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Updates from week commencing 25 May 2020

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

Friday 29 May



Weekly roundup


Here’s our weekly roundup of the five major things that happened this week in relation to the COVID-19 pandemic and UK dentistry. We hope you find it useful.



As mentioned in the video:




Ongoing discussions with NHS England


Following the letter published yesterday confirming that practices in England could open for face-to-face care from 8 June, we have held further discussions today with NHS England and the Office of the Chief Dental Officer.


We know that dentists and patients have plenty of questions about the way ahead and further guidance will be issued from NHS England in the early part of next week. We’ll update you when we have more to share.





Answering your questions on re-opening


Our advice team continue to work hard to get you the most up-to-date information possible. There isn't yet a 'one size fits all' answer on re-opening. That’s why, we’ve pulled together your most frequently asked questions on it and added them to our FAQ page:


  • What’s the BDA’s position on re-opening?
  • Could I face CQC sanctions for providing non-essential care?
  • Do I need to worry about concerns being raised with the GDC?
  • What about mixed practices?
  • What if my staff do not want to return to work?
  • Will I get bad press coverage if I re-open?
  • What about practices in Wales, Scotland and Northern Ireland?
  • What PPE is essential for re-opening?





Practices: a poster and letter for your patients


To help you communicate with patients while you’re preparing to open, we've produced two items to help you:






Responding to your concerns on returning to work


We have been receiving a lot of enquiries about returning to work now that the CDO has confirmed that face-to-face patient care can resume.


We are currently preparing a toolkit which will answer many of your questions. We aim to have that toolkit ready for members early next week.


We are also receiving many questions on matters relating to NHS funding and other aspects of NHS dentistry in terms of returning to work. We are currently working to get answers from NHS England to many of these questions. We will keep you updated on all developments.





Frustration with government announcement on reopening dental practices


We understand that many dentists and their teams are frustrated with the way yesterday’s news was broken regarding dental practices re-opening from 8 June. We share that frustration.


An announcement to the public at the same time as to the profession has put practices at a disadvantage in terms of their preparations and decisions about how and when they can start to deliver care.


We have made it clear to NHS England that there is now a huge job to be done in managing patient expectation over the coming days. We are meeting with NHS England and other stakeholders this morning and will support the profession to help get those messages out from today.



Thursday 28 May 2020



Government confirms face-to-face patient care can resume


The Government has given the green light for the restoration of routine care services in England.


NHS England and the Chief Dental Officer have now confirmed that practices can provide face-to-face patient care from 8 June. This could see varying levels of treatments made available, with individual practitioners exercising their professional judgement on the pace of change.


We welcome the news, while also noting the caveat that availability and fitting of PPE, social distancing measures and appropriate cross-infection control may mean practices will have to move at different rates.


We have also warned that the whole business model that the service is based on could change unalterably upon reopening, with social distancing and cross-infection control reducing capacity and potentially access levels by as much as two thirds.


We are continuing to press for the NHS contractual framework to reflect the new reality and for additional support for private dentistry, including a business rates holiday – already offered to leisure and retail sectors – to be expanded to dental practices, alongside other support to mitigate against reduced patient numbers.


Our Chair Mick Armstrong said: "A return of high street dentistry will be welcome news to millions of patients left with few options during lockdown, but key questions remain. It is right to allow practices to decide themselves when they are ready to open. Dentists will be keen to start providing care as soon as safely possible, but we will need everyone to be patient as practices get up and running. 


"Dentist can open their doors but won't be able to provide a full range of care without the necessary kit. Longer term practices can only stay afloat with ongoing support, while social distancing continues and the costs of providing care are sky high."





Prompt to Prepare: Our concern over publication delay


We have expressed deep concerns over delays in publication of this morning's Prompt to Prepare letter by the Office of the CDO. Despite being dated 19 May, the letter was only published today. While offering some advice for practitioners looking to resume clinical work, the document has not addressed the issue of a timetable, or offers any hint of what the approach to restoring services would look like.


Our Chair Mick Armstrong has said: "The inability of government to communicate with dental practices in a timely manner is causing huge stress and anxiety. These delays will only increase the burden on dental teams and will prevent the efficient reopening of practices. This document is merely filling a vacuum left by government inaction. We have no more time for papers that leave us with more questions than answers. What we need is real clarity, and we need it now."





Members: Receive daily emails on latest COVID-19 research
For members interested in keeping up to date with the latest COVID-19 literature, our library is now providing a daily email service.


