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Coronavirus: the financial impact

This is a challenging time for dentists. Here we have collated advice on the financial impact of the COVID-19 outbreak and the mitigation measures being introduced. Each section covers the UK as a whole, then offers nation-specific information where it has been issued.

Page last updated: 12:02  1 July 2020.

On this page you will find:

 

1. Useful links for GDPs

2. Business support measures promised by Government

3. Business interruption cover

4. NHS dental services provision

5. NHS provisions for sick pay

6. Associates in NHS practice

7. Associates in mixed practice

8. Salaried services (HDS, CDS etc)

9. Private practice

10. Associates in private practice

11. Annual Retention Fee

12. Private capitation schemes

13. Paying staff during practice closure

 

NHS advice on COVID-19

 

NHS advice on self-isolating 

 

UK Government response 

 

Stay at home guidance for households with possible coronavirus (COVID-19) infection 

 

Public Health England Guidance to health professionals 

 

BDA resources for returning to face-to-face care 

 

Guidance on infection prevention and control for COVID-19 

 

Guidance and support for employers and businesses 

 

2. Business support measures promised by Government

The following support measures are available from the Government:

 

  • Coronavirus job retention scheme covering 80% of furloughed workers' salaries. Depending on your practice’s situation, this could be cheaper than laying off staff. See our guide to this scheme in our section ​below on Paying staff during practice closure.
  • Government-backed loans of £330 billion have been made open to all businesses. We are worried that many dentists are having difficulty accessing these, and are instead being offered commercial loans at very high rates. Please contact advisory services if you are unable to access a reasonable commercial loan. That information will be useful to us in discussions with the Government to help members.
  • Business interruption loans, with the Government paying the first 12 months' interest.
  • Bounce Back Loan Scheme (BBLS) enables smaller businesses to get access to 100% taxpayer-backed loans after concerns have been raised about slow and difficult access to the coronavirus rescue schemes. The scheme offers businesses loans up to £50,000 within days of applying. No capital or interest repayments are due for one year. The Government will pay the interest for the first 12 months.
  • £10,000 extra cash grants have been made to some of the smallest businesses, some dental practices with rate exemptions have already received this.
  • Local Authority Discretionary Grants are available for small business who are not eligible for the Small Business Grant Fund or other government initiatives. We are looking into whether dentists are able to apply for these.
  • The Government will refund up to two weeks’ SSP per eligible employee.
  • Limited measures were also announced to support the self-employed, but a cap was placed on these, limiting the amount of dentists in private practice that can avail of it.

We’re pushing for confirmation that this will be applicable to dentists and dental practices. We advise you to review the relevant sections of this page, we update it when more information becomes available.

 

Help for self-employed dentists

We are very disappointed that self-employed people who earn more than £50,000 will not be eligible for help under the Government's scheme. We have written to the Rt Hon Rishi Sunak and spoken to HMRC. We will continue to campaign to help associate dentists, please see the relevant sections below.

 

Help for self-employed dental hygienists and therapists

Self-employed hygienists and therapists are likely to qualify for help under the Government’s self-employment income support scheme. It will be up to self-employed hygienists and therapists to claim the money themselves. Practices should be sensitive to their needs and help where possible. Practices will need them when they reopen for normal business.

 

Statutory sick pay

We are still waiting on this legislation. However, the Government has said that Statutory Sick Pay (SSP) is payable from the first day of sickness. You do not have to wait three days before starting to pay SSP.

 

The Government has already changed some of the SSP legislation so that SSP is payable to people isolating themselves in accordance with national health guidance. SSP is payable for those who are self-isolating in accordance with UK Government guidance.

 

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3. Business interruption cover

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 have 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. And 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.

 

That's why, we are taking urgent legal advice in respect to insurers not paying insurance claims made by dentists in regard to business interruption during the COVID-19 pandemic. We have instructed law firm Brown Rudnick LLP to examine insurance policies affecting dental practices. They are now working with our members to gather relevant evidence on the full range of polices in the sector. This legal advice will shape the guidance that we will be offering a profession that has been blindsided by a lack of effective insurance during a period that has seen routine care suspended and cash-flow for many practices fall to zero.

 

The Financial Conduct Authority (FCA) has now identified representative samples of business interruption insurance policy wordings to be examined in a legal test case.

 

We were the first trade union or professional body to directly engage with the FCA following the failure of most polices to pay out for losses incurred during the pandemic. While we welcome the news, we have expressed concern that the FCA's 'one size fits all' approach will fail to address the specific needs of our members.

 

Our Chair Mick Armstrong has said: "This move looks like positive news for many businesses facing crippling losses during lockdown. The issues we have identified with our legal team remain and continue to affect our members' ability to claim under policies. To that end, the FCA still has many questions to answer."

 

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4. NHS dental services provision

General Dental Practitioners

England
NHS England wrote to practices on 25 March 2020 and on the 15 April 2020 confirming that 2019-2020 reconciliation is to be based on figures from April 2019 to February 2020. Figures for March 2019 will be used instead of March 2020 as a default. Alternatively, practices may agree with their commissioner to use March 2020 or average UDA delivery over an appropriate three month period in 2019/20 agreed with their commissioner. For practices that have underperformed, there will be clawback in the normal way.

 

More recently, NHS England and the CDO for England, Sara Hurley confirmed that the temporary NHS contract arrangements, which include monthly payments to practices equivalent to 1/12th of the annual contract value, would continue.

