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Coronavirus: your FAQs

We answer your frequently asked questions on COVID-19 and your dental practice.

Page last updated: 16:44 27 March 2020

Dental practices are getting in touch with us to ask what to do if their staff or patients have or are suspected of having COVID-19, commonly referred to as the coronavirus. Read our live updates page for the latest information. Here are the answers to your FAQs, which we update as often as possible.


 

Coronavirus and the dental profession

1. What is the BDA doing to reduce my concerns? 

This is an unprecedented situation. We are lobbying the Government to ensure that your needs are represented at this difficult time. We are working to get you answers as fast as possible and keep you up-to-date with this ever-changing situation.


Please be assured that we are doing everything in our power on the issues that matter to you. Our priority is the safety of you, your team and your patients and the financial sustainability of your practice. 


2. What are you doing for private practices? 

Private practices are particularly badly affected by the pandemic. We're campaigning on behalf of private practices all over the country to try to ensure financial sustainability for your practice. You can find out more about our efforts here.


 


Coronavirus and the dental team

3. What is the guidance on COVID-19?

Despite the UK-wide shutdown, all practices should seek to maintain a basic service, that is providing telephone advice, triaging and writing prescriptions for analgesia and medication where appropriate. NHS 111 is overloaded and we have a duty to reduce pressure on the system wherever possible.

 

England 

All dentists in England should review the advice recently published by NHS England. This includes:

 

  1. All routine, non-urgent dental care including orthodontics should be stopped and deferred until advised otherwise
  2. All practices should establish (independently or by collaboration with others) a remote, urgent care service, providing telephone triage for their patients with urgent needs during usual working hours, and whenever possible treating with advice, analgesia and antimicrobial means, where appropriate.

It also contains important information about NHS financial support for practices. We are now pulling together comments on a number of key issues that require further clarity. If you have any questions about the NHS England letter, please use our form.

 

Primary Care Support England (PCSE) are also working with NHS England to support dentists. PCSE are prioritising the fulfilment and delivery of supplies and ensuring that performers are on the list and able to provide services to the NHS. Should this situation change, PCSE will update you on its website.

 

Wales

The Welsh government has moved to a red alert. This means:

 

  • Further restrictions on GDS routine care with the new measures for patient telephone-triage and remote prescribing
  • Practices may remain open for very limited and carefully risk-assessed patient consultation, but all dental care that can be delayed must be put on hold
  • Patients needing urgent care involving AGPs must be referred to properly equipped local Urgent Dental Care Centers. Health Boards are working with practices to co-ordinate referrals.

We are pressing for answers to the concerns of dentists in Wales. Business continuity funding remains a high priority and we have raised concerns about ensuring associates and DCPs are not disadvantaged by dint of being self-employed. We will keep you updated.

 

The CDO has written with further details about business continuity. This lays out provision for payments of ACV for April May and June with certain expectations attached. We've argued that practices would struggle to pay 100% of staff wages with the ACV payment at 80%.

 

The CDO also recognises that mixed contract practices will need further financial support for their private practice element. We're pushing for clarification on this and will update you as soon as possible.

 

Dentists in Wales may also review the guidance previously sent out to Welsh GDPs and CDS dentists. This provides a level of clarification on clinical and financial issues. A bi-lingual public information poster has also been provided for Welsh practices.

 

Northern Ireland

We are pushing daily for answers to questions of financial sustainability and the pandemic in Northern Ireland.

 

All GDPs in Northern Ireland have just received a letter from Michael Donaldson at the Health and Social Care Board outlining the next steps dental practices must take in the latest COVID-19 response. The HSCB guidance includes telephone triage, withdrawing from aerosol generating procedures and importantly, refers to future steps that will be taken, including setting up five central emergency centres to be operated by GDPs and nurses.

 

Dentists in Northern Ireland should also review the latest guidance and business continuity plans published on 18 March. We are pushing for clarity on a number of issues relating to this and will update you here.

 

More information is being made available by the Business Services Organisation.

 
Scotland

letter from CDO, Tom Ferris, has outlined Scotland's next phase of COVID-19 preparedness which is now in effect. This includes: 

 

  • All routine dentistry to cease
  • Pregnant or immunosuppressed team members not to provide or assist in the direct care of patients
  • Aerosol Generating Procedures (AGPs) to cease
  • Practices to triage, advise and reassure patients via new 'buddy arrangements' whereby patients can contact a dental professional (by phone) during normal work hours
  • FFP3 will be available at designated urgent care centres where patients are being assessed and treated.

The letter also seeks to reassure us that the CDO is working to source additional NHS funding to address concerns on practice sustainability.

 

The Scottish Government previously issued guidance along with an accompanying memorandum that outline the financial support being put in place to mitigate the disruption of service caused by the COVID-19 outbreak in Scotland. We are working to clarify a number of key issues raised by the guidance and will keep you updated.


Dentists in Scotland should review the guidance on COVID-19 provided by Health Protection Scotland. Guidance is also available for COVID-19 in social or community care and residential settings in Scotland. We will update you once new guidance is issued. 


