Friday 26 June 2020
20:30
Weekly roundup
Here's my weekly roundup of the major things that happened this week in relation to the COVID-19 pandemic and UK dentistry. I hope you find it useful.
Useful links
15:45
England: Risk assessments for at-risk groups
NHS England and NHS Improvement have sent
a letter to dental practices regarding risk assessments for at-risk staff.
Some staff are reporting that they are yet to have their risk assessments. NHS has asked that all employers deploy risk assessments within the next two weeks and complete them within four weeks.
They are asking for the following metrics to be published following on from staff reviews:
- Number of staff risk-assessed and percentage of whole workforce
- Number of black, Asian and minority ethnic (BAME) staff
- Percentage of staff risk-assessed by staff group
- Additional mitigation over and above the individual risk assessments in settings where infection rates are highest.
The BDA has
a risk assessment
that all members can download, as well as
further guidance on risk assessments
should you need it.
13:45
Wales: Clarifying NHS contract plans
This week, some members of the Welsh GDPC and the BDA Welsh Council met with the CDO for Wales, Dr Colette Bridgman to primarily discuss the proposed NHS dental pandemic recovery plan and how this will work with the NHS contract in Wales.
An FAQ sheet is being developed by Welsh GDPC which will be released shortly.
13:25
Northern Ireland: Avoiding a catastrophe in dentistry
Yesterday, Richard Graham (Chair of the Northern Ireland Dental Practice committee), Caroline Lappin (NI Council Chair) and Tristen Kelso (NI Director) all gave evidence to the Northern Ireland Assembly Health Committee on the impact of the pandemic on dental services in Northern Ireland.
You can
watch the Assembly Health Committee and hear their evidence here
(it starts at 2 hrs 12min).
In his blog:
Avoiding a catastrophe in Northern Ireland dentistry, Richard puts forward his case in more detail.
11:13
Scotland – Phase 3 discussions begin
We had an initial meeting with the CDO and Scottish Government yesterday about plans for Phase 3. This follows the Scottish Government’s announcement on Wednesday that dental practices may be able to move to Phase 3 of reopening from 13 July. This will involve practices beginning to see registered patients for non-AGP routine care.
We discussed a range of issues, including PPE supplies, practice arrangements and the funding package. The CDO and Scottish Government are working on all these areas and we plan to meet with them again next week to discuss further.
Thursday 25 June 2020
17:02
Scotland: Date announced for next phase of return to practice
The Scottish Government has announced Monday 13 July as
an indicative date that dental practices can move to Phase 3 of lockdown easing.
This will involve practices beginning to see registered patients for non-aerosol routine care, and work will begin to return aerosol generating procedures to practice safely.
Work is under way to develop a revised Statement of Dental Remuneration for Phase 3 – our Scottish Dental Practice Committee is represented in these discussions.
16:41
Virtual wellbeing support for members
While restrictions are being gradually eased, they are not the same in every region. To compliment your access to counselling and emotional support you may need further support such as mental health first aid training, or support after a critical incident.
Health Assured’s extensive range of additional services are available to members during the pandemic. Expert advisors and trained clinical staff can deliver virtual support - just as effectively and compassionately as in-person. Mental health first aid training, wellbeing workshops and critical incident stress management are included.
15:12
Northern Ireland: Future of dental services in doubt without action from government
Today we told the Assembly Committee for Health that the future of dental services in Northern Ireland are now hanging in the balance.
In
oral evidence presented at 12:30 today, we explained that dental practices are set to resume face to face care later this month at a fraction of their pre-pandemic capacity, limited by PPE costs and shortages, and requirements to meet strict social distancing and decontamination guidelines.
NI dental leaders have said the combination of lower patient numbers and higher costs will have a devastating impact on high street services. We have warned the very system on which Health Service dentistry operates - the item of service - which sees dentists remunerated on the basis of treatments delivered, will be unable to cope with an expected collapse in patient numbers unless the government is willing to offer long term support or change the current model.
The Department of Health has intimated existing support packages could be wound down after August, and any future support will have to be ‘subject to the confines of the dental budget’.
Dentists will be able to provide non-urgent care to the public from 29 June, with aerosol generating procedures (AGPs) using high-speed instruments scheduled to start from 20 July. A majority of the practices that have reopened in England are operating at less than a quarter of their pre-COVID capacity.
Richard Graham, Chair of the BDA’s Northern Ireland Dental Practice Committee said: “The future of dental services in Northern Ireland now hangs in the balance.
Without adequate ongoing support from government it is frankly impossible to sustain a model based on activity when activity has fallen through the floor. In addition, clarity on last week’s commitment to provide PPE support is needed urgently.
Dentists need support, and a conversation must start on finding a new way to restore confidence in the sector.”