 

In a letter on 28 May, it was confirmed that these payments will remain unchanged, subject to variable costs abatement. Contract holders should also assume that current conditions, for example paying associates, continue until you hear otherwise.

 

We are in on-going discussions with NHS England regarding how the contacts will be introduced for the rest of the 2020-21 financial year. In the meantime, practices should be reassured that their contract values will continue to be paid from 8 June and that these payments will not depend upon any specific level of care at that time or delivery of  UDAs.

 

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

  • NHS contract payments to practices are maintained
  • Contract delivery is maintained
  • All practice staff required to be available in other NHS areas
  • Practices must pay staff at same level.

Furloughed workers scheme and NHS contractual payments

 

There have been two different state schemes to help dental practices with an NHS contract:

 

1. The Government furloughed workers scheme. This allows employers to lay staff off, pay them 80% of their pay, and claim that 80% from the Government. The Government has said that it doesn’t expect furloughing to be used by organisations who receive public funding towards staff costs. This is discussed further below under the heading “Clarity for mixed practices”.

 

2. The NHS will, subject to certain conditions, continue to pay dental practices in England and Wales their NHS contract value.

 

Clarity for mixed practices on financial support

 

One of the conditions of the NHS payment is that practices benefiting from this continued NHS funding will not be eligible to seek any wider Government assistance to small businesses which could be duplicative. This caused a lot of concern for NHS practices, especially those whose NHS contract value is a relatively small proportion of their income.

 

On Thursday 2 April 2020, NHS England clarified that mixed practices can claim for furloughed workers for part of the time, in respect of private income and still receive their NHS income. NHS England has said that it will be asking of evidence of the portion of NHS/private income used in any applications for additional support.

 

The amount of money claimed under the furloughed workers scheme should be in proportion to the private income of the practice.

 

Staff cannot be furloughed and paid in full from NHS payments at the same time. They should be either furloughed on 80% pay (subject to agreement) or paid in full in accordance with the new NHS income conditions.

 

Self-employed people who earn less than £50,000 a year are able to claim money from the Government's Self-Employment Income Support Scheme (SEISS). Most associates earn more than £50,000 a year and will not be eligible. Associates who are eligible should have been contacted directly by HMRC by now. There is a question about associates who do a mix of NHS and private work. Those associates should still be receiving NHS income from their practice. If they claim their loss of trading profit from the SEISS, this could be deemed as duplicative relief and could fall foul of NHS rules. The BDA is seeking clarification on this point and will update members as soon as we have further information.

 

Furloughing staff

 

Please note that the scheme will close to new entrants from 30 June. From this point onwards, practices will only be able to furlough employees that they have furloughed for a full 3-week period prior to 30 June.

 

This means that the final date by which practices can furlough their staff for the first time will be 10 June, so that the current 3-week furlough period to be completed by 30 June. Employers will have until 31 July to make any claims in respect of the period to 30 June.

 

Staff have to be furloughed for at least three weeks at any one time. Staff cannot do work for the employer whilst they are furloughed. Otherwise, there are few set rules as to how choose what staff to furlough or for how long.

 

The question of who goes on furloughed leave and when should, if possible, be subject to agreement between the practice and staff. Practice managers and owners should meet with staff online to discuss options. We suggest that all staff are furloughed for part of this shutdown, and paid in full as NHS staff for part of the shutdown.

 

It makes sense if the proportion of time staff are furloughed is the same as the proportion of private income at the practice. So, if private income amounts to 33% of total income, then each member of staff can be furloughed for 33% of the time and paid in full under the NHS scheme for the remainder. If we assume this lockdown is for three months, then that would be one month as furloughed and two months as NHS. If private income is 50% of practice income, each staff member could be furloughed for six weeks and paid in full under the NHS scheme for the remainder.

 

Mixed practices can use this new tool to calculate the amount of money you are entitled to claim from the Government if you were to furlough some of your staff for a given period of time. To make it easier we've always made a demo video on using the furlough calculator.

 

We have drafted a letter for members with mixed practices to give to staff to explain the situation and seek their agreement to be furloughed workers .

 

We're answering many calls from members on staff and associates pay in England. Members can access our answers to these questions here .

 

Keep good records of what you claim. 

 

See the section below on how to claim for furloughing payments.

 

Self-employed staff (such as hygienists and therapists) should use the Government help for self-employed people.

 

Some staff will have good reason to be furloughed workers. But we ask everyone to remember that there is a global pandemic and this skills and knowledge that dental staff have may be very helpful. All staff should therefore consider carefully whether they are in a position to contribute in some way to the national effort. There are a variety of roles that dental practice staff can undertake. Members should encourage their staff to help. At present, the BDA is advising members to pay staff regardless of whether they volunteer for wider duties.

 

Wales

From 1 July 2020, NHS practices in Wales will receive 90% of their contract value. This will then move up to 100%, potentially from September. In return for this 90% of contract value, practices will work within the scope of the de-escalation plans, at present in the amber phase, and work through the back-log of patients as best as possible on a prioritisation of needs basis.


Practices can be in heightened amber and only offering non-AGPs, or be in low amber and be offering AGPs as well, as long as they are set up and signed off by the relevant authority.


Key to this offer of 90% is the move away from the UDA system, and its replacement with the UDAS, (units of dental assessment). This is a move from payment based on activity, toward payment based on patient need and number. And filling out the Assessment of Clinical Oral Risks and Needs (ACORN) risk assessment form is an important part of that.