4. Where can I get further details about the furloughed workers scheme?

We are getting many calls from members about the furloughed workers announced by the government. Mixed practices in England are particularly concerned, because the terms of NHS help seem dependent on practices not taking other forms of state aid to avoid duplicating financial help. Others have questions relating to whether furloughed workers can be rotated. We are pushing for answers from government to all of your questions. We will provide further advice as soon as we have further information.


5. Who should self-isolate and what should they do?

The government has said that everyone should stay at home unless necessary, for example for travelling to and from work. The government's guidance for staying at home is here. The dentists and their teams will be providing emergency care should follow guidance on whether it's safe for them to do so.


We believe members of the dental team over 70 years of age should stay at home. We also believe that members of the dental team under the age of 70, with an underlying health condition (such as asthma, diabetes, heart disease) should also stay away from work.


Advice has been published for pregnant women who are working in the NHS and other work settings. Women who are less than 28 weeks pregnant should practise social distancing but can continue working in a patient-facing role, provided the necessary precautions are taken. Women who are more than 28 weeks pregnant, or have underlying health conditions, should avoid direct patient contact. It has also recommended that pregnant women, regardless of gestation, should be offered the choice of whether to work in patient-facing roles during the pandemic.


Staff should also stay at home if they, or a member of their family, have coronavirus symptoms (the latter group should self-isolate for 14 days following the family member's diagnosis). Others will also have been advised to self-isolate. Staff staying at home for these reasons should be treated as if they are on sick leave.


The UK government has said that statutory sick pay (SSP) should be payable from the first day of the sickness period. Employers with fewer than 250 employees will be eligible to reclaim two weeks' SSP for each employee who has been affected by COVID-19. This has not yet been formalised in emergency legislation, but it may include a clause allowing it to be backdated. Ensure you keep records of any absence due to COVID-19 to be able to claim this back from the government.


6. What if one of my staff or associate dentists is pregnant?

New advice has been published for pregnant women who are working in the NHS and other work settings. Women who are less than 28 weeks pregnant should practise social distancing but can continue working in a patient-facing role, provided the necessary precautions are taken. Women who are more than 28 weeks pregnant, or have underlying health conditions, should avoid direct patient contact. It has also recommended that pregnant women, regardless of gestation, should be offered the choice of whether to work in patient-facing roles during the pandemic.

 

7 What if a staff member has coronavirus?

If a member of staff has coronavirus, they should follow government advice and standard sickness procedures should be followed.


Staff should contact the practice and update them on when they will be able to return. They will either be entitled to sick pay or, depending on the terms of their contract of employment, statutory sick pay.


Check your contracts of employment and the practice's policy on sick pay. They will need to self-isolate for seven days after which symptoms should have abated, if they are not getting better they should seek medical advice and keep the practice updated.


At present, we do not know whether staff with coronavirus can also be furloughed workers receiving 80% of their pay. We cannot yet confirm whether staff sickness absence may impact on financial help from the NHS. We think it would be unfair if it did and are pushing for answers.

 

8. What if a staff member needs to care for a dependent?

Generally, if a dependent has been asked to self-isolate, the staff member will have also been given the same instruction and will follow the sick advice above.


If, however the reasoning for dependent care is due to school closures and being unable to find alternative care options, then it can be treated as time off for dependents. This might be paid or unpaid, or could be agreed as holiday, depending on the choice in our model employment contract.


At present, we do not know whether staff at home caring for a dependent can also be furloughed workers receiving 80% of their pay. We cannot yet confirm whether such staff absence may impact on financial help from the NHS. We think it would be unfair if it did and are pushing for answers.


9. Will NHS dentists be redeployed?

Efforts to deal with COVID-19 will likely include wider NHS staff than doctors and nurses. This could involve the redeployment of NHS dental staff. Dental staff have an array of transferable skills such as expertise in cross-infection control and could offer immeasurable help in hospitals or new urgent care centres. We're ready to advise NHS England on the roles that NHS dental staff could reasonably undertake. We will update you when we know more.



 

Coronavirus and practice management

10. What if the practice can’t meet its UDA obligations because of the disruption?

Practices in England and Wales are understandably concerned about meeting UDA obligations. NHS England has written to practices on 25 March 2020.


The letter says 2019-2020 reconciliation will be based on figures from April 2019 to February 2020. Figures for March 2019 will be used instead of March 2020. For practices that have underperformed, there will be clawback then in the normal way.


For 2020-2021, NHS England will revise contracts so that:


  • NHS contract payments to practices are maintained
  • Contract delivery is assumed to be maintained
  • All practice staff are required to be available in other NHS areas
  • Practices must pay staff at same level
  • Practices benefiting from continued NHS funding will not be eligible to seek any wider government assistance to small businesses which could be duplicative. We do not yet how that will work for private and mixed practices.

We ask members to be patient and to wait for further details of the government's and NHS England's schemes. We will provide further advice and assistance as soon as we have further information.


Wales

The Welsh Government has provided guidance on practice continuity for all dental practices and details are currently under discussion for the ACV from April onwards.


We have been assured that the last two weeks in March are covered by a 4% waiver of practice UDA target. This means if you have completed the requisite UDAs up to mid-March you will not be subject to clawback.