14:40
Toolkit for returning to face-to-face care
Our
returning to face-to-face care toolkits support dentists to reopen as safely and efficiently as possible.
The latest version of our toolkit for England was updated on 19 June 2020.
The new version includes updated information on:
- Face masks for all staff p7 and 9
- Ventilation measures p29
- Solution when using rubber dams p30
- Fit testing cover from BDA Indemnity p32
- UK guidance reference on FFP2/3 masks p34
- Scrub washing instructions p36
- Fallow time after AGPs p43
Scotland
We have adapted our toolkit for members in Scotland. It will support you and your team to resume practising as safely and efficiently as possible.
The document references the Scottish Dental Clinical Effectiveness Programme's (SDCEP) published guidance where there are (minimal) differences in approach to England.
Northern Ireland
Our NI team and committees have been heavily involved in the production of government guidance. Where comprehensive guidance already exists, we don’t want make the lives of members more complicated by asking them to read or comply with more than is necessary.
Wales
We understand that the Welsh Government is producing additional guidance to help dental teams complete ACORN forms for patients, both routine and urgent. BDA Wales and WGDPC are pressing to ensure that documents are clear, measured and do not overtly add to practice stressors. We will keep you updated.
11:57
Northern Ireland: Health Committee evidence
At 12:30 today, Richard Graham, Chair of the NIDPC, will be giving evidence to the Northern Ireland Assembly Health Committee on the impact of the pandemic on dental services.
We will have more updates on this following the session.
11:00
Important information on air conditioners
Many of you have been seeking advice on what to do about air conditioning within your practice, especially during the current high temperatures.
According to the Health and Safety Executive (HSE), the risk of air conditioning spreading Coronavirus in the workplace is extremely low.
As stated on its website: "You can continue using most types of air conditioning system as normal. But, if you use a centralised ventilations system that removes and circulates air to different rooms it is recommended that you turn off recirculation and use a fresh air supply.
You do not need to adjust air conditioning systems that mix some of the extracted air with fresh air and return it to the room as this increases the fresh air ventilation rate. Also, you do not need to adjust systems in individual rooms or portable units as these operate on 100% recirculation.
If you’re unsure, ask the advice of your heating ventilation and air conditioning (HVAC) engineer or adviser."
The HSE also confirms that employers must, by law, ensure an adequate supply of fresh air in the workplace.
Good ventilation can help reduce the risk of spreading coronavirus, so focus on improving general ventilation, preferably through fresh air or mechanical systems.
Where possible, consider ways to increase the supply of fresh air, for example, by opening windows and doors (unless fire doors).
Also consider if you can, improving the circulation of outside air and prevent pockets of stagnant air in occupied spaces. You can do this by using ceiling fans, desk fans or opening windows, for example.
The risk of transmission through the use of ceiling and desk fans is extremely low.
09:20
England: Associates in disputes over NHS payments
NHS England advises associates with concerns about not receiving previous NHS earnings, or indeed having their contract terminated, to bring this to the attention of their local NHS area team. The local area team is the body responsible for the management of NHS dental contracts. The contact details for the local teams can be found on
page three of the Letter of preparedness dated 20 March.
In late March we secured commitment from NHS England that practice owners would be required to ensure that all staff including associates, non-clinical and others continue to be paid at previous levels.
We know that the vast majority of contract holders have done the right thing and continued to make payments to associates and other staff. Some pay disputes have been resolved fairly but many are now stuck awaiting a framework to enforce action.
To address the issue we proposed a temporary legislative solution to ensure that we were able to use more than words to influence a practice owner not making appropriate payments. We know that discussions have been taking place with the Department of Health and Social Care, but we’ve told NHS England we need resolution of this issue now so that we can make sure that all associates are treated fairly.
Until we hear back from NHS England, our attempts to resolve associate members’ situations are hampered. Please be assured that we will keep up the pressure and update those who have logged cases when we have information. The moment we have a way forward we will resume this service.
Wednesday 24 June 2020
17:08
Upcoming webinar: Predictable placement of rubber dam
In partnership with Health Education England, next Thursday (2 July 2020), we invite you to register for an hour-long
webinar covering quick, easy and predictable techniques for the placement of rubber dam.
The session includes video demonstrations and offers an opportunity to ask questions.
Learning objectives:
- Familiarise participants with quick and easy techniques for the placement of rubber dam
- Know the criteria for equipment selection
- Develop a predictable methodology to isolate the operation field, even in difficult situations
- Have an appreciation of alternative methods for isolation
- Understand the role of the dental nurse in the quick delivery and placement of rubber dam
- Be able to isolate a single tooth as well as quadrants with rubber dam in a consistent and efficient manner for various clinical situations.
