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Updates from week commencing 14 September 2020

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

Friday 18 September 2020



England: Failure to extend flu jabs scheme risks deepening crisis on access


NHS dentists in England this week received a letter strongly encouraging "all NHS frontline workers" to participate in the free flu vaccine scheme.


However the letter is not relevant to dentists in England as the government does not recognise them as key workers and therefore excludes them from the scheme.


Branding the policy 'absurd', Chair of the BDA's General Dental Practice Committee Dave Cottam said: "Officials need to apply their own logic to dentists and their staff. Continued failure to treat us as key workers hits our teams, and millions desperate to access our services. We are NHS frontline workers. Devolved governments have recognised this. The risks remain the same, regardless of your postcode."





COVID-19 and Community Dental Services: the challenges ahead


Next month we're hosting a webinar outlining the current COVID-19 related challenges facing the community dental services and the implications on vulnerable groups.


Participants will get the chance to ask each speaker questions.


The webinar, on Thursday 8 October, counts for one hour's CPD and is free to members or £50 to non-members.


Book a place on COVID-19 and Community Dental Services: challenges ahead webinar now.





Urgent action on tooth extraction backlogs


The scandal of increasing waiting times for tooth extractions for children and vulnerable adults with tooth decay in England cannot be left unchecked.


Charlotte Waite, Chair of the BDA’s England Community Dental Services Committee calls on the government to take action to ensure the most vulnerable patients are not left waiting for urgent tooth extractions.


Read: We need urgent action on tooth extraction backlogs.





Wales: New survey of dental laboratories to assess viability


BDA Wales has conducted a telephone survey of 52 dental laboratories across Wales to ascertain their viability during the COVID-19 pandemic.


The pandemic has affected many aspects of dentistry and the repercussions for dental labs, who supply the products that dentists need to treat their patients, has not gone unnoticed. The survey confirmed our fears that dental labs have been hugely affected, with the vast majority still working reduced hours and others yet to reopen. Furthermore, numerous dental labs have expressed financial difficulties and there is anxiety that some will close as a result.


We will continue to conduct further analysis of this data in order to advise the Welsh Chief Dental Officer, Dr Colette Bridgman.





SDCEP work on aerosol generating procedures


The Scottish Dental Clinical Effectiveness Programme (SDCEP) is leading a rapid review of the evidence related to the generation and mitigation of aerosols in dentistry and the associated risk of coronavirus transmission.


The findings of this review are likely to inform government policy. We are still expecting a comprehensive report covering fallow time to be published imminently.


In the meantime, SDCEP are looking for responses to their survey to better understand the current provision of AGPs in dentistry.


Please complete the questionnaire which should take 10-15 minutes. Your responses will help inform policy development about the challenges faced by and will help identify any further support required. The survey will be open until the middle of next week.



Thursday 17 September 2020



Scotland: New SDPC working group to feed into post COVID funding model for NHS dentistry


The Scottish Dental Practice Committee (SDPC) has established its own New Funding Model Working Group to consider options for a suitable post Covid-19 NHS funding model.


The CDO, Tom Ferris,  has acknowledged that the current Statement of Remuneration (SDR) is no longer fit for purpose, an issue which has become even more evident during the current Covid-19 pandemic. Consequently, Mr Ferris has informed the SDPC that he will be taking advice from the profession in developing a new long-term funding model for NHS dentistry and the SDPC will be involved in discussions with other key stakeholders about the financial and regulatory changes.


The New Funding Model Working Group will meet for the first time in mid-October. The CDO has indicated that the overall process will be a long-term initiative requiring a national consultation in spring 2021, and thereafter legislative changes.





Russ Ladwa inaugurated as BDA's 134th President


Russ Ladwa has today taken office as the BDA's 134th President.


A former Dean of the Faculty of General Dental Practitioners, Dr Ludwa has chaired both the Federation of London Local Dental Committees and the Dental Vocational Training Authority, and was a board member of the odontology section of the Royal Society of Medicine before being made its president.


In the 1980s Russ was involved in establishing the Asian Odontology Group and was a founding member of the Association of Dental Implantology.


In 2012, having been a life-long member of the BDA, Russ was elected to its board, serving until 2019.