We support the protection of the contract value and the move away from the activity treadmill and we welcome confirmation that there will be no patient number target up until March 2021. This new model may stay after March 2021, and we all can shape it. However, we appreciate that many questions remain and can only be answered with time. We are working to keep you as up to date as possible.


Is sticking with the UDA model an option?


Yes. You can stay with the UDA model if you wish. In making any choice, we encourage you to consider social distancing, provision of AGPs and patients throughput. UDA numbers will also be ghosted in the background, so practices will be able to see a comparison.


Please also note that there could be clawback if you stay with the UDA. Your UDA target would be 75% of the original. This target did not count for April, May and June. So when deciding whether to stay with the UDA model, you should factor in how much activity you can complete going forward, and whether it will allow you to meet your UDA target.


If you feel it is best for your practice to stick with the UDA system, letting your Health Board know would be a good place to start. 

 

Northern Ireland

During this period support payments totalling 80% of a GDP’s average monthly gross Item of Service income are being offered each month with no changes to allowances or registration fees. Crucially, GDPs are allowed to access wider Government support in direct proportion to their percentage Health Service/Private split. Duplication of support is not permitted.

 

The Department of Health have issued an updated FAQ on the Financial Support Scheme (FSS) for General Dental Services (GDS) in Northern Ireland. It provides an outline of how dentists in a range of situations can expect their payments to be calculated. We advise you to review this document, particularly if your circumstances changed during the 12-month period used to calculate the amount of support given.

 

We have 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.

 

We have also written to the Health Minister Robin Swann to seek clarity on issues relating to the phased return of the GDS. We're seeking clarity on whether financial supports will continue for so long as they are needed and whether there will be a reduction of the abatement on FSS payments as costs increase alongside an increase of face-to-face care.

 

We also continue to seek clarification from Department of the Economy regarding those wider business support measures available to businesses in Northern Ireland.

 

Scotland

We advise you to review this summary of the sources of financial support currently available to dentists in Scotland during the crisis. We are continuing to press the Scottish Government for additional funding mitigation measures for mixed dental practices.

 

The Scottish Government issued a revised funding package for NHS dentists on 30 March. This will provide 80% of the average income from items of service and patient contributions. This is what we asked for – a more equitable funding solution. This should hopefully provide much-needed reassurance to many dentists.

 

The Scottish Government subsequently issued a memorandum setting out more details about the funding package. In addition, Practitioner Services has published a Q+A to answer some of the queries it has received from dentists.

 

On 9 April, the Scottish Government clarified that mixed dental practices that receive NHS support funding, can also apply for support from other government sources to cover the private element of their income. These latter claims should be proportionate to the amount of private dentistry delivered.

 

We have written to the Cabinet Secretary for Finance to seek additional funding for private dentists to help them remain viable, and copied the letter to all other MSPs and all MPs in Scotland. This complements the BDA's UK-wide approach to seek additional support from the Chancellor.

 

For information on paying staff during closure and the options open to NHS practices in Scotland, please see section 12 below.

 

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5. NHS provisions for sick pay

There are provisions for long-term sick pay in all four nations. In all four schemes, there is no pay for four weeks, then NHS dentists are paid an amount based on their normal pay for the next 22 weeks.

 

The pay is due if a dentist cannot work due to sickness. At this stage, we have asked the relevant authorities to see how they are going to interpret this provision.

 

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6. Associates in NHS practice

COVID-19 is a global issue. We ask all our members to behave responsibly. Associates should work with practice owners to agree cover for emergency work and other dental work that can be carried out. There will, of course, be members of the dental team who are particularly susceptible to the dangers of COVID-19. In these unprecedented circumstances, we ask all associates and practice owners to work together constructively.

 

England

The NHS has said that it will continue to pay NHS contract payments to practices.

 

Neither England nor Wales will be paying 100% of the contract payments. In England, there will be an agreed and fair reduction for any variable costs associated with service delivery (e.g. in recognition of reduced consumable costs and lab bills). In Wales, the Government will pay 80% of the NHS contract value. 

 

There are a number of conditions that apply to the continued NHS contract payments. Those conditions include:

 

  • All staff, including associates, continue to be paid at previous levels
  • Practices don't seek other assistance which would be duplicative
  • All available staff may be required to be redeployed.

What should practices pay associates?

 

The starting point is that practices should continue to pay associates the NHS contract payments they would have received had COVID-19 not happened.

 

There are few hard and fast rules. We ask practice owners and associates to follow the following principles in working out pay for associates:

 