16:15
England: Respirator fit testing
Plans are in place to train 560 fit testers from the dental sector across NHS regions, who will each fit test colleagues in local practices.
Once trained, fit testers will be provided with a fit testing kit to enable them to begin testing in their region. NHS England and Improvement is arranging for fit testers to be engaged under an honorary agreement for these activities, which will cover any liabilities arising through that agreement.
For further details on local arrangements, please contact your local regional dental team.
15:40
PPE and fit-testing: what you need to know
Dentists have two important challenges in terms of PPE and COVID-19. The first is sourcing the right equipment. The second is getting it correctly fitted.
In his blog, Tarik Shembesh, a dentist who is leading the fit-testing program in London's urgent dental centres, shares
10 things you need to know about fit-testing PPE and the dental practice.
14:15
England: Confirmation from NHS England on payments
We have received confirmation from NHS England on a number of issues related to the payment of associates and employed staff.
For clarity on issues related to NHS associates and sick pay, pay during self-isolation, pay during continued redeployment, see our
financial impact page.
For advice on the rights of employed NHS staff, see
question 21 on our FAQ page.
12:20
Three things you can do for your mental wellbeing
BDA president Roz McMullan supported front line staff in a Northern Ireland hospital during the early weeks of the COVID-19 outbreak.
She reflects on the increasing levels of stress dentists are under and looks at three strategies for mitigating it.
If you want to hear more from Roz on this topic, register for her webinar:
Understanding your wellbeing in a COVID-19 world taking place,
tomorrow from 19:30-20:30.
11:40
Funding for oral and dental health research
The National Institute for Health Research (NIHR) is interested in receiving research proposals promoting good oral and dental health which might include COVID-19-related dental research.
Details on how to apply.
10:32
Webinar: Resuming dentistry - what does the guidance say?
Our head of Indemnity, Len D'Cruz will be joining CDO Sara Hurley and other speakers at the LDC Confederation's webinar on resuming dentistry tomorrow (Thursday 25 June) from 19.00 - 20.00.
The webinar will explore how practices can safely return to practice and transition to providing the full range of dental provision.
Register for the webinar.
A recording will be made available following the webinar. Questions can be submitted in advance.
08:30
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Tuesday 23 June 2020
17:50
Return to practice advice
We have worked with the Scottish Dental Clinical Effectiveness Programme on their
comparison of the five main documents advising on return to dental practice, which has been published today.
The short paper has been produced with the agreement and involvement of all the source organisations and sets out that, whilst the five main documents are structured differently, their content is largely similar.
16:50
Northern Ireland: DOH clarifies Financial Support Scheme
Dentists in Northern Ireland have today received
an update on the Financial Support Scheme (FSS) from the Department of Health. The FSS will continue in its current form for July and August.
However, the Department intends to amend the FSS to a scheme that encourages dental ‘activity’ in September. Further details of this scheme have not yet been released.
We will update you as soon as we know more.
16:45
Members: We've made these tools for you
We've been producing a series of helpful tools to help members through some of the more complex areas of the current crisis. We hope you'll find them useful. You will need to be logged in to access them.
Toolkit for returning to face-to-face care
Download our returning to face-to-face care toolkit to support dentists to reopen as safely and efficiently as possible. Already downloaded it? Check that you have the latest version.
Furlough calculator for mixed practices
- Mixed practices can use this tool to
calculate the amount of money you are entitled to claim from the Government
if you are furloughing some of your staff for a given period of time. To make it easier we've made a
demo video on using the furlough calculator.
- We have also drafted a
letter for members with mixed practices
to give to staff to explain the situation and seek their agreement to be furloughed workers.
Webinars
Our
webinar on financial packages
, furloughing and retaining your staff, and paying associates in NHS and mixed practice is available to watch in four edited videos. We have also made available the slideshow that our expert advisors referred to during the webinar.
Other webinars available to members:
Pay dispute resolution service for associates
Corporate bodies and practice owners with NHS contracts will continue to be paid on the condition (among others) that they pass on income due to associates. If you encounter issues, we will take them up on your behalf. See more about
logging your pay dispute with us.
Remote consultation guide
We've put together guidance on
how to conduct a remote consultation
with your patients and avoid some of the common pitfalls.
Risk assessment
We created a
risk assessment
to support members in providing urgent care risk assessment to support members in providing face-to-face care. We've also updated it with guidance on record-keeping for NHS practices and triaging.
NHS Mail account for private practices
It's important that private practices have access to an NHS email account. Without one, it will make it much harder for you to be able to make referrals to UDCs and issue prescriptions. To set it up you need to answer 14 questions on data management and security. Here's our
guide on how best to answer these questions
24/7 counselling and support
This is a particularly stressful time to be a dentist. Members can access
our 24/7 counselling service Health Assured and we encourage you to reach out.