On his presidency, Dr Ludwa stated:  "Clearly the coronavirus pandemic will inevitably loom large over my presidency. So, I am heartened the BDA has stepped up and shown real leadership when it hasn't always been forthcoming from the authorities. This challenge, huge as it is, will dominate, but not define my term of office.”





Wales: CDO responds to local lockdown in Rhondda Cynon Taf


The CDO for Wales, Dr Colette Bridgman, has advised that the latest Standard Operating Procedures for Wales remain as guidance for those working in areas under new lockdown measures.


Dr Bridgman reiterated the message that as long as practices are following the SOPs, then the dental team, the patient and subsequent patients are safe. There will be no need to return to red alert, or even heightened amber, unless staff in the practice are in higher risk groups.


Local lockdowns have generated discussion on three key areas:


1. Travel

While  some health boards may ask dentists not to see patients for routine checks to reduce travel in or out of area, Dr Bridgman is clear she has built clinical judgment and flexibility into the SOP as it is important that the recovery in dentistry continues.


The Welsh Government have said that justification for travel in local lockdown would include ‘to attend healthcare appointments’ – no reference was made to whether that is for essential or routine.


2. Urgent vs routine care

The CDO is still asking NHS providers to ensure urgent needs are met first before resuming routine checks etc. It is assumed all practitioners will exercise similar caution as we all need to contribute to supressing this virus in communities.


It is also necessary to resume dental care, so it is a balance between direct and indirect harm from COVID-19. Routine dental treatment to address back log of delayed care and routine check and assessment of patients who are at risk is essential to healthcare delivery in dentistry.


3. Social distancing

It appears that a lack of social distancing in staff rooms, car sharing and not wearing masks in healthcare team settings (including in dental practices) could be the reason that some staff are testing positive.
The SOP does make reference to keeping up to date with local circumstances and the fact that the amber phase is and can be dynamic. Dr Bridgman is clear that clinical judgement and flexibility are needed here, particularly for private elements of practice which are not receiving the same financial support as NHS providers.





Northern Ireland: Additional payments issued to maternity cases


After several months of campaigning for fairer financial support payments for female dentists on maternity leave during the 19/20 reference period, additional payments have finally been made.


This payment should be reflected in the August-September schedules just issued.


We advise our members to whom this applies to please check your schedule for references to additional maternity payments.


We want to thank the members of the NI Assembly Health Committee for supporting us in having this issue addressed.





Diversity equality, PPE and PAPR hoods
Dr Singh, a Sikh dental surgeon from Suffolk, failed his fit-test (for enhanced PPE) despite passing the exercises. The reason came down to his beard and turban, which according to the guidance, interfere with the border of the masks and hence reduce their efficacy.
Trying to tackle the issue of diversity equality in PPE, Dr Singh road tested various PAPR hoods in the hope the answer lay in the loose head piece that does not require fit-testing. Unfortunately, as Dr Sign outlines in his blog, this was not to be. 
Read Coronavirus: Why PAPR hoods are not the solution Sikh dentists need.



Wednesday 16 September 2020



Join our presidential meeting this evening from 8pm


In what will be the first online presidential installation in the history of the BDA, this evening we'll be welcoming our new president Russ Ladwa and saying farewell to current president, Roz McMullan. Both Russ and Roz will delivering speeches.


Register to attend the online meeting - Wednesday 16 September at 8pm.





Elections: Do you want to represent your profession?


Nominations are open 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.





Video for members: What you need to know about abatement in England


Since NHS England announced abatement would be 16.75%, we've been inundated with queries about what this means and how it will affect your NHS income.


We have put together a short film of essential advice for members detailing what you need to know about abatement in England right now .


The film answers the following three questions:


1. What does abatement for NHS contracts mean?

2. How does abatement affect what I pay my associates?

3. What do I do if my practice owner doesn’t pay me what I am due?





Webinar: Dealing with difficult patients


It will likely be some time before dental services return to what patients previously experienced as normal. So now, more than ever, knowing how best to deal with your patients is essential.


We're hosting an hour-long webinar tomorrow, covering practical tips to help you and your team put patients at ease, build rapport, defuse difficult situations and prevent complaints escalating.


Register for our Dealing with difficult patients webinar.





New publication: Guiding principles to mitigate risk


The Dental Schools Council and the Association of Dental Hospitals have today published a report outlining guiding principles for open plan clinics.


