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Live updates: Coronavirus and dentistry

The BDA is doing everything in its 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. I am regularly adding to this page to keep you updated on what we are doing to help you through the challenges of COVID-19.

Martin Woodrow
Chief Executive

 


Friday 29 May 2020

20:30

 

Weekly wrap-up

 

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:

 

 


 

17:40

 

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.

 


 

17:10

 

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?

 


 

13:50

 

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:

 

 


 

12:18

 

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.

 


 

09:55

 

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

17:57

 

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."

 


 

14:15

 

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."

 


 

13:10

 

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.

 


 

12:15

 

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.

 


 

8:26

 

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

16:58

 

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?

 


 

16:35

 

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 practise. 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.

 


 

16:20

 

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?

 


 

14:10

 

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.

 


 

12:20

 

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.

 


 

11:12

 

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.

 


 

09:28

 

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

 

17:00

 

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.

 


 

16:56

 

#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.

 

 


 

11:00

 

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.

 


 

10:40

 

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."

 


 

18 - 24 May 2020

 

This week, restrictions began to be eased at varying rates across the UK. Unlimited outdoor exercise and some interaction between households has been allowed.

As a result of these developments, we know that many dental practices want to begin face-to-face care, and we saw progress in this area:

 

The Scottish Government outlined a four-phase route map through and out of the COVID-19 crisis.

 

Similarly, the Welsh Government have introduced a road-map describing the rationale for moving out of lockdown and away from the current red alert phase.

 

We continue to wait on clarity in England and Northern Ireland. However, in England the CQC confirmed its position that it cannot require providers of dental services to close unless it finds clear evidence of a breach of regulations.

 

We continue to advise members that a full risk assessment should be done by the practice and team, and treatment is provided only where it is safe to do so.


Read all the updates from week commencing 18 May 2020


11 - 17 May 2020

This week the DoH reported the lowest daily death-rate increase since the beginning of lockdown and the planning for a post-lockdown Britain was ramped up. While we reiterated the official message that nothing has changed for dental practices, we joined NHS England, the CDO and Health Minister for a new series of meetings addressing how we increase dental activity once restrictions ease.

 

We called on UK governments and employers to work with us to deliver our new nine-point blueprint for a safe return to work for NHS staff. We also took action on business interruption cover this week, by engaging the law firm Brown Rudnick LLP for legal advice on insurers not paying insurance claims made by dentists during the COVID-19 pandemic.

 

The Self-employment Income Support Scheme went live this week and we received word that NHS England are considering possible regulatory changes to ensure that contract holders pass on anticipated payments to associates.

 

Read all the updates from week commencing 11 May 2020


4 - 10 May 2020

This week the global focus shifted to how dentistry will look post-lockdown. We are working with administrations around the world to outline how dentistry can move forward in a safe and effective manner when the current restrictions are lifted. Our board and our health and science committee are detailing how we prepare for that.

 

We submitted evidence to the House of Commons Health and Social Care Committee who are holding a new inquiry into delivering core NHS care services during the pandemic and beyond. Our focus was on the provision of dental care in the post-lockdown period.

 

The government finally acknowledged the shortages in PPE faced by our members working in England’s urgent care system. We've been urging Health Minister Jo Churchill to address PPE supply and she has confirmed the government are working to urgently resolve this ongoing issue.

 

We made progress in Northern Ireland regarding changes to the Financial Support Scheme (FSS) and continued to press the NHS for clarity around the NHS contractual frameworks particularly in regard to an abetment figure.

 

Read all the updates from week commencing 4 May 2020.

 

27 April - 3 May 2020

This week we held a minute's silence to commemorate health care workers who have died of COVID-19. Priority for your safety is still our main concern during this time.

 

Our campaign to help private practices continued to have an impact, as 28 Conservative MPs from across England reiterated our message in a new letter to the Chancellor asking for relief in business rates to be extended to mixed and private dental practices. The full impact of our campaign was detailed in CEO Martin Woodrow's new blog.

 

Talks continued with governments across the UK to develop position papers regarding the return to practice post-lockdown. We're working with NHS England to consider what clinical practice will look like, what PPE will be required, and what contractual systems we will need.

 

Our new furlough calculator went live to help members in mixed practices calculate the amount of money they're entitled to claim. We held a successful webinar - joined by over 800 members - covering financial packages, furloughing and the paying of associates in both NHS and mixed practices. The edited webinar is available to all members on our website.

 

Read all the updates for week commencing 27 April

 

20 - 26 April 2020

The PM returned to work this week after a fortnight recovering from COVID-19, and discussions turned to what life might look like post-lockdown.

 

PPE remained a dominant issue in the news as frustrations over supply intensified.  We secured widespread media coverage, including a segment on Radio 4's Today programme, regarding the frustrations felt by dentists working in urgent dental centres (UDC) with inadequate PPE. Our campaign for private practices also garnered cross party support as 101 MPs signed our letter calling on the government to address the risks faced by the dental industry.