14:10
Scotland: Financial support information updated
The Practitioner Services Division (PSD) has updated its
FAQs on COVID-19 NHS financial support payments.
The FAQs have been updated in response to members' queries since the Scottish Government confirmed that NHS financial support payments will remain in place as practices reopen to treat NHS patients from 22 June.
Updates include information for Vocational Trainers and Vocational Dental Practitioners, and for dentists who:
- Have not worked in Scotland for a full 12 months
- Are about to return from maternity leave
- Have been on long-term sick leave.
10:30
Using PPE safely
Join over 5,000 other dental professionals who have completed our PPE CPD course. Watch the video, answer the questions and receive a certificate on using personal protective equipment.
10:00
Scotland: Toolkit for members returning to face-to-face care
We have adapted our toolkit for members in Scotland. It will support you and your team to resume practising as safely and efficiently as possible.
The document references the Scottish Dental Clinical Effectiveness Programme's (SDCEP) published guidance where there are (minimal) differences in approach to England.
Download the toolkit.
09:15
Letter to NHS England re outstanding contractual issues
Dave Cottam, Chair of the General Dental Practice Committee, has
written to NHS England and NHS Improvement in frustration that we are still awaiting a resolution on essential issues.
We need progress on our proposal for a temporary legislative solution to ensure that appropriate payments are made to associates. Without that framework in place we cannot assist our associate members with their pay disputes.
We are also waiting for an answer to the question of how much of a reduction for variable costs associated with service delivery would be applied to contract values.
Monday 22 June 2020
16:45
Dental articles on COVID-19
You can now access a selection of dental articles related to COVID-19 and dentistry through our library’s newly created
virtual packages. This list will be updated regularly.
16:05
Scotland: Seeking financial support for mixed practices
Dentists in Scotland can reopen from today. However, we have been advised by colleagues that some practices cannot afford to reopen, or will face severe financial difficulties due to increased costs of paying unfurloughed staff as well as materials and lab bills.
We have written – again – to the Cabinet Secretary for Finance seeking additional financial support for mixed practices, especially those with a high percentage of private income.
Mixed practices make up the vast majority of practices in Scotland, and it is vital that they remain viable to meet a huge oral health backlog since practices closed in March due to the pandemic crisis.
14:25
Scotland: Toolkit for members returning to face-to-face care
We have adapted our toolkit for members in Scotland. It will support you and your team to resume practising as safely and efficiently as possible.
The document references the Scottish Dental Clinical Effectiveness Programme’s (SDCEP) published guidance where there are (minimal) differences in approach to England.
Download the toolkit.
13:45
Wales: Red alert to be lifted today
The CDO Wales, Dr Colette Bridgman, confirmed on Friday that the Welsh Government will be
lifting the red alert in dentistry from today. This corresponds to the First Minister's announcement also on Friday, that there will be an easing of lockdown measures from today.
In this phase, dental practices will able to provide more care and treatment for patients. However, practices will need to make sure that measures are in place to ensure a safe environment for staff and patients.
Social distancing and infection control measures will mean that fewer patients can be seen, so dental teams are being asked to prioritise those who need more urgent care.
Dental practices who are ready to do so can treat more patients ahead of the earlier planned date of 1 July.
12:20
Seeking guidance on fallow time after AGPs
The current guidance for fallow time - the length of time when the surgery room is closed to allow the aerosol to settle after an AGP - is 60 minutes. However there is a shortage of evidence to explain the effectiveness of this time period. Many countries either have no fallow time for AGPs or a very short period.
We are pressing government agencies and other organisations to provide the evidence for this guidance as it has a significant impact on the delivery of care to patients, access to dental services and the viability of dental practices in the high street.
We have more information on fallow time in the latest version of our
Returning to work toolkit (p43).
11:32
Three things you can do for your mental wellbeing
BDA president Roz McMullan supported front line staff in a Northern Ireland hospital during the early weeks of the COVID-19 outbreak.
Here she reflects on the increasing levels of stress dentists are under and looks at three strategies for mitigating it.
If you want to hear more from Roz on this topic, register for her webinar:
Understanding your wellbeing in a COVID-19 world on Thursday at 19:30-20:30.
09:00
England: New version of toolkit available for download
The latest version of our returning to face-to-face care toolkit is now available for download.
The new version includes updated information on:
- Face masks for all staff p7 and 9
- Ventilation measures p29
- Solution when using rubber dams p30
- Fit testing cover from BDA Indemnity p32
- UK guidance reference on FFP2/3 masks p34
- Scrub washing instructions p36
- Fallow time after AGPs p43
Download the toolkit.
