Friday 17 April 2020
Friday wrap up: What happened this week
Here's my weekly round up of the major news in our sector this week and what we have been doing to campaign on your behalf. We hope you find it useful.
As mentioned in the video,
here is our survey on PPE. Please complete and share it.
Please see our
Advice for Associates for more on our new pay dispute resolution service.
To send in your questions for our webinar, please visit our
Webinar for members page.
Finally, follow the link to
nominate someone for our Honours and Awards.
Have a safe weekend.
Our latest meeting with the Health Minister
BDA Chair Mick Armstrong and I have had two meetings in recent days with Health Minister Jo Churchill to discuss the establishment of the urgent dental centres in England.
We understand that, as of the close of play yesterday, there were in excess of 160 hubs up and running across England, with further centres planned in the coming days. We remain concerned about some local reports indicating that there have been ongoing delays in getting patient treatment started, due to various reasons including supply of personal protective equipment and fitting of masks.
We are continuing to monitor developments and raise concerns in discussions with NHS England. We are particularly interested in the supply of PPE for clinicians working in urgent care settings and are running a
survey to inform us of local developments. If you are involved in providing urgent care, please do complete it.
Our concerns about individual practices negotiating terms with NHS England
We are aware that FTA law is advising dental practices to write back to NHS England setting out the terms on which NHS practice owners should accept a proposed variation. We are concerned about the idea of individual practices negotiating terms with NHS England just at the moment.
There are a number of reasons for this:
1. The government has brought into force regulations that allow for the suspension of contract terms. The BDA is in discussion with NHS England and we are seeking urgent clarification on the issues facing NHS dental practices, including the suspension of UDA targets during this period.
2. Like so many, NHS England is struggling with a huge workload at the moment. Increasing that workload with individual contractors negotiating contract amendments seems a poor strategic choice right now.
3. There are principles at stake which will be in the minds of everyone in NHS England.
a) There is a global pandemic. Tens of thousands of people are dying. There is a massive requirement for NHS services to cope with the huge number of COVID-19 infected people who are seriously ill.
b) Businesses are failing. People are losing their jobs. Many others are having important medical treatment (including cancer treatment) postponed.
c) People are going to work in difficult circumstances: think of all the medical professionals in the COVID-19 wards, some of whom have died as a result.
d) To help the country get through this crisis, the government is borrowing and spending a substantial amount of money that will take generations of tax-payers to repay.
e) Right now, what the government and the NHS need to concentrate on is ensuring that the health service can cope with the increased demand on services due to COVID-19. That is its priority. At the same time, it is also ensuring that NHS dental practices and NHS dentists have money to survive and that dentists are able to redeploy wherever possible to help the wider effort.
f) NHS England is giving NHS dental practices money in return for a request that dentists do something to help in the wider effort. We believe there will be no clawback in relation to UDAs during the shutdown. We are seeking clarification on that.
4. We are concerned that an attempt to enter into individual contract negotiations at this time may be seen as opportunistic and inappropriate at a very difficult time for the nation.
We therefore suggest a little patience. We are working hard to speak to members and understand your concerns. We are also working hard to negotiate with NHS England to get NHS practice owners the right clarity and a fair deal.
Wales: Urging the government for financial remedies
Today we have contacted Welsh Ministers on your behalf to request that they act immediately to put into place a raft of financial remedies to support dental practices providing private care.
In a letter sent from Tom Bysouth, Chair of WGDPC, and Dr Katrina Clarke, Chair of Welsh Council, to Rebecca Evans AM, Minister for Finance, and Ken Skates AM, Minister for Economy and Transport, the dire economic situation for dental practices in Wales was detailed regarding loss of private income. The letter has pressed the fact that many practices will likely run out of funds within the next couple of months, while at the same time practices and dentists are being refused financial support from the various government schemes because of current criteria.
We have copied the letter to all MPs in Wales and have requested that Ministers and MPs write to the Chancellor asking for a change in the criteria that will allow dental practices and dentists the financial support they deserve.
We await a response and will update you as soon as we can.
Thursday 16 April 2020
Members: Join our webinar
On Wednesday 29 April our expert advisors will be online answering your questions on:
- Financial packages on offer and how they work
- Furloughing and retaining your staff
- Paying associates in NHS and mixed practices.
