getting the message out across national and local media.

Chair of the BDA's England Community Dental Services Committee, Charlotte Waite, was interviewed on the BBC News at Six last night, highlighting the levels of frustration dentists feel in not being able to treat patients at the new urgent dental centres (UDCs) due to the lack of PPE.

Charlotte said: "It's been difficult for the last few weeks, we are frustrated that we haven't been able to get [UDCs] up and off the ground, individuals across our networks have been trying hard... but without appropriate levels of PPE, we cannot treat patients." This follows up on the piece she wrote last weekend calling for a more "sensible and reasonable" approach to this problem.

Head of BDA Indemnity, Len D'Cruz, was also interviewed on LBC News London Live news yesterday. He too spoke about how our data shows dentistry is facing a critical shortage of PPE.

CDO's COVID-19 dental services webinar

Sara Hurley, Chief Dental Officer (England), and Matt Neligan, Director of Primary Care and System Transformation, are inviting all oral health professionals to a webinar which will take place tomorrow, Friday 24 April at 16.00.

You can connect to the webinar shortly before it starts.

Wales: DFT Trainer Grant reinstated to 100%

On 9 April, the Welsh Government informed HEIW about the reduction by 50% in the Educational Supervisor Trainer Grant and reduction in FD service costs to 80% from April to June 2020. This caused considerable concern and we wrote to the Welsh government to seek a satisfactory resolution.

In our response, we argued that the Dental Foundation Training process is front-loaded at the start of the training year. We also explained that although there is currently a reduction in the amount of clinical work being carried out, increased pastoral and educational support is being provided. Many educational supervisors are working increased hours to provide electronic tutorials and case-based discussions to mitigate the loss of study days and to ensure the foundation dentists complete their portfolios. We also asked for the rationale for the reduction in the DFT service fee.

Chief Dental Officer, Dr Bridgman has now replied to our concerns, outlining why the service fee could not be increased for the quarter. However, we are pleased to see Dr Bridgman has agreed to reinstate the Trainer Grant to 100%.

NHS England webinars

NHS England and NHS Improvement are hosting further webinars, starting today. The topic of these sessions will be digital primary care and establishing a 'total triage model'.

• Today (23 April) at 16:30 – 17:00: Using accuRx throughout COVID-19 for video consultations
• Friday 24 April 11:00 – noon HETT: The prolific digitalisation of primary care in response to COVID-19
• Tuesday 28 April 12:30 – 13:00: Helping your patients access online services remotely.

Private practice: Parliamentary recognition for need to expand financial support

Our campaign to extend financial support to dentists in private practice is influencing the debate at a national and regional level.

Ben Lake MP for Ceredigion Wales has tabled a parliamentary motion which highlights many of our concerns. We are pleased to see that there is strong recognition by many MPs of the vital role dentists play in their communities and the untenable position which many private practices now face. Our message on the imminent risk of high numbers of closures and the disastrous consequences for the dental industry and patients alike has been heard. Financial support for dentists in private practice is essential and we will continue to campaign on your behalf.

Wednesday 22 April 2020

17:35

Planning for dentistry after lockdown

As well as campaigning to improve the financial stability of dentists and dentistry in the short-term, we are also looking ahead. We are thinking about how dentistry might look like when we move out of current restrictions. We're exploring how we might seek to increase activity in a safe and effective way, and we are looking at what has been attempted elsewhere.

We have had early discussions with NHS England about what that looks like for dentistry. These are important discussions for all dentists, including those in private practice who have lost income due to the restrictions, and for the general public. We'll report further on this in the near future.

NHS dentistry: Further clarity being sought

We continue to press on getting support for private dentistry, but we also know that there are still plenty of questions to answer on the NHS support package for practices across the four nations. We continue to meet regularly with NHS representatives and expect answers to some of your key questions soon.

With NHS England, we have been discussing the level of deductions for variable costs associated with service delivery (e.g. consumables) to be applied to contract values. This is particularly important for payments to be made to associates, and we expect to have an update by the end of the week.

Associates: Resolutions underway in first pay dispute cases

We have begun the process of resolving the first round of pay dispute claims made by associates during the COVID-19 pandemic.

As Sarah Canavan, Chair of our Associates Group, has said: "the overwhelming majority of corporates and practice owners are acting in line with the deals we've struck with governments. But in those rare cases where this isn't happening, we are already working to resolve matters swiftly and constructively. We aim to help all parties reach a fair agreement in line with NHS rules."

This is the only route available to many associates who are seeking clarity on their pay at this difficult time. Our aim is for this dispute resolution service to resolve issues in a fair and satisfactory way for everyone involved.

New cases can be logged here.

Private dentists: Campaign for financial support continues

Our campaign for financial support for private dentists continues at a national and regional level.

Today, for example, we have written to the Scottish Cabinet Secretary for Finance on your behalf to highlight the precarious position of wholly and mainly private dental practices in Scotland. We've requested that such practices are included within all support measures for businesses in Scotland to help them remain viable during the current crisis.

We have copied the letter to the Minister for Public Health, Sport and Wellbeing, to all other MSPs and to all MPs in Scotland. We understand that a number of private dentists have already contacted their respective MSPs and Scottish Ministers to voice their concerns about financial sustainability.

We await a response and will update you as soon as we can.