  • Payments to associates for March 2020: To calculate end of year figures for the contract year 2019-2020, NHS England is going to use activity figures from March 2019 instead of figures from March 2020. It therefore makes sense for practices, where possible, to pay performers for March 2020 based on their March 2019 activity. That won’t always be possible or pragmatic. Where March 2019 figures are unavailable or unrepresentative, practices should pay associates based on their average UDA performance over the last few months. Where practices believe that the March 2019 figures would be inappropriate or unfair, they should discuss this with their commissioners, who have been asked to take a reasonable and common-sense approach.
  • Those who have been performing NHS dental services should continue to receive the same income had this crisis not happened. A way to consider this may be simply to look at the amount on the pay statements, look at what you paid on average after deductions for lab fees and licence fee, and use that figure.
  • Agreements to start or end associateships are, generally, likely enforceable and should be kept. In most cases, if a practice has agreed that an associate can start an associateship, the associates should start and should receive the NHS contract payments.
  • NHS Maternity pay, Parental leave pay, Adoption leave pay and Sick Pay should be payable in the normal way. Dentists returning from maternity leave whose 2019-20 figures may not be representative of their normal monthly activity should be treated fairly and a pragmatic solution should be agreed. Dentists who are in the high risk groups and may not be able to work assisting the practice with telephone triage or able to be deployed should be treated fairly.
  • Some associates will not volunteer for wider NHS duties or be available to help at the practice. Some of those will have good reason to self-isolate. For others, it will be a question of personal choice. At the time of writing, more dentists have volunteered for redeployment than have been called to help. Therefore, at present, it seems very unlikely that there will be clawback either in relation to redeployment or, for that matter, in relation to UDAs. However, if practices are struggling to get associates to help at the practice, one option for practices is therefore to withhold some money due to associates under the terms of the NHS help until it is clear whether there will be any such clawback.
    Practice owners making any such withholding should:
    • Be clear about what their overall obligation is as a practice to support the NHS (for example if the practice derives only 50% of its income from the NHS, it is not obliged to make all staff available)
    • Discuss with the associate why they are considering withholding money,
    • Listen carefully to the associate’s personal circumstances and arguments against withholding, and
    • Give the associates a written statement showing what money is being withheld, why it’s being withheld, and stating that the money will be paid to the associate promptly once if it become clear the NHS will not be clawing back any contract payments to the practice because the associates did not redeploy.
  • There is nothing to stop parties agreeing something different.
  • Parties should act fairly, professionally, with patience and understanding. It is a difficult time for everyone.

Re-opening and NHS associates 

 

Associates should continue to be paid in line with the letter of 25th March, unless ALL of the following occur:


  • The practice is reopening for work and has put in place a safe system of work and
  • The associate has refused to work at the practice that is reopening (either for some hours or all hours) and
  • The associate has not made reasonable efforts to engage a locum to cover the absence.

Practice should continue to pay self-employed associates their NHS-related payments, if they self-isolate because they have symptoms, test positive for COVID-19 or are contacted by the test-and-trace service.


NHS England have also confirmed that sick pay should be paid to performers who are extremely vulnerable, those who are pregnant and in the third trimester; and those in particular list of vulnerable people (e.g. Type 2 diabetes); and who are not receiving NHS contract payments because they cannot work. We are currently waiting to see if these changes are going to be backed up by changes to the SFE.


If an associate is still working on redeployment, the practice should still receive income in relation to that associate's NHS notional activity and associates should continue to receive their NHS income if they are not receiving pay for that redeployment. Their redeployment must also be on the approved list for this to apply, e.g. contract tracing.


What if associates believe they are not being paid the money they should be?

 

We have launched a pay dispute service to help associates and practice owners reach a fair agreement on NHS pay that is based on the NHS conditions for continued contract payments.


At present, we are waiting on further guidance from NHS England that may help us understand the best way help associate members.

 

Where we are not able to help the parties reach agreement, and if the local area teams or health board is informed that the practice was in breach of the conditions of the continued contract payment, action may be taken. We will do our best to help parties resolve any disputes in a fair and constrictive way.

 

Northern Ireland

During this period support payments totalling 80% of a GDP’s average monthly gross Item of Service income are being offered each month with no changes to allowances or registration fees. Crucially, GDPs are allowed to access wider Government support in direct proportion to their percentage Health Service/Private split. Duplication of support is not permitted.

 

The Department of Health have recently issued an updated FAQ on the Financial Support Scheme (FSS) for GDS in Northern Ireland. This provides an outline of how dentists in a range of situations can expect their payments to be calculated. We advise you to review this document, particularly if your circumstances changed during the 12 month period used to calculate the amount of support given.

 

Some of the issues we've flagged with FFS now been addressed. However, we continue to push for further improvements to the scheme on your behalf.

 

We continue to seek clarification regarding the availability of wider business support measures to businesses in Northern Ireland, including support for the self-employed and any impact wider business support has on DoH measures. We are seeking to ensure that DoH support is fair and balanced for both NHS and private practices. We are also seeking clarification from the DoH on issues such as locum cover, those with holding/temporary DS numbers and those previously on maternity or sick leave, amongst other issues.

 

Corporate bodies and practice owners with NHS contracts continue to be paid during this time, on the condition that they pass on income due to associates. If you encounter issues, we will take them up on your behalf. See more about logging an associate pay dispute with us.

 

Scotland
The Scottish Government has advised dentists that providing routine dentistry is now no longer sustainable. It has said that dentists will receive 90% of their average monthly item of service income (net of patient charges for fee paying patients) and they will protect NHS commitment status. In return, dentists and other staff are asked to assist the wider NHS.

 

We wrote asking for clarification and further clarification was provided on 19 March 2020. The 90% of average monthly item of service fees excludes patient fees; which often make up most of the item of service fees. The Scottish Government’s aim is for Scottish practices to receive about 75% of their NHS earnings.

Associates’ NHS income is usually paid to the practice. Our view is that practices should pay that money, minus license fee, to the associates in the normal way.

 

It is a condition of this NHS financial support in Scotland, that where a practice closes, dentists and other staff should assist the wider NHS, including the PDS, when asked by the NHS Board.

 

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7. Associates in mixed practice

England

We have received clarification from HMRC over the position of associates under the Government’s Self-Employed Income Support Scheme who are also continuing to receive NHS income.

