Internet Explorer and Edge browser users:
To download Word, Excel or PowerPoint files please right-click on the file you wish to download, and select 'Save target as...'

Updates from week commencing 10 August 2020

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

Friday 14 August



Scotland: Advice for Carestream users about restarting AGPs from Monday 17 August


Practices in Scotland can start delivering aerosol-generating procedures (AGPs) for NHS patients requiring urgent care from Monday 17 August. The Scottish Government has just informed us that Carestream will not have their systems ready in time for Monday – they anticipate that their “go live” date will be Thursday 20 August.


Practices using Carestream are being asked to add details about AGPs to their clinical notes and then to transfer the information to Carestream when it goes live. The Scottish Government has apologised for the delay, and Practitioner Services Division is working with Carestream to make sure their systems are operational as soon as possible.





England: Further clarification of contract and abatement issues for orthodontics


Important information for contractors providing orthodontics has been published by the BDA, NHS England, the British Orthodontic Society and the Association of Dental Groups.


This letter contains information on: service delivery expectations during the pandemic, clinical monitoring activities, abatement, the resumption of patient care, associate payments and service delivery in the coming year.


It should be considered alongside the previous clarification letter on mandatory services.



Thursday 13 August




England: Guidance for supervised toothbrushing programmes


Public Health England have issued infection control guidance for supervised toothbrushing programmes in early years and school settings. It seeks to manage any public health risk arising from the COVID-19 pandemic against the significant oral health improvement benefits of daily supervised toothbrushing.




England: Updated travel advice


Are you or your team planning to travel? If so, we advise you to check whether you'll need to plan to self-isolate on your return.


The initial list of exempt countries came into force on 7th July 2020. It's been amended since, and so we've updated this list to help you and your practice plan better. We've also outlined what self-isolation requires of you by law.




Mental health and the pandemic


The NHS Confederation has produced a report on the expected mental health impacts of the crisis. It warns that NHS leaders expect demand for mental health support to increase and to remain high for some time, which will likely have implications on resourcing and staff wellbeing.


Speaking to the BBC, Sean Duggan of the NHS Confederation, made clear that he did not want to "medicalise everything... It's perfectly normal to feel uneasy and anxious" at such an uncertain time, but that, there was a real increase in people needing mental health services.


We recommend that dentists who are in need of support contact the Dentists' Health Support Programme or reach out to services in their area. Members can also call Health Assured 24/7 on 0800 030 5182 for access to confidential counselling and emotional support.



Wednesday 12 August



Northern Ireland: RQIA told inspections must not resume as planned


Today we met with the RQIA to outline our objections to their plan for the renewal of site inspections in September. We made clear that extra disruption caused by an RQIA inspection is the very last thing practitioners need in the current circumstances.


This meeting followed our letter to the CMO last week making clear that this move was unnecessary and unreasonable, as the profession seeks to rebuild following lockdown. We have suggested using the Emergency Support Framework (ESF) approach being adopted by CQC in England, which comprises of a supportive telephone conversation instead of on-site inspections.


RQIA will be issuing a further communication to practitioners to set out further details of their proposed approach to inspection. We have urged them to reflect the concerns raised on behalf of the profession. We have also asked the regulator to consider providing practices with the option of an off-site inspection, and to move away from a compulsory on-site inspection.


Various assurances were given, including that all practices selected for inspection would receive a supportive telephone call with an inspector a month in advance of an inspection taking place, and around flexibility to set a mutually convenient date for inspections. We will continue to advocate on behalf of the profession, and will update you.





Reckless reporting of WHO guidance sends dangerous message to patients

Today we've warned against misreporting of latest guidance from the World Health Organisation, which has been incorrectly interpreted as cautioning against attending the dentists for all but urgent cases. 

 The document, published on 3 August, advocates that "Oral health care involving AGPs (aerosol generating procedures) should be avoided or minimized, and minimally invasive procedures using hand instruments should be prioritized" for settings "with widespread community transmission."

It is inappropriate to apply this advice in the UK's current context, where dentists already operate extremely high levels of decontamination. At present the authorities have mandated dentists to use full PPE - as used in ICUs - for AGPs combined with a 60 minute fallow period between patients. The UK's approach is highly cautious by international comparison and is currently under review. 

There is no evidence of transmission through dental AGPs since they resumed in June in England. We believe there is a need to balance AGP risk against risk to patient oral health, particularly given the huge drop in oral cancer checks at routine appointments since lockdown.