To request a daily email detailing recently published articles on dentistry and COVID-19 plus a selection of other COVID-19 content and reference links, please fill out this form.





BDA Benevolent Fund webinar on finances and COVID-19


The BDA Benevolent Fund invite you to sign up for their up-coming webinar on financial advice. This free one hour webinar will take place next Thursday, 4 June, at 16.00. It aims to highlight the support that is available to dentists and dental students and provide you with tools to help you manage your personal finances during this difficult time. It will cover:


  • State Benefits
  • Self-employed support
  • Mortgages
  • Credit cards and loans
  • Overdrafts
  • Savings
  • Pensions, investments and insurances
  • General money-saving tips.





Prompt to prepare for routine care in England


This morning the Chief Dental Officer, Sara Hurley, has published guidelines on how dentists in England should prepare for the resumption of routine care.


The document lays out the staff and patient considerations that are necessary for a return to work, including practice pace, staff training and the levels of personal protective equipment required by dental practitioners in primary care settings.


You are encouraged to review and make the appropriate adjustments to protocols, procedures and practice infrastructure for the safe and effective resumption of routine dental care. They have said that further guidance will follow, which will cover urgent dental care and alternative (non-AGP) evidence-based care planning.



Wednesday 27 May 2020



Answering your questions on re-opening


Our advice team continue to work hard to get you the most up-to-date information possible. There isn't yet a 'one size fits all' answer on re-opening. That’s why, we’ve pulled together your most frequently asked questions on it and added them to our FAQ page:


  • What’s the BDA’s position on re-opening?
  • Could I face CQC sanctions for providing non-essential care?
  • Do I need to worry about concerns being raised with the GDC?
  • What about mixed practices?
  • What if my staff do not want to return to work?
  • Will I get bad press coverage if I re-open?
  • What about practices in Wales, Scotland and Northern Ireland?
  • What PPE is essential for re-opening?





Seeking clarity on position of mixed practices in England


As we move towards the provision of more face-to-face dentistry, we are concerned about the lack of clarity regarding the position of mixed NHS/private practices.


NHS practices are expected to follow the advice produced by NHS England and the Office of the CDO as to how they approach treating patients under any phased return to practice. Private practices are free to determine how they provide care to patients, with the GDC and CQC clear that they have no powers to intervene unless there has been a clear breach of regulations.


The position is potentially less clear for the majority of practices which provide mixed care. At present, NHS practices are directed to triage patients remotely and refer into the urgent care system where appropriate. In a phased return to work, it is quite possible that there will be interim arrangements for patient referral for some NHS treatment, for example if it involves aerosol generation. Delivering that urgent care may take more time, and practices may have limited NHS capacity and therefore might not suit a patient in pain. As an alternative, a mixed practice may wish to offer to treat such a patient locally under private contracting arrangement, assuming they are able to provide safe care including having the appropriate personal protective equipment.


There is some uncertainty about how NHS commissioners might react in circumstances at this time where a mixed practice with an NHS contract chooses to take such an approach.


We have therefore asked NHS England to clarify what legal objection there could be to practices offering the option of private care in these circumstances rather than using the NHS care system. We will update you when more information becomes available.





Have your say: Returning to face-to-face care


Eddie Crouch, Vice Chair of our Board, has called on members to tell us how you feel about resuming face-to-face care.


Reflecting on the bind dentists find themselves in, he said: "There is a lot of misinformation out there, which we have been trying to counter, and we have been lobbying on your behalf to get clarity... I want to get back to work as soon as possible, and I know many of you feel exactly the same. It’s been frustrating not being able to help patients who are in pain.."


Read more of Eddie's blog: Coronavirus: when will dentists reopen to see patients face-to-face?





Northern Ireland: Financial Support Scheme Update


Yesterday, the Chair of the NI Dental Practice Committee, Richard Graham, and BDA NI Director, Tristen Kelso, met with senior Department of Health officials to discuss member concerns with the Financial Support Scheme (FSS).


We were pleased to see some clarity provided on staff salaries, the FSS interaction with wider Government support programs, and the extension of patient registration. The Department has also confirmed that superannuation will be applied to FSS payments. However, there has been little progress on issues relating to maternity and GDPs moving practice.


We will continue to regularly engage with the Department on FSS issues over the coming month.





Rollout of COVID-19 antibody testing for NHS staff


Each NHS region is now coordinating the rollout of antibody testing to NHS staff in their area. It should be noted that these tests only indicate whether or not you have had the virus. There is currently no evidence that the presence of antibodies indicates that a person cannot be re-infected, pass the virus on to others, or have protective immunity. Public Health England are conducting a study on whether the antibodies detected by this test indicate immunity.