 

The various NHS financial support mechanisms across the UK have sought to protect NHS earnings during the pandemic. One of the conditions attached to on-going payments to contract holders in England is that associate NHS earnings continue to be paid at previous levels. We set up a process for resolving disputes where earnings are not passed to associates on and we are discussing with NHS England a regulatory mechanism to ensure that this happens.

 

Self-Employed Income Support Scheme 

 

Separately, the Government established the Self-Employed Income Support Scheme (SEISS) to offer financial support during the pandemic. The scheme allows individuals to claim a taxable grant worth 80% of average monthly trading profits, paid out in a single instalment covering 3 months’ worth of profits, and capped at £7,500 in total.

 

One of the eligibility criteria under the scheme is that it is only open to those earning less than £50,000 from self-employed roles. We continue to lobby for the removal of this unfair and arbitrary limit. However, those self-employed associates earnings less than £50,000 are eligible to claim under the SEISS.

 

HMRC’s view 

 

Given that associates in England are potentially in receipt of NHS earnings as well as separately being eligible for the SEISS, we have been in contact with HMRC so that we can give clear advice to associates. HMRC have clarified to us their view on the SEISS as follows.

 

  • NHS England has put out clear guidance that dentists will be fully remunerated for the NHS work they would have otherwise undertaken during the outbreak, subject to some basic requirements.
  • As regards non-NHS activity, the Government has set out a range of UK-wide measures which will support private income for dentists. If they meet the criteria, private dentists who are self-employed could be eligible for the Self-employment Income Support Scheme (SEISS) and those who are employees and receive a salary through a PAYE scheme could be eligible for the Coronavirus Job Retention Scheme.
  • The SEISS eligibility criteria does include that the dental practitioner has been adversely affected by COVID-19. If part of the dental practitioner’s income stream reduces, but another part remains the same, it is still legitimate for them to claim the SEISS. Dental practitioners will receive the full grant based on 100% of their trading profits, even if only 50% of their profits have fallen. If the NHS continues funding the dentists for their work, it would still be legitimate to claim the SEISS if the rest of their trading profits were adversely affected. 

We have also discussed the matter with NHS England. Their expectation is that NHS contract holders should be paying associates in line with previous earnings, consistent with their existing advice.

 

In summary, if associates fulfil the criteria for the SEISS scheme, continue to receive NHS payments, but have seen any drop in their overall income (for example due to a reduction in private earnings), they can make a claim for a SEISS grant.

 

If associates are eligible and want to claim the first grant under the SEISS, the claim must be made on or before 13 July 2020. The scheme is being extended and associates may be able to make a claim for a second and final grant in August 2020.

 

Northern Ireland

HMRC has indicated (see above), that if associates fulfil the criteria for the SEISS scheme, continue to receive FSS payments, but have seen any drop in their overall income (for example due to a reduction in private earnings), they can make a claim for a SEISS grant.

 

One of the eligibility criteria for the SEISS scheme is that it is only open to those earning less than £50,000 from self-employed roles. We continue to lobby for the removal of this unfair and arbitrary limit. However, those self-employed associates earnings less than £50,000 are eligible to claim under the SEISS.

 

Associates should note that they are required to make a declaration each month when applying for Financial Support Scheme (FSS) funding if they are in receipt of other government supports. Duplication of support for HSC activity is not permitted under the FSS, and GDPs wishing to claim for support from wider business support schemes must do so in relation to private activity only.

 

Scotland

We are seeking clarification from the Scottish Government on the position of associates in mixed practice. To date, PSD have advised associates: "We consider that you should not claim any aspect of NHS income which you would normally receive, from HMRC. We would advise you speak to your accountant and other professional advisers to determine your course of action.  Practitioners should be aware that we are required to share data with HMRC in order to validate taxation and payments. We anticipate that HMRC will reconcile any payments they make."

 

However, HMRC has indicated (see above), that if associates fulfil the criteria for the SEISS scheme, continue to receive NHS payments, but have seen any drop in their overall income (for example due to a reduction in private earnings), they can make a claim for a SEISS grant.

 

One of the eligibility criteria for the SEISS scheme is that it is only open to those earning less than £50,000 from self-employed roles. We continue to lobby for the removal of this unfair and arbitrary limit. However, those self-employed associates earnings less than £50,000 are eligible to claim under the SEISS.

 

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8. Salaried services

If you are a salaried dentist, working in Hospital Dental Services, Community Dental Services or prison dentistry, for example, your employment status should not be affected by this crisis. You will continue to receive your salary.

 

However, it should be noted that they may be deployed elsewhere within the health service, as the outbreak progresses. For more info on this please see our latest advice on redeployment (see questions 21-25). This may prove quite stressful and members should be aware that they have access to our 24-hour counselling service.

 

If you are a salaried dentist and have an issue, please reach out: 

  • Members employed on national terms and conditions within the salaried/community dental service, in dental schools, in the armed forces or a variety of other employed roles within the NHS, please contact: employmentrelations@bda.org
  • Members working under hospital terms and conditions can contact the BMA for employment relations support: 0300 123 1233 (please quote your BDA membership number).

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9. Private practice

This is an exceedingly challenging time for business in the UK. The COVID-19 outbreak is impacting the incomes of private practices and many are currently in desperate financial circumstances. We are lobbying Government and representing your interests during this difficult time.

