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Updates from week commencing 1 September 2020

All the updates and what we've been working on during the Coronavirus outbreak.

Friday 4 September 2020

15:15

 

In the news this week

 

We speak to national and local media daily to represent you and your interests. Here's some of the coverage we've received this week:

 

  • Millions of dental appointments missed during lockdown - BBC Radio Derby held a discussion about our report that millions of dental appointments were missed during the lockdown
  • Patient access across England has "fallen off a cliff" since March - several news outlets in England continue to highlight our warning about tens of millions of patients unable to get NHS care
  • Sky News reports millions of people have been doing their own dentistry during lockdown

 


 

15:05

 

Scotland: Dentists can give flu vaccinations this winter

 

The seasonal flu vaccination programme is a life-saving public health measure. However, delivering the programme during the pandemic will be more challenging as GPs, who previously delivered most of the vaccinations, are seeing fewer patents. That’s why, dentists have been asked to get involved.

 

General Dental Practitioners in Scotland can now support the NHS’ 2020/21 flu vaccination programme which should help save lives and relieve pressure on the NHS this winter.

 

The programme is voluntary and dental contractors are free to opt in or out. Those that do opt in will receive a one-off participation fee and a fee per immunisation.

 


14:05

 

Elections: Do you want to represent your profession?

 

Last Thursday, nominations opened for six seats on the BDA's board. If you are interested in influencing positive change for dentists and dentistry, we encourage you to nominate yourself for the relevant regional seat and/or UK-wide seat. The following seats are up for election:

 

  • Eastern
  • North West
  • West Midlands
  • Wales
  • UK-wide (One of the two UK-wide seats is a by-election, the term for which will be until 31 January 2022).

All members (apart from student members) are eligible to self-nominate, if they have been a member since 28 August 2019. Learn more about how you can get involved and the work of the BDA board today.

 


 

12:15

 

England: Defending PHE’s health improvement programmes
 
More than 70 organisations, including the BDA, have now endorsed a joint statement on the future of Public Health England’s health improvement functions. This letter has been sent to the Prime Minister, the Secretary of State for Health and the new leadership of PHE.
 
We’re standing together alongside the BMA, the Faculty of Public Health and the Royal Society for Public Health, to say that neglecting health improvement measures, in order to fight COVID-19 is a false choice. PHE programmes to counter smoking, obesity, tooth decay, alcohol and mental health must not become a casualty of the government’s push to abolish PHE.

 

As the statement warns: “Reorganisation risks fragmentation across different risk factors and between health protection and health improvement. Organisational change is difficult and can be damaging at the best of times and these are not the best of times. A seamless transition from the current to the new system is essential.”

 


 

10:20

 

New statement on dental education

 

The GDC, the Dental Schools Council, COPDEND, the dental faculties and the Joint Committee for Postgraduate Training in Dentistry have issued a new statement outlining the situation of dental training in the UK.

 

This is relevant to anyone studying dentistry at undergraduate or postgraduate level, also to those undertaking Dental Speciality Training and preparing for assessments provided by the Royal Colleges.

 


 

Thursday 3 September 2020

14:00

 

Northern Ireland: Seeking a resolution on pay and private dentistry support  

 

We have urged the Department of Health to clarify timescales in relation to a pay uplift for dentists.

 

In a letter sent today to Health Minister, Robin Swann, we have requested an update on when a resolution in relation to dentist pay will be confirmed.

 

We believe that this is a reasonable request given a pay policy is now in place following the DDRB report in July which recommended a 2.8% uplift. Our letter also emphasises the need to clarify pay issues regarding the CDS, who worked additional hours in the outbreak of COVID-19.

 

We have also sought a progress report on conversations between DoH and the DfE in relation to additional support for private dentistry.

 

We will of course keep you updated on all progress as it develops.

 


 

10:30

 

Scotland: New DVT contract expected

 

A new NHS Education for Scotland (NES) DVT contract was issued on Monday, which caused concern due to the inclusion of a clause. It states that if the practice is required to shut down due to COVID-19 there would be a period of unpaid leave.

 

We raised concerns with NES over this and have received apologies for the breakdown in communications about the contract. NES will now work on a revised version of the DVT contract and seek feedback from us before it is issued.

 

We advise members that any DVT contracts which have completed and submitted to NES will not be taken forward. For those who have not yet signed their contract, they should discard them and await a new version.

 


 

09:30

 

England: New SOP and update on fallow time

 

Last week the CDO for England, Sara Hurley, wrote to practices to announce the updated Urgent Dental Care and Transition to Recovery Standard Operating Procedures (SOP) in England.

 

The framework reiterates the guidance, as published by Public Health England guidance, that fallow time should remain at sixty minutes in a neutral pressure room (which is what most dental surgeries are).

 

However, there was one notable clarification. Practices were informed that a reduced figure of 20 minutes of fallow time is feasible if they can achieve 10-12 air changes per hour (ACH) in a single room using ventilation systems.

 

We welcomed this pragmatic approach as a step towards improving the capacity of dentists providing services to patients, and we look forward to more guidance as things develops.