Tuesday 11 August



Scotland: Advice on restarting AGPs in practice from 17 August


If you are an NHS dentists in Scotland wishing to resume aerosol-generating procedures (AGPs) for urgent care on/after 17 August, we recommend you read the latest advice for the Scottish Government.


This memorandum sees them take on board many of the issues we have highlighted in our campaigns and includes information on: practice ventilation requirements; expected patient numbers per surgery; PPE supplies; financial support; and the revised Statement of Dental Remuneration.


Please note, there is no obligation to restart AGPs from this date – dentists can 'opt in' if they choose. However, practices wishing to provide AGPs are required to have their arrangements signed off by their NHS Board.





Northern Ireland: Grant available for FD supervisors


We are pleased to see that a grant of £5000 will be made available to FD supervisors in Northern Ireland. FDs have faced great uncertainty regarding extended training and securing satisfactory completion of their clinical competencies.


We continue to monitor the situation closely as the FD training year officially ends, but hope that this grant will go some way to enabling Educational Supervisors to continue their valuable role at this unprecedentedly difficult time. We met with the Dental Dean today to discuss this and related issues and we will continue to update you.





Scotland: Concern over funding package for VDPs


We are concerned about the funding package available to Vocational Dental Practitioners (VDPs) in Scotland and the consequences they face financially should they move to an associate position at the end of their VDP year in August 2020.


The latest PSD FAQ's state that in most circumstances any COVID-19 top-up payment will no longer be payable to a VDP taking on a dental list in August. Instead, there will be an equivalent VDP top-up to the VDP salary, which is referred to under Section 5 of the FAQs.


Many VDPs who are continuing to care for the same list of patients as they were whilst a VDP, will receive a reduced top-up compared to what is currently being provided for servicing that list. It is concerning that VDPs who have become associates will likely have a lower income than the new VDPs joining the profession.


We have contacted James Boyle, Associate Dean of Vocational Training, NHS Education for Scotland who said that the NES adviser team had been working hard to support and advise those leaving training. He said that many of their trainers were also advising their VDPs and in some cases retaining their VDPs, in order to support their introduction to the workforce. However, when the VDPs leave training, Vocational Training will cease its formal involvement with them, although trainers and advisers continue to offer support and advice as a matter of routine.


We have raised these issues with the CDO and will update you on any progress made.



Monday 10 August



Northern Ireland: Updates from Public Health Agency


Dentists in Northern Ireland can now sign up for updates from the Public Health Agency. 


This month's newsletter contains information on COVID-19 clusters in Northern Ireland. It shows that Newry, Mourne and Down District Council currently have the highest case rates, and that clusters in Northern Ireland have been associated with both workplaces and community gatherings, in domestic, hospitality and sporting settings.





Calls for facemasks to be made mandatory in healthcare settings


Ministers are being called on to reconsider and extend laws on face coverings to protect healthcare workers. The Government have been asked to make masks compulsory in healthcare settings as laws on face coverings are extended to cover churches and cinemas, but not hospitals. The advice that visitors in healthcare settings, such as hospitals and GP practices, currently has no legal force. Ministers have been urged to reconsider and extend the laws to protect healthcare workers.




England: Clarity on associates pay and abatement issues


After pushing for answers on various issues relating to associates pay and abatement, we are pleased to see NHS England provide clarity on a number of issues last week:

  • Abatement reconciliation: It confirms our understanding that abatement monies due from the early part of this financial year will be collected across the second half of the year.
  • Patient care activity: It provides clarity on what constitutes patient care activity for the current contractual arrangements when practices are trying to calculate whether they have met the 20% activity threshold.
  • Practice obligations: It reiterates practices' obligations around passing on payments to staff, including associates. It recommends the use of Net Pensionable Earnings as the best way to do this, which has been our stated position for some time. However, it also recognises that other methods of payment can be appropriate where agreed.
  • Tie-in arrangement for associates: It says that these are not expected where payments are passed on.
  • Urgent care centres: It confirms that they are not subject to the 20% activity minimum threshold during the current arrangements.



Nominations open for NHS Parliamentary awards

Do you know NHS staff members, carers and volunteers that have gone above and beyond? Nominate them for the NHS Parliamentary award!

These awards were launched by NHS England and NHS Improvements to celebrate NHS staff, carers and volunteers. They were designed to encourage health and care organisations to engage with their local MPs and tell them about the work they do and to build up relationships. So you can nominate individuals or teams/services for their work within the NHS.


Nominations are open until midnight on Tuesday 1 September 2020. However, we recommend you forward completed nomination forms by 18 August 2020 and then follow up with your MP to ensure they have received the nomination and will be submitting it.