The intention of the Welsh Government instruction is that the change/flexibility offered is for up to 4% being available if needed. So up to 4% (of UDA activity) can be credited where this flexibility is needed toward meeting the 100% target.


The same flexibility is applied whether the practice has performed at 85% or 95% of contracted activity - they get 4% added. If the 4% does not bring the practice to 95% then recovery of the underachieved amount is an option for the Health Board to consider.


The Welsh Government will continue to make contract payments to practices for April to June 2020. It is likely that, in return practices and practice staff will need to be available to carry out other duties for the NHS. We have asked for further details and the Welsh Government will be providing answers in its next communication. 


11. How do I communicate what's happening to my patients?

We advise you to contact patients by email, text message and through the practice's voicemail to explain the need for appointment cancellations. You should explain that you are following government guidance and acting in the name of public safety.


Your practice should seek to maintain a basic service throughout the shutdown, that is providing telephone advice, triaging and writing prescriptions for analgesia and medication where appropriate. This will help reduce the pressure on systems such as NHS 111 at this crucial time. You should advise your patients to get in touch with you in the first instance if they feel they need urgent dental care, rather than attending A&E.


Local authorities are setting up treatment centres where urgent dental care can take place safely during the pandemic. Once the emergency dental care system has been set up in your area, you should refer patients in need of immediate treatment there. 


12. Why isn't anyone eligible for business interruption claims on their insurance? 

Business interruption insurance covers a business for loss of income during periods when they cannot carry out business as usual due to an unexpected event. It aims to replace certain losses sustained by the business during the period of the disruption.


The Association of British Insurers has warned that only a small number of companies in the UK will have cover which allows them to claim on their insurance for the impact of the Coronavirus pandemic. 

We understand that insurance companies will not cover additional risks, which were not factored into the pricing of the policy. We acknowledge that these are unprecedented circumstances. However, we are very concerned that many of our members will not be covered for closures due to COVID-19.


We will continue to lobby government on behalf of dentists, who have been financially impacted by this crisis.


13. What should staff do once my practice has to close?

NHS staff may be redeployed to other areas in return for the NHS continuing to make payments to NHS practices. See your nation's most recent guidance (question 2) for the most up-to-date information on this.

If the NHS does make payments to practices, that payment will likely be on condition that practice retain staff. It is not yet known how this will work for mixed NHS and private practices.


Aside from the NHS scheme to support practices in return for services in other areas, practice owners have the following options:


  1. Agree with employees that they are furloughed workers, as part of government scheme to keep staff employed on 80% pay
  2. Lay off employees on guarantee pay
  3. Agree with workers that they work reduced hours for proportionately-reduced pay
  4. Consider making staff redundant.

For more information on these options see our Financial Impact page.


Associates should check their associate agreement carefully to see what terms may be applicable in case of practice closure and discuss with practice owners what measures both parties can take to mitigate any losses.


14. Should I cancel my indemnity policy to save money?

Many dentists are facing financial pressure and some have asked whether they should cancel their indemnity. We recommend that you think carefully before cancelling. If you retain your policy, you will not face a delay in returning to work when the situation changes. Keeping your policy active means that you will have cover for any GDC investigations, for example that relate to your personal or professional conduct. We recommend you speak to your indemnity provider before making a decision.

 

15. Dentists can't access business rate exemptions, what are you doing about this?

New measures were introduced in the 2020 Budget to give business rate exemptions to retail businesses. Dental practices were not included in this. We believe that in the context of the business disruption caused by the COVID-19 outbreak, it is essential that this exemption be widened to include dental practices. We've made representations to the Government to that effect and we will update you on any progress made.


16. What support can mixed practices receive?  

At present it is unclear how mixed practices will avail of the support structures put in place for NHS practices across the UK. In England, is not clear whether mixed practices can avail of both government support for private work and NHS support measures. In Northern Ireland, by contrast, the Department of Health has raised this as a possibility. In Wales, the CDO has acknowledged the need for financial assistance for the private portion of mixed practices' incomes. We are pushing for answers on your behalf and will update you once more information is available.


We are pushing for clarity on these and related questions. We will update you once we know more. 


17. Can I avail of multiple forms of government assistance? 

We are lobbying all four governments for a clear answer on this. At present, we know:


Northern Ireland, a full list of the business support measures that have been put in place in response to COVID-19, and the Department of Health have stated that they expect dental practices in NI will be eligible for support from both UK-wide and NI Executive sources.


England, it is unclear. It may be that mixed practices in England cannot avail of government and NHS support measures. We are seeking clarity on this crucial issue and will update you once we have it.


Wales, the CDO has acknowledged (link to latest CDP letter) the need for financial assistance for the private portion of mixed practices' incomes. We will update you once more information is available.



 

Coronavirus and your patients

18. What should I do to protect my patients?

We recommend you review latest guidance available for your area, see the answer to question 2 above.


We advise you try to deal with emergency patients over the phone if possible. If you need to see patients, you should avoid aerosol generating procedures. Until dental centres can be opened with the appropriate PPE, procedures and equipment to provide a full range of dental treatment in a safe environment, you may need to prescribe pain medication or antibiotics.