 

In particular, we anticipate the imminent publication of the SDCEP report which should provide further clarity and detail, including options for practices that cannot comply with the 10-12 ACH recommendation.

We welcomed this pragmatic approach as a step in the direction of improving the capacity of dentists providing services to patients, and we look forward to more guidance as things develops.

 


 

Wednesday 2 September 2020

16:30

 

England: Defending PHE’s health improvement programmes

 

More than 70 organisations, including the BDA, have now endorsed a joint statement on the future of Public Health England’s health improvement functions. This letter has been sent to the Prime Minister, the Secretary of State for Health and the new leadership of PHE.

 

We’re standing together alongside the BMA, the Faculty of Public Health and the Royal Society for Public Health, to say that neglecting health improvement measures, in order to fight COVID-19 is a false choice. PHE programmes to counter smoking, obesity, tooth decay, alcohol and mental health must not become a casualty of the government’s push to abolish PHE. 

 

As the statement warns: “Reorganisation risks fragmentation across different risk factors and between health protection and health improvement. Organisational change is difficult and can be damaging at the best of times and these are not the best of times. A seamless transition from the current to the new system is essential.” 

 


 

15:30

 

Wales: Clarity on patient charges

 

We had raised the issue of patient charge collection with the Welsh Government and they have recently provided us with some clarification on what’s to be done during the amber phase.

 

It’s now been confirmed, that if a patient attends the practice for treatment an FP17W needs to be completed and submitted in the usual way, and a charge should be paid if applicable. Exceptions are to be made for patients attending an Urgent Dental Centre or receiving telephone triage, charges are not applicable in these cases.

 


 

14:25

 

Wales: Updated guidance from Welsh government

 

The CDO for Wales, Colette Bridgman has written to all primary care dental teams in Wales in order to update the industry on the progress of reinstating NHS dentistry.

 

The letter includes a review of the Standard Operating Procedures (SOP), which includes changes in SOP settle time following AGP and non-AGP procedures.

 

The SOP review also covers the reintroduction of more services in low amber phase, latest news on eRMS and future intentions and opportunities for NHS dentistry in Wales that will inform the dental contract reform programme in April 2021.

 


 

14:00

 

Elections: Do you want to represent your profession?

 

Last Thursday, nominations opened for six seats on the BDA's board. If you are interested in influencing positive change for dentists and dentistry, we encourage you to nominate yourself for the relevant regional seat and/or UK-wide seat. The following seats are up for election:

 

  • Eastern
  • North West
  • West Midlands
  • Wales
  • UK-wide (One of the two UK-wide seats is a by-election, the term for which will be until 31 January 2022).

All members (apart from student members) are eligible to self-nominate, if they have been a member since 28 August 2019. Learn more about how you can get involved and the work of the BDA board today.

 


 

12:02

 

Scotland: Guidance for submitting queries to Practitioner Services Division

 

Last Thursday we met with Practitioner Services Division (PSD) officials to discuss issues regarding dentists' queries about Covid-19 support payments. The answers to many queries can be found on PSD's Covid-19 Frequently Asked Questions which are updated regularly.

 

PSD continues to receive a vast number of queries from dentists about the Scottish Government's NHS support funding package and how it relates to their individual circumstances. PSD deals with such queries in the order they are received, therefore it may take some time to receive a response. Members are reminded of the importance of completing PSD information request forms accurately, and to only send from an NHS email account.

 

BDA Scottish Dental Practice Committee representatives previously peer-reviewed PSD's process for calculating the financial support payments to individual practitioners. They were satisfied that the PSD approach was fair and transparent, and commended PSD on their efforts to address dentists' queries.

 


 

11:30

 

Scotland: Dentists need non-expired PPE

 

We have serious concerns about some of the Personal Protective Equipment (PPE) provided to dentists in Scotland for aerosol-generating procedures (AGPs). Dentists across Scotland have reported receiving face masks that date as far back as 2001, and with expiry dates going back to 2012.
 
We have repeatedly sought firm evidence from NHS National Services Scotland that expired masks have been robustly assessed and are safe to use. This has not yet been provided. That's why, we’re urging dentists not to use expired masks and calling on the Scottish Government to provide dentists with safe PPE.

 


 

09:45

 

Webinar: COVID’s impact on landlords and tenants

 

Our new webinar is designed to help commercial landlords and tenants understand how to tackle any commercial letting problems they are facing during the pandemic.

 

Sign up to become familiar with the guidance and tools commercial tenants and landlords can use to effectively tackle problems arising during the pandemic, and to receive an update on current government guidance in regard to commercial lettings.

 

It will take place on Thursday 10 September at 19:30 – 20:30. BDA members can attend this webinar for free, but must login and register in advance to reserve their space.

 

Non-members or Dental Care Professionals can call our events team to book their place for £50 and £30 respectively, on 020 7563 4590 (open Monday to Friday 09:00-17:00).

 


 

Tuesday 1 September 2020

17:25

 

Seeking commitment from the government on public health

 

When the secretary of state, Matt Hancock, announced that Public Health England was to be abolished, we immediately sent an open letter urging the government to clarify their plans for public health provision.

