BDA Chair Mick Armstrong explains why it is not "business as usual" for dentists opening from 8 June in England and calls for more support for dentists and their teams.
I think we are all still recovering from the bombshell that was delivered to dentists on the 28 May via the BBC news ticker: that dentists could reopen their practices and return to work from Monday 8 June.
This was nothing short of ‘disrespectful to the profession’ as my colleagues have pointed out
numerous times on national TV and radio.
We knew that colleagues wanted to get back safely and effectively, for themselves, their staff and their patients. But the Government, once again, ignored what dentists had to say and implied to the public that dentists would all be opening and ready from 8 June.
We know that this will not be the case for many, here are five things you need to know:
1. Managing patient expectations: a mountain to climb
This is not a return to
business as usual, as was clearly conveyed to us when we surveyed over 2000 practices across England and found that a little over one third were ready to open on 8 June.
"Whilst we are relieved to be able to get back to work, we simply haven’t been given enough notice or support from Government to help us get back to seeing our patients"
Whilst we are relieved to be able to get back to work, we simply haven’t been given enough notice or support from Government to help us get back to seeing our patients.
I know many of you will have had your phones ringing off the hooks. Colleagues have said to me they’ve had patients shouting down the phone to them, unable to understand why they can’t get an appointment next week.
We have been working hard trying to get your stories out in the local and national media to explain why huge numbers of patients can’t be seen. We’ve highlighted the issues around backlogs, PPE supply, preparing practices to enable social distancing and the extended time needed in between appointments in order to decontaminate. On top of all of this there is the problems of getting staff back to work who have been furloughed or redeployed and the on-going issue of childcare as well as those who are vulnerable and need to shield.
We have demanded clarity for dentists and their team members to have ‘key worker’ status so they can finally access childcare if needed.
We’ve been outlining what patients will experience when we do get back to work and when they do make it through our doors, so their expectations can be in line with our ability to treat them.
2. Shrinking stocks of PPE and rising costs
Since the beginning of the COVID-19 crisis, we have been clear that getting hold of the right PPE is one of our major issues. In the early days of the pandemic, we asked dentists to donate their stocks to frontline hospitals, ICUs, GPs, pharmacies and care homes, and many of you generously did. This helped keep many of our healthcare colleagues safe and prevent the spread of the Coronavirus to their patients.
But this has left dentists without access to existing supplies and the price of even basic face masks jumping from pennies to pounds.
"We've called on NHS England to include dentists in the supply chain, which they have now promised"
We've called on NHS England to include dentists in the supply chain, which they have now promised. However, we know even some urgent dental centres are struggling with supplies.
Industry sources estimate that the need for new kit and the pressure on the supply chain means PPE costs per patient will increase by 700% for non-AGP activity and around 6,000% for AGP, compared to pre-pandemic costs.
survey showed that fewer than one in five practices will be able to offer a full range of treatments, especially those that require AGP (which represents the overwhelming majority of modern dentistry), mainly because of a lack of kit.
And we continue to hear some horrifying stories of Victorian and DIY dentistry that patients who are so desperate to get out of pain, are feeling the need to resort to because they can't get to see a dentist.
This cannot continue.
3. Ongoing financial support will be needed
For both NHS and private practices, we know that fewer patients and increased costs mean many of you are facing financial meltdown and closure. While we've had some support, if the Government pulls the plug now, many contract holders may just walk away. The numbers simply won't add up.
"Without private care, NHS dentistry will be gridlocked as patients will struggle to find anyone able to help them"
Most private practices have not been able to access any Government support nor receive any relief from business rates. We have been relentlessly campaigning for financial support for private practices to stay afloat during the pandemic.
Even those who are able to return to work, we know the books will be harder to balance. Without private care, NHS dentistry will be gridlocked as patients will struggle to find anyone able to help them.
These problems have long term consequences for patients and the profession. England already had access problems, but now with these added challenges, we are likely to only be able to see a fraction of patients, as the queues get longer and longer.
4. Weathering this emotional rollercoaster: support for dentists' wellbeing
I think physically and emotionally, a lot of dentists and their teams are in a very difficult place at the moment.
I feel we are really now at rock bottom and I want to acknowledge that, in spite of the many who may be managing to ‘carry on’ and ‘make it work’, many more are faltering under the pressure.
What feels like endless last-minute missives from the Government, our regulators, and commissioners, confusing guidance, pages of documents to read, scared colleagues and team members, angry patients, making the finances add up - we are facing a perfect storm.
If you are struggling, please don’t feel you are alone, there is support out there - BDA members can access
Health Assured, or you can try the Practitioner Advice and Support Scheme (PASS) via your Local Dental Committee.
Dentists can also access the
NHS Practitioner Support Programme , Dentists' Health Support Trust , and
ConfiDental . If you urgently need support, Samaritans are willing to listen, at any time of day or night.
5. Together we are stronger
We've set out our case to government in an
open letter to Matt Hancock.
Lobbying is a key part of what we do. But throughout this crisis, we have been pulling our resources together to provide everything we can for our members. Our
advice, services, toolkits and webinars have been designed solely to help support you through this crisis.
We've tried to keep you regularly updated and we will continue to do that, but we need your support too.
We understand that dentists have been squeezed financially, and
BDA membership might feel like a 'dispensable' cost. I would strongly urge you to remember that it isn't - we can only continue to do what we do with the support of our membership.
We can get through this, but only if we stand together.
Mick Armstrong, Chair