07 June 2020
Dentistry now faces financial meltdown, with the costs of delivering care skyrocketing as practices prepare to reopen from tomorrow (Monday 8 June).
The cost of PPE alone, ignoring other treatment costs, for treating a single patient using aerosol-generating procedures (AGPs) – using high-speed instruments like a drill – was around 35-45 pence pre-pandemic, and could now stand at £20-30 depending on exact PPE requirements and usage.
Higher-end PPE is now required for AGPs that form the overwhelming majority of dental treatments, which involve the use of high-speed instruments that can carry the viral load into the air.
Industry sources estimate that the combination of intense competition and pressure on global supply chains for PPE and the Public Health England guidance for enhanced PPE required across both non-AGP and AGP activity means that PPE costs per patient could increase by around seven times (or 700%) for non-AGP activity, and around 60 times (or 6,000%) for AGP activity when compared with pre-COVID-19 activity.
Surgical face masks (type IIR) have increased in price from around 6-8 pence each pre-COVID-19 to around 60 pence each today. New Public Health England PPE requirements for higher-end PPE are requiring kit never previously needed, including respirator masks, and fluid-resistant gowns required for both the dentist and nurses. FFP2 masks are now ranging from around £4-£5 each, and disposable fluid-resistant gowns around £5 each.
Practices face the growing risk of financial collapse. With practices facing higher costs and radically reduced patient numbers, practices report they will struggle to remain open.
Only 8% of those polled by the BDA
estimate being able to maintain financial viability based on anticipated patient numbers and added costs post lockdown. Dentistry is currently reliant on commercial wholesalers for kit, like masks.
The BDA is pressing for urgent access to the government supply chain for PPE, and for the temporary VAT cut on PPE – which closes on 31 July – to be extended, and potentially to become permanent, given widespread use across the UK economy.
PPE shortages are affecting the majority of high street dentists, with only 35% currently having the necessary PPE to resume face to face patient care. Levels of capacity in most practices reopening are less than 25% of pre-pandemic levels, potentially leaving millions without access to care.
The BDA has said it is now inevitable that patient access across England will fall significantly below levels seen in former access ‘hotspots’ such as West Yorkshire, Cornwall and Cumbria. Dentist leaders anticipate only a tiny fraction of the nearly 40 million courses of treatment delivered by NHS in England last year to be possible under current conditions.
BDA Chair Mick Armstrong said:
“Dentists have little prospect of meeting the backlog built up during lockdown when we face PPE shortages and crippling increases in costs.
“Dental practices are businesses and the sums no longer add up.
“A service running on empty will barely be able to scratch the surface of even urgent cases. Normal service can only resume for millions of patients if government is willing to step in.”