 

Subsequently, we also wrote to the new interim CEO of PHE, Michael Brodie. In this follow up letter we set out our concerns about the future of the dental public health workforce. We sought urgent assurance that crucial health improvement functions will be preserved, from epidemiology to supporting commissioning, and reducing inequalities.

 

Today we received a response from Mr Brodie, acknowledging the importance of maintaining dental public health in the new structures and committing to engage with us on the development of plans.

We will keep you updated on  any developments as they occur.

 


 

17:00

 

England: NHS pay survey

 

NHS England expect practice owners to ensure that all staff, including associates, continue to be paid at previous NHS levels during the pandemic.

 

If you have concerns that these expectations are not being met, NHS England now ask you to fill out the new Pay Concerns Survey form on Compass. This form is in the ‘COVID-19’ option on the front screen and then ‘COVID-19 Performer Pay Concerns Survey’.

 

As your association, we are doing everything possible to support associates to resolve pay disputes and we continue to push for clarity from NHS England on the issue.

 


 

16:40

 

The latest on general practice contractual arrangements in England

 

Dentists working in general practice in England continue to operate under current NHS contractual arrangements which have included assessment of activity since 20 July. Courses of treatment and patient triage are being counted and at least 20% of previous course of treatment volumes are expected. Practices are also expected to maintain the same NHS to private proportions as occurred pre-lockdown.

 

During this time, many of the existing contractual provisions rules continue to apply. Patients requiring an urgent appointment should be offered the next available slot, whether or not they have been treated on the NHS previously at the practice. Contractors have been advised by the NHS to prioritise patients with urgent care needs. NHS England advice is that the sequencing and scheduling of patients should take into account the urgency of needs; the particular unmet needs of vulnerable groups and practices' available capacity to undertake activity.

 

As we reported last week, we are currently in discussions about what the NHS contract should look like for the rest of this financial year. As our discussions with NHS England continue over the coming weeks we will again be seeking a balanced approach that recognises ongoing constraints and increased cost pressures on practices. It must also be flexible as the pandemic's progression is unlikely to be predictable or consistent across England.

 

Whilst there are some specific requirements on practices, this current framework relies on trust. We need the profession to do the right thing during this period in providing high quality patient care in the spirit as well as the precise wording of these current arrangements. If that does not happen, it will inevitably influence the framework for the second half of this year and potentially beyond.

 

If colleagues act outside of the spirit of the interim contractual framework agreed, their actions are likely to jeopardise our position as a profession. In particular, the 20% volume of care requirement to receive full contractual payment is not a minimum, it is a threshold. Practices must continue to spend the same amount of time seeing NHS patients as prior to the pandemic. Priority should not be given to private patients where NHS capacity still exists.

 

NHS England's July letter of preparedness indicated that it expected all practices to be providing face-to-face interventions, delivering as comprehensive a service as possible (whilst recognising that capacity may still be constrained). There is nothing to stop practices doing routine assessments, but there is an expectation that priority must be given to patients in pain, irrespective of whether they are new patients or not to a practice.

 

As a profession, we have risen to the demands made by this dreadful pandemic. If we get the current period right, it sets the tone for what can be agreed for the rest of this year and beyond. We might even see some good come out of this in the shape of longer-term NHS contractual provisions that are finally fit for purpose. If we get it wrong, we are much more likely to see a return to low trust, high scrutiny contractual arrangements.

 


 

13:20

 

England: Calling on the Chancellor to set out action plan

 

A new report underlining the need for coherent support for dental services, particularly for mixed and private services has ben published. In response, we have sent an open letter to the Chancellor calling on the department to develop a coherent, funded plan in order to help maintain the viability of the dental sector.
 
The paper – the work of a short life working group bringing together a unique range of official and professional bodies – examines the current national and local financial support packages currently available to dental practices.

 

It sets out key recommendations, including calls for an extension of the coronavirus job retention scheme for the dental sector, lengthening the repayment period for government loans, and extension of business rates relief for dental practices.

 

The report hinges on wide ranging survey data gathered by the BDA that found in England:

 

  • Two thirds of practices (66%) are running at less than a quarter of pre-pandemic capacity
  • 79% are likely or extremely likely to face financial difficulty in 3-6 months
  • 54% lack confidence their practice could maintain current staffing levels in the coming year
  • 78% determine 'fallow time' to be the greatest obstacle towards increasing activity levels

 

Since the onset of the pandemic we – and many MPs – have received mere boilerplate responses from the Treasury regarding support for dentistry. We’ve yet to see any real awareness of the unique challenges facing this service. We hope that this report will address this gap in understanding.

 


 

12:40

 

Pain relief poster for your practice

 

Antibiotics are not indicated in most instances of toothache, and this new poster is a helpful reminder of analgesic options to be combined with local operative measures.

 

It includes recommendations on pain relief for both children and adults, and is a helpful reminder while we remain in a phase of remote triage and limited availability of face-to-face care.