Please post your questions here beforehand. There won’t be a chance to ask questions live during the webinar.
We will be emailing the webinar link to members the day before it takes place. Otherwise you can keep track of all updates via our Webinar page.
Insight from around the country
Financial support for dentists in private practice and progress on urgent dental centres are two of the most urgent issues we face. Here are some perspectives from around the country on what's been achieved so far and what needs to be done next.
Northern Ireland: Communicating the private practice struggle to MPs
The struggle of those with private dental practices to access business support and grants has been communicated to the Minister for the Economy this morning.
In a letter sent by Richard Graham, Dental Practice Committee Chair, to the Minister for the Economy, the need to ensure that private practices can weather this crisis was emphasised. Mr Graham pressed the precarious position of dental practices operating in Northern Ireland who have lost access to all of their Health Service and private income sources overnight as routine dentistry was halted in response to COVID-19.
All NI MPs have received a copy of this letter for their information to highlight the ongoing concerns.
Associate pay dispute resolution service launched
Corporate bodies and practice owners with NHS contracts will continue to be paid assuming certain conditions are met. One of those is that they are obliged to pass on income due to associates. Practices are also required to support the wider NHS pandemic effort, and this is likely to involve associates if NHS money is to be passed on. Of course, we expect the overwhelming majority of corporates or practice owners to pay associates appropriately.
If this is not the situation for you we will take up this issue on your behalf.
We know that everyone is anxious and fearful right now. We will try to resolve all issues constructively with the practice. Our primary aim with this service is to ensure that any issues are resolved in a fair and satisfactory way for everyone involved and so that effective working relationships are maintained.
Wednesday 15 April 2020
Updated standard operating procedure released
Trailed two weeks ago by the CDO in the webinar, NHS England has tonight released its updated standard operating procedure and fourth letter of preparedness.
Share your story with your MP
We are speaking up for dentists directly with ministers and officials. You can play your part by sharing that story with your MP and asking them to take action on your behalf.
Our immediate priority is quite rightly on supporting the healthcare effort where we can. But we also need our services to still be there for patients in future.
One in five practices say they will struggle to keep their heads above water this month. And the vast majority of self-employed colleagues will get nothing from the Chancellor’s deal. We need to see a safety net in place for every practice, and every practitioner.
We’ve been speaking out to government and the press. And your voice can help make a difference.
Dentistry in the news
We're speaking to national and local media daily to represent you and your interests. Yesterday we saw coverage on a range of issues, including:
- The Sunday Times warns dental services will be decimated
- LBC’s Nick Ferrari on dentists’ concerns during lockdown
- Belfast Telegraph – only 75% of surgeries financially sustainable for up to three months
- Scotland: 8 in 10 dental practices which applied for government loans turned down
- Wales: self-employed need help extended to those earning more than £50,000 p/y.
Redeployment information for dental teams in Scotland
The Chief Dental Officer for Scotland has written to dentists and their teams to ask for their support in the overall NHS Scotland response to the COVID-19 outbreak.
The NHS financial support is given on the condition that there should be no reduction in workforce and dental staff are required to contribute to the wider NHS response. The CDO has therefore asked that dentists and their teams volunteer to support their local NHS Boards.
The letter includes a range of settings where dental staff may be required. As redeployed dental staff will be working on behalf of NHS Boards, they will be indemnified in line with other NHS staff.
Honours and awards deadline moved to 31 July
We know that many dentists are going above and beyond for their colleagues, patients and communities during this difficult time. That's why, we've extended our Honours and Awards deadlines to ensure that this good work can be properly recognised. Let's celebrate the good being done by dentists, send in your nominations by 31 July and tell others to do the same.
Revised PPE guidance published by Health Protection Scotland
Health Protection Scotland has published revised PPE guidance on its website (the dental care section is on page 13), including a separate appendix on infection prevention and control in urgent dental care settings. Changes to the previous version of the guidance appear to be minimal.
Northern Ireland: Financial Support Scheme will account for individual circumstances
Following intensive lobbying over the past week, we are pleased to see the Department of Health in Northern Ireland has written to GDPs to clarify a number of points in relation to the FSS. It assures dentists that their individual circumstances will indeed be taken into account, and that the intention is to apply the scheme in a fair, reasonable and proportionate manner.