 

Business support made available from the Government

Chancellor Rishi Sunak has pledged additional support for business, on top of measures set out in the budget. These include:

  • Coronavirus job retention scheme covering 80% of workers' salaries. Depending on your practice’s situation, this could be cheaper than laying off staff. See our guide to this scheme in our section on ‘Paying staff during practice closure' below.
  • Government-backed loans of £330 billion have been made open to all businesses. We are worried that many dentists are having difficulty accessing these, and are instead being offered commercial loans at very high rates. Please contact advisory services if you are unable to access a reasonable commercial loan. That information will be useful to us in discussions with the Government to help members.
  • Business interruption loans, with the Government paying the first 12 months' interest.
  • £10,000 extra cash grants have been made to some of the smallest businesses, some dental practices with rate exemptions have already received this.
  • The Government will refund up to two weeks’ SSP per eligible employee
  • Limited measures were also announced to support the self-employed, but a cap was placed on these, limiting the amount of dentists in private practice that can avail of it.

This situation is untenable. We’re pushing for a fair and equitable solution for mixed and private practices. Our CEO, Martin Woodrow, recently outlined why it's so important for us to fight for private practices during the COVID-19 pandemic and how our campaign for support is having an impact.

 

Members with mixed practices, we've put together a tool to help you calculate how much you are entitled to claim as part of the furlough scheme. Watch this demo video to help you use our furlough calculator.

 

This is a stressful time and members should be aware that they have access to our 24-hour counselling service. Dentists who are worried they cannot meet their current personal household expenditure can also apply to the BDA Benevolent Fund for financial assistance.

 

Business rate exemption should be given to dentists

Dental practices were not included in the new measures introduced in Budget 2020 to give business rate exemptions to retail businesses. 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 government to that effect and we will update you on any progress made.

 

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10. Associates in private practice

Self-employed dentists face huge uncertainty in the face of COVID-19. The measures announced by the Chancellor on 26 March to support the self-employed during the COVID-19 outbreak will not support the majority of self-employed dentists.

 

This is an untenable situation. We're working hard on your behalf, lobbying government to provide sufficient financial support to the self-employed during this time of national crisis. We will update you when more information is available.

 

Chancellor Rishi Sunak also told the House of Commons:

  • Self-employed are all eligible for the business interruption scheme
  • VAT has been deferred
  • The Universal Credit enhanced rate is available to all self-employed, which includes housing support
  • Self-assessment tax payments have been deferred until January 21.

Both your safety and the financial viability of your practice are driving priorities for us. Our CEO, Martin Woodrow, recently outlined how our fight for private practices during the COVID-19 pandemic is having an impact, we encourage you to read it.

 

This is a stressful time and members should be aware that they have access to our 24-hour counselling service. Associates in significant financial hardship may also speak to the BDA Benevolent Fund about their situation and the possibility of financial aid.

 

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11. Annual Retention Fee

The COVID-19 epidemic has put many dentists and dental teams into a difficult financial situation. That's why, we are calling on the General Dental Council for the Annual Retention Fee (ARF) to be waived or at least reduced. However, the General Dental Council has now said that it will not make changes to the ARF levels or introduce an emergency payment scheme to allow registrants to pay by instalments, we have published an open letter to the Chair of the Council, Bill Moyes.

 

With the profession now facing grave financial uncertainty, we have criticised the failure by the regulator to show flexibility to colleagues, some of whom have seen their incomes fall to zero. It has also called for much-needed transparency in the process for setting the ARF. The GDC retains a budget operating surplus and significant reserves.

 

BDA Chair, Mick Armstrong, said: "Despite recognising the dire financial circumstances in which many practices and individual registrants find themselves, the GDC has not seen fit to provide even token support... Greater transparency into the reasoning behind this decision would have been the very least response registrants should have received."

 

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12. Private capitation schemes

Most patients will likely continue to pay into private capitation schemes. Some may stop. Practices will continue to get the capitation money. In many cases, practices will continue to pay associates their share of the capitation money. 


We believe that it is best if practices do continue to pay all (or most) of the capitation money to associates, but on condition that associates remain at the practice for a period of time, say six months after the shutdown ends. We say this because, if associates continue to receive the capitation payments, they are – in effect – being paid to do the routine work as associates with those payments. They should therefore remain as an associate at the practice long enough to carry that work.

 

 

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13. Paying practice staff during closure

Practice owners have the following options:

 

  1. Members with mixed practices, we've put together a tool to help you calculate how much you are entitled to claim as part of the furlough scheme. Watch this demo video to help you use our furlough calculator.
  2. Agree with employees that they are furloughed workers, as part of government scheme to keep staff employed on 80% pay
  3. Lay off employees on guarantee pay
  4. Agree with workers that they work reduced hours for proportionately-reduced pay
  5. Consider making staff redundant. 

Furloughed workers

The Government provided details of the furloughed workers scheme on Thursday 26 March 2020 to reduce lay offs due to the pandemic. This will pay up to 80% of the wage costs of workers who are not needed at this time, up to a maximum of £2,500.

 

The Chancellor has said that the furlough scheme introduced to pay the wages of workers on leave because of coronavirus will be extended to October. However, he has said the Government will ask companies to "start sharing" the cost of the scheme from August onwards, we are seeking clarification and will update you once more information is available.

Please note that the scheme will close to new entrants from 30 June. From this point onwards, practices will only be able to furlough employees that they have furloughed for a full 3-week period prior to 30 June.


This means that the final date by which practices can furlough their staff for the first time will be 10 June, so that the current 3-week furlough period to be completed by 30 June. Employers will have until 31 July to make any claims in respect of the period to 30 June.