The purpose of the document is to support all UK/Irish dental hospitals and schools towards the safe return to educational placement provision within open plan clinics.



Tuesday 15 September 2020



Business Interruption Insurance: High Court rules in favour of policyholders


The High Court has today ruled in favour of a number of the arguments advanced for Business Interruption Insurance policy holders by the Financial Conduct Authority (FCA).
The FCA brought the test case against 8 insurance companies representing 21 different insurance policies, and the result is likely to affect claims by some 350,000 small and medium sized firms, including many dental practices and laboratories.


The BDA was the first trade union or professional body to directly engage with the FCA following the failure of most polices to pay out for losses incurred during the pandemic.  A number of policies held by BDA members were considered by the High Court either directly or as a result of being in very similar terms to one of the 21 sample policies considered.


Each policy will now need to be considered against the detailed judgment to work out what it means for policyholders.  Whilst those policies with “Disease” wordings are likely to benefit from the decision, the High Court has taken a more restrictive approach to “Prevention of Access” clauses and the impact of that approach is now being worked through.


Those with affected claims can expect to hear from their insurer within the next seven days.  The FCA has confirmed that although policyholders will be pleased to see a decision in their favour, the eight defendant insurers are not liable across each and every one of the 21 different types of policy wording in the representative sample considered by the High Court.


Today's judgment is complex, running to over 150 pages and deals with many issues. It remains possible that one or more of the insurance companies involved could now lodge an appeal, in respect of which they have been urged by the FCA to indicate their intention to do so as quickly as possible.





Join our presidential meeting


In what will be the first online presidential installation in the history of the BDA, on Wednesday evening we'll be welcoming our new president Russ Ladwa and saying farewell to current president, Roz McMullan. Both Russ and Roz will delivering speeches.


Register to attend the online meeting - Wednesday 16 September at 8pm.





The dental profession’s mental health crisis


Promoting wellbeing and looking at the causes of stress and burnout are key strategic aims for us. Since the COVID-19 pandemic hit, we've had consistent feedback that pressure and stress have increased.


In a new blog, our Chair, Mick Armstrong looks at the ongoing impact, discusses the case we presented to the Health and Social Care Committee's inquiry into workforce burnout and sets out what we need for dentistry going forward.


Read: The dental profession's mental health crisis: what needs to happen.





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:


  • Last Saturday, the 6.30pm news bulletin on BBC 1 Wales highlighted that it could be next year before the backlog of dental cases could be treated. The segment also featured a warning from BDA chair of the Welsh general dental committee, Tom Bysouth, that many of Wales’ 500 dental surgeries were facing the threat of redundancies or even closure. The presenter added that the BDA has called for support for dental practices.

  • Many of Wales’ 500 dental surgeries are facing the threat of redundancies or even closure: the chair of BDA’s Welsh general practitioners committee, Tom Bysouth, told the BBC that dentists are "firefighting" to deal with a "huge backlog" and will not catch up until 2021.

  • During an interview with Danny Kelly on BBC Radio West Midlands, BDA vice chair, Eddie Crouch said that at least 10 million check-ups have been lost since February.





England: Urgent call for action plan on tooth extractions


Alongside sector leaders and learning disability charity Mencap, we are urging the Health Minister, Matt Hancock to set out a crucial action plan to ease the backlog on tooth extractions in hospitals.


In an open letter to the Health Secretary, we have all called on the government to publish an internal Public Health England review into the true scale of extractions under general anaesthetic, which is thought to be significantly understated in official statistics.


Our letter warns that many young and vulnerable patients across England are now expected to see waiting times of up to a year lengthen significantly.
Extractions, performed under general anaesthetic on children and adults some with a complex mix of medical conditions, including autism and learning difficulties, are the responsibility of community dental services and hospital dental services.


Our frontline intelligence from across the English regions suggest that many services have yet to resume treatment since the start of lockdown. Furthermore, capacity has often halved to meet social distancing and additional infection control procedures.
Tooth decay has been the number one reason for hospital admissions among young children, with recent analysis by the Local Government Association indicating 180 procedures took place every working day in England in 2018/19 on patients aged under 18.





Scotland: Expired PPE concerns raised with Minister and CDO


We have written to the Chief Dental Officer and the Minister for Public Health, Sport and Wellbeing to highlight our concerns about dentists being supplied with enhanced PPS that is past its expiry date. We are aware of the consternation that our recent press release about out-of-date PPE caused among the profession and within the Scottish Government, and took the opportunity to explain our stance on the issue.