Northern Ireland: Appraisals and mandatory training suspended for Community Dentists

The Department of Health has confirmed that appraisals for Community Dentists in NI will be suspended until September 2020, unless there are special circumstances. The DoH will review the suspension after this date.

Regarding mandatory training, CPD and Quality Improvement Activities Clinical Directors are encouraged to work within their organisations to make sensible changes in these areas, to release clinical capacity and allow focus on the COVID-19 response. There are minimum training requirements for staff returning to the HSC.

Submit your questions for our advice webinar

Members all over the country are submitting questions in advance of our advice webinar next Wednesday at 14:00 - 15:00. So far, a great number of the queries received are on paying associates in NHS and mixed practices. Roughly:

• 50% are about paying associates in NHS and mixed practices
• 25% are queries around the government's furlough scheme
• 25% are on the various financial relief packages available.

We call on those of you who haven't sent in your questions, particularly those in private practice with questions on the government's furlough scheme or the various financial packages available, to submit your questions today.

Please make your voice heard before noon tomorrow, so that our advice team can support you with the best possible answers to your questions. We will also make a recording of the webinar available for members to view afterwards.

Widespread coverage of your PPE concerns

We secured widespread media coverage for the problems dentists and UDC's are facing with a lack of Personal Protective Equipment (PPE) yesterday.

Our survey of more than 1,000 members on their views on the adequacy of personal protective equipment (PPE) in the urgent dental centers (UDC's) was featured by BBC News. BBC Radio 4's Today programme highlighted dentists' frustrations over their inability to treat patients because they are not getting the appropriate PPE.

Our survey findings were also cited hourly on BBC's national and regional news, throughout the day and in around 200 BBC outlets right across the UK.

Tuesday 21 April 2020

19:15

101 MPs urge Chancellor to throw dentists a lifeline

We applaud the call from 101 MPs – from 7 parties – who have joined forces to demand immediate action from the Chancellor to save the UK's dental services.

Fleur Anderson, Labour MP for Putney, Roehampton and Southfields has led efforts in parliament, delivering a stark warning to the government that unless urgent action is taken dental practices across the country will not recover from the COVID-19 crisis.

The BDIA launches AGP resilience challenge
 
The British Dental Industry Association has launched an initiative to outline how widespread dental activity could potentially resume. With potential easing of lockdown restrictions, the BDIA wants to map out how the industry might respond and adapt, particularly in relation to aerosol generating procedures. Consequenlty they have created the AGP Resilience Challenge (ARC).

The challenge aims to contribute to a better understanding of the issues surrounding the mitigation of the potential risks associated with aerosol generating procedures (AGP) and how the industry can facilitate the provision of safe and effective dental treatment going forwards.

Read more on the BDIA's AGP Resilience Challenge.

BDA on Radio 4 Today

Our Vice Chair, Eddie Crouch was on the BBC's Today programme this morning discussing PPE supply and the frustrations felt across the dental sector. 
  
Listen in from 45mins 10 sec.

Businesses wishing to support the response to COVID-19
 
We are receiving messages from dentists and businesses connected to the dental industry indicating that they are able to access useful supplies, including personal protective equipment. They're kindly asking how to offer these supplies to front line NHS workers. The best option in such circumstances is to follow the advice on GOV.UK: Offer Coronavirus support from your business.

12:20

BDJ Coronavirus content free-to-view

The British Dental Journal has collated all of its material relating to dentistry and the COVID-19 pandemic and made it free and accessible to all users.

More content, currently comprising editorial, opinion and letters, will be added with every issue.

Read the Coronavirus content from the British Dental Journal.

Monday 20 April 2020

18:40

Claiming for money under the job retention scheme

The government has now provided guidance on how to claim for money under the job retention scheme (known as furloughed workers scheme). We have put some additional information on our Financial impact page.

What we're doing to help private practices

One of our key areas of focus this week remains pushing the case for private dentistry. We've been working persistently in this area for the past month as we believe that private practices and associates providing private care have been left behind when it comes to government support.

Here's an overview of what we've been doing and will continue to do to help private practices receive an equitable solution from the Government.

• We pressed the Government to allow fair access to business rate relief and have repeatedly pushed the Chancellor to adjust the rules on support for the self-employed so that dentists earning over £50k can access help.
• We've joined up with other health sector organisations to make the case together.
• We've collated evidence for our campaigning work via two surveys measuring the impact of the pandemic on dental businesses and the £50k threshold on associates. Your responses has been hugely valuable in helping us articulate the ramifications for private practices in particular. We've secured widespread media coverage as a result.
  
• We have been making the case directly to Members of Parliament and many of you have helped us by writing to your own MPs. Thank you for that, it's really helpful for MPs to hear directly from their constituents. In Scotland, Wales and Northern Ireland, we have also been writing to MPs and devolved administrations to argue the case on your behalf.
• We know that several groups have been formed to articulate the frustrations of private dentistry and we are doing our best to ensure we can work together effectively. Our General Dental Practice Committee has set up its own group to look at the specific needs of private practice during the pandemic.  
   

Having been successful in securing support, in relation to NHS income, across the four nations, we will be continuing to do whatever we can to make the case for private dentistry and expect to see more parliamentary interest this week.

We will keep you updated on developments.