Maternity/paternity leave and furlough scheme  
 
People on maternity and paternity leave who return to work in the coming months are eligible for the government’s furlough scheme. 
 
Although the scheme closes to new entrants on 30 June, meaning that June 10 was the last day on which staff can be furloughed for the first time, the Chancellor has made clear that parents on statutory maternity and paternity leave who return to work in the coming months will be eligible for furlough scheme even after this cut-off. 
 
How the furlough scheme works

You may, with their agreement, designate employees as furloughed workers. This includes employees who are currently self-isolating. You can then submit information to HMRC about the employees that have been furloughed and their earnings through a new online portal that HMRC will set out.

 

Employers will not have to top up the remaining 20% of the furloughed workers’ pay. A draft letter to give to employees in mixed practices is accessible for members . Note that template says you will pay 80% of their pay. You may choose to pay more if you wish. If you do, insert the appropriate percentage in the letter. If you have a purely private practice, see the furlough letter for private practices .

 

Some staff will have good reason to be furloughed workers. But we ask everyone to remember that there is a global pandemic and this skills and knowledge that dental staff have may be very helpful. All staff should therefore consider carefully whether they are in a position to contribute in some way to the national effort. There are a variety of roles that dental practice staff can undertake.

 

For the question of how furloughed workers will tie in with help from the NHS, please see Section 4. NHS Dental Services Provision.

 

The key points of the furloughed workers scheme are:

  • You can claim up to 80% of furloughed workers usual monthly wage costs
  • The maximum that can be claimed is
    o   £2,500 a month, plus
    o   Employer NI contributions and
    o   minimum automatic enrolment employer pension contributions
  • The scheme can be used at any time during period from 1 March 2020 to the end of June 2020. The scheme may be extended if necessary
  • We welcome confirmation from both the Treasury and NHS England that mixed practices can make full use of the furlough scheme in proportion to their private activity
  • You can claim for any employees who were on your PAYE payroll, and who had received a payment that had been notified to HMRC by 19 March 2020,whether full-time, part-time, or employees on a flexible contract
  • You can claim for employees you made redundant after 19 March 2020, as long as you rehire them
  • Whilst being furloughed, employees cannot do any work for you
  • Employees must have been notified that they have been furloughed
  • Wages of furloughed workers are subject to usual income tax and other deductions
  • Employees who work reduced hours during this time are not eligible for this scheme. They will have to be paid in the normal way
  • Normal equality laws apply to who you furlough and who you don’t
  • Employees placed on unpaid leave after 28 February 2020 can be furloughed
  • Employees on sick leave or self-isolating should get SSP, but can be furloughed after
  • Employees must be furloughed for at least three weeks. You can therefore rotate who is furloughed as long as those who are furloughed are furloughed for at least three weeks.

The question of who goes on furloughed leave and when should, if possible, be subject to agreement between the practice and staff. Practice managers and owners should meet with staff online to discuss options. 

 

Mixed practices: It makes sense if the proportion of time staff are furloughed is the same as the proportion of private income at the practice. So, if private income amounts to 33% of total income, then each member of staff can be furloughed for 33% of the time and paid in full under the NHS scheme for the remainder. If we assume this lockdown is for three months, then that would be one month as furloughed and two months as NHS. If private income is 50% of practice income, each staff member could be furloughed for six weeks and paid in full under the NHS scheme for the remainder. We have drafted a letter for members with mixed practices to give to staff to explain the situation and seek their agreement to be furloughed workers .

 

We're answering many calls from members on furlough and staff and associates pay in England, members can access our answers to these questions here .

 

Members with mixed practices, we've put together a tool  to help you calculate how much you are entitled to claim as part of the furlough scheme. Watch this demo video to help you use our furlough calculator.

 

Keep good records of what you claim.

 

How to claim for furloughing workers

Full government guidance on claiming for furlough payments was issued on 20 April 2020.

 

Claims can be made from 20 April onwards. They are made through the Government portal. You will need to sign in to this using the Government Gateway system for your business.


Please note that the scheme will close to new entrants from 30 June. From this point onwards, practices will only be able to furlough employees that they have furloughed for a full 3-week period prior to 30 June.


This means that the final date by which practices can furlough their staff for the first time will be 10 June, so that the current 3-week furlough period to be completed by 30 June. Employers will have until 31 July to make any claims in respect of the period to 30 June.


Payments may take up to six working days to reach the claimant. You can make the claim yourself, or you can delegate this to an agent who usually runs your PAYE affairs (for example, a payroll consultant or accountant).

 

Before making a claim, you should gather the following information:

 

1. In respect of your business:

  • The number of employees being furloughed
  • The dates employees have been furloughed to and from
  • Details of employees – the name and National Insurance Number of each furloughed employee
  • Your employer PAYE scheme reference number
  • Your Corporation Tax Unique Taxpayer Reference, Self-Assessment Unique Taxpayer Reference or Company Registration Number as appropriate for your entity
  • Your UK bank account details
  • Your organisation’s registered name
  • Your organisation’s address.

2. For each furloughed employee you will need to make a claim. Each claim is made up of up to three parts:

  • A claim for the furlough pay being given over the period of the claim
  • A claim for the cost of the employer national insurance payment made on the furlough pay
  • If the furloughed worker is a member of your workplace pension scheme, aclaim for the cost of the employer pension contribution. This must be paid on to the employee’s pension scheme.

To assist in calculating these amounts, HMRC has provided a Coronavirus Job Retention Scheme Calculator. The calculator will work out each of the above elements which form part of your claim for each furloughed employee.