The issue of expired PPE without seemingly robust verification only recently came to light, when GDPs started receiving boxes of 3M 1863 masks to allow them to carry out AGPs in practices. Some of these masks dated back to 2001 and had expiry dates going back to 2012. We repeatedly sought firm evidence from National Services Scotland (NSS) that expired masks have been robustly assessed and are safe to use. Given the lack of reassurance we received, as the trade union for dentists we felt compelled to highlight this issue in the interests of the safety of dentists, their teams and patients.


Many dentists willingly donated their PPE to hospices, pharmacies and hospitals at the onset of the pandemic. In return, NSS has supplied out-of-date masks, and no strong evidence they are safe to use. That is unacceptable. We have called on NSS to make alternative arrangements for supplying ‘in date’ PPE to dentists as soon as possible.



Monday 14 September 2020



England: Further update on NHS contracts


It is now almost two months since NHS England set out the current contractual arrangements for general dental practice in England.

As that letter made clear, further work was to take place with the BDA to develop the contractual framework for the rest of this financial year. This should reflect the gradually increasing activity levels, whilst also recognising continuing constrained capacity due to infection prevention and control guidance and ongoing social distancing requirements.

There has been some anticipation that any revised arrangements would begin half way through the current financial year (i.e. from the beginning of October) and we have had queries as to when there would be clarification about changes.

We wanted to update that discussions between the BDA and NHS England are ongoing. We know that practices and dentists will want to have reasonable notice and clear advice about any changes and we will seek to ensure that practices get time to prepare. We will update further when there is more to share.

In the meantime, practices are reminded that the current requirement to deliver 20% volume of care in order 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. Levels of NHS care will continue to be monitored via returns to NHS BSA.





Free coaching support for NHS dentists and teams in England


Dentists and their teams working under an NHS contract in primary care in England can now access a coaching service run by NHS England and NHS Improvement, which aims to support frontline staff's wellbeing during the challenges of the Coronavirus pandemic.

Available seven days a week, staff can book a slot with experienced coaches at a date and time that suits them.

The offer provides staff in clinical and non-clinical roles across primary care the opportunity to process their experiences, develop coping skills, deal with difficult conversations and develop strategies for self-management in challenging circumstances.

Coaching sessions will continue throughout the COVID-19 pandemic until at least March 2021.

The support is provided independently of your employer, and your employer will not be notified that you are accessing this service, unless you choose to tell them.





Side agreements for associates in England and Wales

We have produced side agreements to help practice owners and associates in England and Wales adapt their pre-coronavirus commercial arrangements to the current situation.


This agreement suspends the operation of UDAs and requires both parties to adhere to guidance from NHS England and the Health Board in Wales. This includes guidance on pay and requirements for providing dental services.

The side agreements are designed to complement the BDA written associate agreements.





MPs join call for targeted Furlough extension


Parliament's Treasury Committee has published its second report on the Economic impact of coronavirus: the challenges of recovery.


Over the summer we set out our case to MPs on the changes needed to support this service, and we welcome that they've backed targeted extensions to the Coronavirus Job Retention (or furlough) Scheme.


Furlough is one of the few lifelines nearly all practices have benefited from.


Up to 80 per cent of practices have made use of the scheme to cover staff in proportion to their private work. And with the service still running at such limited capacity, a 'one size fits all' approach to phase down will hit practices, as well as colleagues in the laboratory sector.
We have already urged the Chancellor to set out his response on furlough extension and other key recommendations set out in a recent report on the resilience of dental practices.





Northern Ireland: Write to your MLA today


Tomorrow an important motion will be debated in the Northern Ireland Assembly and we need your help to ensure that dentists are included.


John Stewart MLA is calling on the Economy Minister to establish a new fit for purpose business hardship fund for those businesses and individuals who have so far been excluded from accessing any financial support. We have asked that the plight of mixed/private dentistry is mentioned in Mr Stewart MLA's opening remarks.


We are asking all of our members in Northern Ireland who this affects to please write to your MLAs before tomorrow and share your experiences.


We have persistently lobbied the NI Executive for additional support for mixed/private-practices in relation to private earnings over the past five months and this is an important step that we can achieve together.