 

We commenced discussions with administrations across the UK to outline how dentistry will resume in a safe and effective manner post-lockdown.

 

Read all the full updates for week commencing 20 April

 

13 -19 April 2020

 

The Easter weekend saw the UK death toll surpass 10,000, as shortages of Personal Protective Equipment continued. Dwindling supplies, particularly for front line health care workers, resulted in delays in opening urgent dental centres being set up in England. Meanwhile in Wales, over 1,400 patients have been seen and 23,000 consulted.

 

Revised Standard Operating Procedures were published by NHS England this week. We were disappointed to see that advice on PPE for non aerosol-generating procedures has not been changed. We continue to voice our concerns with the Health Minister with whom we are speaking on a regular basis. We collated evidence on PPE use via a survey seeking first hand experiences of dental staff in UDCs, and we continued to advocate for you and your patients safety.

 

This week we also launched our pay dispute resolution service for associates, and pushed MPs to consider the plight of private dentists.

 

Read all the updates for week commencing 13 April

 

6 - 12 April 2020

 

This week, the Prime Minster was hospitalised with Coronavirus and cases continued to rise nationwide.

 

Our CEO, Martin Woodrow, met with the Health Minister regarding the delay to urgent care centres in England. We also continued to push for more support for self-employed dentists and private practices. And we called on the GDC to waive the annual retention fee (ARF).

 

We are still waiting on four nations guidance on PPE and pushing for dental staff to be adequately protected. Long awaited guidance on redeployment for dental staff was published, and we answered many of your questions on our FAQ pages.

 

Dentists all over the UK volunteered to help the response.

 

Our advisory team extended their working hours over the Easter weekend to ensure our members get the best support possible.

 

Read all the updates for week commencing 6 April

 

30 March - 5 April 2020

 

PPE remains a huge issue this week as cases rise nationwide. We refuted official guidance that routine PPE is sufficient protection for non-aerosol-generating procedures. We provided members with a risk assessment tool especially for urgent care.

 

There was a breakthrough on funding this week, as the Scottish Government announced they would pay 80% of average income from terms of service and patient contributions to NHS dentists.

 

Dentists in England also received much anticipated confirmation that mixed practices can claim for furloughed workers and still receive their NHS income. We continue to push for Government to extend support to self-employed dentists and private practices, having taken the case to the Chancellor, Health Minister and HMRC.

 

This week we also kept 105,500 people informed of these changes through our Coronavirus webpages, one of which outlines the financial impact of the crisis on dentists. Our advice team answered record numbers of member queries, and our advisors made videos to answer some of your FAQs.

 

Urgent dental centres were set up in Wales, Scotland and NI. But there were  delays in England, which we took directly to the Minister.

Read all the updates for week commencing 30 March

 

23 - 29 March 2020

 

By the end of this week, over a thousand deaths had been recorded in the UK due to Coronavirus.

 

Wales became the first UK country to move to a Red Alert phase this week. This saw restrictions to all routine care and plans to open urgent dental centres announced. The rest of the UK soon followed.

 

With many practices all but closing, this was a stressful and confusing time for many dentists. We issued urgent advice regarding appropriate PPE and aerosol-generating procedures.

 

We campaigned for the Government to revise their financial strategy for self-employed workers. Much-awaited detail on the furlough workers scheme was finally published.

 

We continued to demand clarification on this in relation to NHS payments.

 

We put your concerns about redeployment  to the NHS directly via a form on our website.

Read all the full updates for week commencing 23 March

 

16 - 22 March 2020


This week saw a radical departure from normal life. COVID-19 was officially declared a global pandemic by WHO. Schools, restaurants and bars in the UK close. There was a significant reduction in routine dental treatment across the UK, and we demanded the Government confirm a financial support strategy for the dental sector.


Chancellor Rishi Sunak pledged furloughing, loans and cash grants to come. We sought clarity on what this means for dentists in NHS, mixed and private practices. Early financial support measures were revealed in NI and Scotland and Wales updated their clinical advice. 


We urged NHS England to update their Standard Operating Procedures, which continued to assume little community transmission and referred primarily to travel history as an indicator. 


Once schools were closed, we pressed the Government to clarify if dentists and nurses were ‘key workers’. At every stage, we sought to ensure dentists were not forgotten.  


Read all the full updates for week commencing 16 March


9 - 15 March 2020

 

Britain saw its first eleven deaths from Coronavirus this week. 


There was widening concern about COVID-19 and the potential of impact on the UK. But much of normal life continued, as we awaited information from key Government COBRA meetings.


We focused on informing and protecting the dental profession. Our new Coronavirus pages were launched, to support dentists with the most up-to-date information, and our advisors were busy answering members' concerns.


The Chancellor pledged to offer ‘whatever it takes’ to support NHS services. We opened channels with the Government and NHS to work out how that would look for different dental groups, seen in the ‘2020 Budget’. 

Read all the full updates for week commencing 9 March