On redeployment, they expect that this will happen in proportion to normal Health Service hours worked. We're seeking further clarification on how this will work in practice. The contribution of GDPs to the wider COVID effort has also been acknowledged.
We have been pushing for assurances on your behalf during this difficult time, and will continue to update you as more information becomes available.
Tuesday 14 April 2020
What's happening this week
Urgent dental care
England continues to lag behind the other three nations in relation to setting up its network of urgent care centres. Three weeks on from the letter of preparedness indicating a standing down of routine care and provision via the urgent care system, large parts of England are left without effective urgent care. We know that roughly half of the 160 centres are up and running. We continue to raise our concerns about the lack of appropriate patient care with the Health Minister Jo Churchill, including in another meeting this afternoon. It is clear that she shares our frustrations over the slow progress.
Financial support for private dentistry
We have been raising the profile of the impact of the pandemic on private dentistry in particular, including significant media coverage over the recent weekend. This week we are planning to ask for your help in raising this issue with your own Member of Parliament, making sure that they are aware of the lack of government support for dentistry and the potential long-term impact on patient care.
Personal Protective Equipment
Updated advice was published over the weekend on PPE which applies to all four UK countries. It did not fundamentally change the existing position on what PPE is deemed appropriate in which setting and for which procedures. We are anticipating further advice in England early this week, including a revised Standard Operating Procedure, which we hope will give us more dental-specific guidance.
Associates working in the NHS
One of the requirements for continued NHS payments in England and Wales is that NHS income continues to be shared with associates as appropriate, with the practice and staff also expected to support the wider NHS pandemic effort. This week we will be launching a service to associates offering to help and advise them where practice owners or corporates are not passing on income. We'll update on this as soon as we can.
Answering members' questions on staff and associate pay
We are receiving a very high number of calls and emails from members about issues relating to staff and associate pay. To support you, we have set out our answers to this week's most popular questions (login required). This covers:
- NHS income and paying NHS Associates in England and Wales: March and April 2020
- Paying staff (conditions for NHS payments and furloughed workers).
Appraisals and mandatory training for community dentists
NHS Employers have confirmed that they support our request to suspend mandatory training and appraisals in England, via a letter sent to the chairs of our community dentist's committee. Dentists employed in England under a Salaried Primary Dental Care Service terms and conditions will have appraisals suspended till September 2020. It will be a local decision between managers and staff as to whether appraisals are cancelled or postponed to later in the year.
Decisions about mandatory training should be taken locally, however for current NHS employees who have not changed roles and who have previously undertaken mandatory training, refresher training can be suspended during the current crisis. Returning NHS staff must follow the national guidance.
Request for clarity on dental foundation training completion
Last week, we wrote to COPDEND asking for clarification on their plans for completion of dental foundation training (DFT) in all four countries.
Statements issued early on suggested that there should be ‘minimal if any’ disruption to timescales and w
e believe that any changes would have a knock-on effect on the provision of all postgraduate dental
education. However, the current situation makes it unlikely that all DFT competencies can be met by all foundation dentists (FDs) in the normal way.
There needs to be clarity about changes to the assessment process, which must be fair for all FDs and should be published urgently. We understand that the current situation is unprecedented, however, it is extremely stressful for FDs and they need to be supported and reassured that they can move forward in their careers without detriment.
Our letter also asks for formal confirmation that all payments to training practices in respect of DFT will continue without change. While we believe that this is the intention, a number of educational supervisors have raised queries about this issue.
Staying safe at urgent care centres
We have produced a poster - Staying safe at urgent care centres for getting to and from an UCC safely.
Monday 13 April 2020
COVID-19 testing: A letter to the NHS
NHS Regional directors, regional EPRP leads and trust CEOs have received a letter regarding the testing of NHS staff. The letter, sent yesterday from Pauline Philip, National Director of Emergency and Elective Care, and Sarah-Jane Marsh, National CEO lead for NHS, clarified that to meet the testing criteria you must either be:
- An individual (adult or child) with COVID-19 symptoms living in the same household as a member of NHS staff or wider NHS family.
- A member of staff in the NHS family, with COVID-19 symptoms.
By outlining the parameters of testing, the hope is to increase the safety of NHS staff and patients accordingly.