We understand that the test is to be offered progressively to NHS staff who want it, including those working on NHS premises but not directly employed by the NHS, and those in primary and community care. We assume that this includes dentists and their teams, but have asked for clarification.





Scotland: New SDCEP guidance for return to practice


The Scottish Dental Clinical Effectiveness Programme (SDCEP) has published a practice recovery toolkit which all practices in Scotland should use as the basis for reopening during phase two of “remobilisation” set out in last week’s letter from the CDO. The guidance was developed following a short consultation last week.


The toolkit comprises:


  • a resuming dental services guide
  • patient COVID-19 screening questions
  • a patient management flowchart
  • a template notice for practice entrances (also in appendix 4 of the guide)
  • a practice reopening checklist.

The toolkit will be amended following feedback from the profession, as new information becomes available or as circumstances evolve in the weeks ahead.





Phased return for practices in England?


There is mounting speculation England will follow the lead of devolved nations in taking a phased approach to reopening dental practices.


The UK Government has yet to confirm a date for return to work, but today MPs have called for dentists to be part of the second phase of easing lockdown, alongside non-essential shops, which will open on June 15.


Putney MP Fleur Anderson, who lead over 100 MPs calling on the Chancellor to support practices last month said today “any return must happen sooner rather than later.”


“We urgently need dental practices back. I have constituents who face agonising health issues because of the closure of dental surgeries.


“However if the return of dental surgeries is to be phased, this will mean in the short to medium-term a significantly reduced service and footfall.


“It is therefore vital that dentists get the financial help they need.”


BDA Chair Mick Armstrong added: “A phased return is one thing, but we now need a timetable.


"Practices are already facing financial oblivion, and the 'new normal' could mean a limited range of treatments on offer to fewer patients.


"Ministers have a responsibility to ensure a service tens of millions depend on has a future."




Tuesday 26 May




Wales: Roadmap for dentistry


Last week Welsh CDO, Dr Colette Bridgman, met with WGDPC representatives to discuss in more detail the Welsh Government’s roadmap for dentistry. This describes the rationale for moving out of lockdown into a clearly laid out phased return to general dentistry.


We encourage you to read the Welsh Government’s final framework and SOPs:


Caroline Seddon, National Director BDA Wales, has said: "Colette’s vision is that clinicians will provide a leadership network that will be mutually supportive and collaborative. The plan involves a complete departure from the target-driven treadmill of the 2006 contract. Her hope is that all the learning from successful contract reform measures in the last three years will be fully implemented across all the practices in Wales by way of an individual needs and risk assessed prevention pathway for every patient. We are off to a solid start with nearly 50% of practices involved in contract reform already."


There has been much discussion about how this vision will apply to private practices and how they can be integrated within this new framework. Guided by Health Inspectorate Wales for how this will work on the ground, there is clearly a place for private practices in Dr Bridgman’s plan.


We are continuing to support our members through this very challenging period of transition and we will update you as soon as information becomes available.





#Dentistry24 highlights the issues we face


The annual independent social media campaign, #Dentistry24, took place over the weekend. This campaign usually highlights the positive impacts of dentistry around the world, this year it was a little different.


However, during this very difficult time for dentists, dental teams and dental students, we were pleased to see many taking the opportunity to praise the dedication of their colleagues and looking to learn from their peers in other countries.


Chair of our Board, Mick Armstrong, was among those calling for recognition of the good work being done and the challenges we now face.






Scotland: Financial support information updated

Practitioner Services Division (PSD) has updated its FAQs on Covid-19 financial support payments, with a new section for Vocational Trainers and Vocational Dental Practitioners. These updates also provide new information regarding maternity payments and registering new patients.


We know that the PDS is working hard to resolve a great many individual queries and we look forward to meeting with them again on Wednesday to discuss the latest issues from members.





Have your say: Resuming dental care


Your voice matters. That's why, we're continuing to seek the views of our members on the challenges and issues around resuming routine dental care. The results of this survey will inform the case we make to government on what we need to ensure our patients can see their dentist again.


The survey should take no more than 10-15 minutes to complete and your answers will remain anonymous. As our Vice-Chair, Eddie Crouch, has said: "Dentists need clarity on the plan going forward. Governments also need to hold an honest conversation with patients about what they can expect from dentistry in the future."