 

To use the calculator you will need details of each employee’s normal pay level, their National Insurance category, and dates including when they went on furlough, when furloughing ceased (if applicable), pay period dates (i.e. when each pay period runs to, such as the first to last day of each month), and what date employees are actually paid on. 

 

In respect of the pay level, this will be straightforward for individuals who are on regular levels of pay. However, if an employee has variable levels of pay (for example, because bonuses are paid, or there is a regular change in working hours), then it is more difficult to calculate what level of furloughed pay applies. At the current time, the calculator does not support this particular calculation, but there is further guidance to support such manual calculations. Your payroll provider should be able to support you with this.

 

The calculator will set out the amount you can claim for each pay period. You should save the results of this before moving on to carry out another calculation.

 

Once you have this information you (or your agent) can input this into the Claims Portal. Once complete you should receive a claim reference number. It is important that you keep a record of this (such as a screen print).

 

You should tell your employees that a claim has been made using this system. Further claims can be made if furloughing continues beyond the claim period.

 

Staff of NHS practices in Scotland

We have sought clarification from the Scottish Government with regards to the NHS COVID-19 Financial Support Payment and paying non-furloughed employees, and have been advised that this funding does not place a condition on practice owners to maintain pre-COVID-19 levels of (non-furloughed) employees’ pay.

 

NHS financial support measures are intended to ensure the integrity of the NHS dental team and that once dentists are able to restart NHS dental services, practices will be in a position to do so. The Scottish Government has stated that it hopes “the rational response for a practice owner would be to ensure that happens through continuing to remunerate their employees but it is not a specific condition of the NHS funding. As independent contractors, this is a matter for the practice and employees of the practice”.

 

The NHS COVID-19 Financial Support Payment places the following conditions on dentists:

 

  • There must be no consequential loss of workforce, and
  • Contractors must immediately advise their local NHS Board if their associateship agreement or any other arrangement with a practice has been terminated or put into abeyance.

Practice owners have the following options:

 

  • Practice owners may continue to pay their non-furloughed employees as per the employee’s contract of employment/on the same basis pre-COVID-19, or
  • Practice owners can consult with their employees over reducing their pay. Employees will need to agree to this. National minimum wage rules will still apply. Agreements should be confirmed in writing, or
  • Practice owners may wish to consult with staff to reduce their employee’s contracted hours of work. This approach may have implications over employees being able to be redeployed to the wider NHS, which is a condition of receiving the Financial Support Payment. Consideration will need to be given to the future when a practice owner may wish to consult again with those employees about increasing their hours, or
  • Practice owners who have short time working and/or lay off clauses in their (signed) employee’s employment contracts may wish to consider either of these two options. However, as the NHS is paying dentists public money to help keep their practices running it would not seem reasonable to adopt such an approach as it would go against the spirit in which dentists are receiving the Financial Support Payment.

When seeking to make changes to 20 or more employee’s terms and conditions, including pay and contracted hours, there are further consultation requirements on employers and potentially financial penalties if these processes are not followed.

 

Employees do not need to agree to these changes. If they do not agree to the change a formal process will need to followed. In some cases, employers may have to give notice to an employee, to vary the employee’s employment contract, of up to 12 weeks.

 

Guarantee Pay

Employed staff will either be entitled to full pay or only to guarantee payments during any period where there is no work.

 

What are guarantee payments?

Guarantee payments are £29 per day (£30 per day from April, or less, if the employee would normally earn less than £29/30 in the day). Employees are entitled to a maximum of five days of guarantee payments in any three months. Practices do not have to pay anything to staff once they have had their five days of guarantee payments.

 

When are employees only entitled to guarantee payments?

Employed staff will be entitled to only guarantee payments if, either:


a) The practice has a contractual right to lay off staff without pay. There is a clause in the BDA model contract of employment entitling employers to lay off staff with only guarantee pay.


b) Or, in normal times, they are only paid for the work they do; so they do not get paid normally if there is no work.

 

In all other circumstances, where practices have no work for staff, they will have to pay staff in full if the practice closes or if they need fewer staff.

 

How long can practices keep staff on guarantee payments?

If staff are on guarantee payments for more than four consecutive weeks (or more than six weeks in any 13-week period), they can give the practice a notice to claim redundancy pay. The practice may, if it wishes, issue a counter notice to that. A tribunal would then decide whether there is a reasonable prospect of the employee returning, within four weeks of giving the original notice, to full employment for at least 13 weeks. The provisions are not very simple. Our advice team is happy to advise on individual situations.

 

Reduced hours

You may agree reduced hours working. You could suggest or ask your staff to suggest to you a temporary cut in hours and hence a proportional reduction in their pay. There is no obligation for them to agree, but if you are frank and explain the circumstances and the alternatives (lay-off or even possible closure of the business) then they might be agreeable. However, note that the same rules on staff being able to claim for redundancy (see above) apply if you reduce staff hours on short-time working to 50% or less of their normal hours.
 
Any agreement to reduced hours or short-time working should be put in writing – including the new hours, the rate of pay, the date the reduced hours start and the date for reviewing reduced hours or the date that they return to their normal hours – and signed by the employee.

 

Redundancy

The Government is keen to avoid redundancies if at all possible. That is why is has introduced pay for furloughed workers. However, practices may be able to make staff redundant. There is a procedure to follow. We provide advice on redundancy . Staff who are made redundant may be entitled to Statutory Redundancy Pay, which can be calculated here.

 

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