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Updates from week commencing 26 October 2020

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

Sunday 1 November 2020

15:20

 

England lockdown from 5 November

 

Following the Prime Minister’s announcement on Saturday evening, we are seeking urgent clarification as to the position of dental services during the four week period of additional restrictions from 5 November.

 

Based on the Government guidance so far published our interpretation is that dental practices will continue to operate as at present. The guidance says that individuals can be outside of their homes for specific purposes, which include ‘for any medical concerns, reasons, appointments and emergencies’.

 

The guidance also says that:

 

‘A number of public services will also stay open and you will be able to leave home to visit them. These include... the NHS and medical services like GPs. We are supporting the NHS to safely carry out urgent and non-urgent services and it is vital anyone who thinks they need any kind of medical care comes forward and seeks help.’

 

Our view is that this includes dentistry, but we are seeking confirmation and will update you as soon as we have more information.

 

There is no reason why practices should shut.

 

Dental teams have risen to the challenge during the pandemic and are delivering vital care while ensuring the safety of both staff and patients.

 


Friday 30 October 2020

15:10

 

England: Download our updated toolkit

 

An updated edition of our toolkit for providing care in the context of COVID-19 is now available for members. This version includes the latest guidance from the revised Standard Operating Procedure for England, published earlier this week. It is designed to support you and your team to practise as safely and efficiently as possible.

 

This latest version for England now includes guidance on:

 

  • Isolating (p9)
  • Risk assessment for pregnancy (p10)
  • NHS Test and Trace (p10)
  • Fallow time (p30)
  • Mitigation and air changes (p31)

As well as updates on the following areas:

 

  • Pregnancy (p10, 19)
  • Job retention and support schemes (p17)
  • Workers support scheme (p20)
  • Changes to associate contracts (p23)
  • Training (p25)
  • AGPs (p47)

Download the toolkit for England

 

Our updated toolkits for Wales and Scotland will be available for download soon.

 


 

13:40

 

Scotland: Revised operational guidance issued

 

Revised Standard Operating Procedures (SOPs) have been published for dentists in Scotland. These follow SDCEP's recent rapid review of AGPs and publication of the 4-nation dental Infection Prevention and Control Guidance.

 

Dentists can offer a full range of NHS treatments from 1 November, although it will not be business as usual. Complex issues such as physical distancing, fallow time and the use of enhanced PPE will limit the volume of care that may be provided. The revised guidance includes updated fallow times following AGPs depending on ventilation and other factors.

 

While the guidance is not prescriptive, dentists will be expected to apply it to their individual settings and adapt it to allow for minor local variations.

 


 

11:39

 

Dealing with difficult patients

 

We are seeing reports of some patients complaining about or refusing to cooperate with social distancing and mask wearing in dental practices. There may be various reasons for this, such as medical issues or a general unhappiness with the restrictive nature of the rules. Unfortunately, as the weather gets worse this winter, and people continue to be asked to wait outside dental surgeries, these complaints are likely to continue. 

 

If this situation arises in your practice, we encourage you to calmly explain to patients that the practice must follow government guidelines. Tell patients that compliance is essential for patient and staff safety, and that the practice's insurance cover may also depend on it. The practice's visible signs of compliance such as screens, hand sanitising, social distancing signage, mask wearing and PPE use will demonstrate your own commitment to following the rules, most of which is a legal requirement to be a COVID-safe workplace. This is a difficult situation for all concerned, but we hope that by staying calm and reminding patients of the reasons for the inconvenience, you can avoid any negative incidents with patients. 

 


 

10:03

 

Blog: How a ventilation upgrade saved my practice

 

Since the outbreak of the pandemic, dentists have been concerned about ventilation in practices and the transmission of COVID-19.

 

Following this week's revised guidance on fallow times and AGPs, a practice owner in Yorkshire tells us how he upgraded the ventilation in his practice and the impact that it has had on their capacity.

 

"Installation work began three weeks after we were allowed to return to face-to-face care in June… Our fallow time is now down to 20 minutes and we are seeing four times as many patients than we were after lockdown. The recommendations from the recent SDCEP report, published in September, followed by the new standard operating procedures this week reassure us that this was the right approach to take."

 

Read Cliff Palmer's blog: How a ventilation upgrade saved my practice

 


 

Thursday 29 October 2020

15:02

 

Advising record numbers of members  

 

Claire Bennett, employment lawyer and BDA Advisor, looks back at the start of the crisis and how we've been supporting members during the pandemic:

 

"I recently supported an associate who was stuck in what they felt was an intractable dispute with a practice owner. It took a little over six weeks, three hour-long phone calls and 37 emails to reach a resolution… [But] I was pleased to be able to resolve this contentious situation, and to help both the associate and the practice owner to move on.

 

In this way, I fight hard for each member I represent and I know my colleagues do too. At last count, our advice team had replied to 19,555 emails since March, an unprecedented number. This shows how hard we're working on members' behalf at this challenging time." 

 


 

13:44

 

Scotland: Revised operational guidance issued

 

Revised Standard Operating Procedures (SOPs) have been published for dentists in Scotland. These follow SDCEP's recent rapid review of AGPs and publication of the 4-nation dental Infection Prevention and Control Guidance.

 

Dentists can offer a full range of NHS treatments from 1 November, although it will not be business as usual. Complex issues such as physical distancing, fallow time and the use of enhanced PPE will limit the volume of care that may be provided. The revised guidance includes updated fallow times following AGPs depending on ventilation and other factors.

 

While the guidance is not prescriptive, dentists will be expected to apply it to their individual settings and adapt it to allow for minor local variations.

 


 

08:52


Donate blood plasma to fight COVID-19


In a recent blog, Emily Black shares her experience of getting coronavirus and calls on dentists and dental students to donate convalescent blood plasma to help fight the virus and save lives.


“Within two weeks of sending off an application form, I was learning how to handle national 111 calls specifically about COVID-19, as the South-Central Ambulance Service became the national hub taking any call related to coronavirus in England. Working on the phones, I saw how badly COVID-19 was hitting some people. It was one thing to hear it from the news, but another to speak to a breathless patient on the phone and send them an emergency ambulance.”


“I would encourage anyone who has been exposed to COVID-19, to consider donating their plasma for critically ill patients”


 



Wednesday 28 October 2020

17:35

 

Only three days left to access your nhs.net account

 

Dentists are asked to make sure that you access your NHS.net email address by 31 October. From the end of October, any email addresses that have not been accessed in the last 90 days (excluding the new practice email addresses) will be deleted.

 

Don't miss out. Your nhs.net email account is a secure way to communicate with colleagues and NHS Local offices. It gives you wider access to the Microsoft Office 365 suite, allowing you to:

 

  • Talk to and collaborate with NHSmail colleagues from different organisations and locations
  • Setup audio and video conference meetings in Exchange Online
  • Create a Teams site for project work, upload files and collaborate using persistent chat features
  • Download and access Teams features on your mobile device.

 


 

16:01

 

Northern Ireland: Clinical audit and peer review continue remotely

 

We'd like to remind practitioners in Northern Ireland that they can continue to undertake clinical audit and peer review sessions online. Both clinical audit and peer review are accepted as verifiable Continuing Professional Development (CPD) and are payable under the SDR.

 

A recent communication from the Acting Chief Dental Officer has confirmed that all six CPDA sessions may be claimed for online activity. There are 4 CPD development outcomes listed by the GDC.

 

Peer review involves 4-8 practitioners from at least two practices meeting to discuss topics relevant to their day to day practice, whether that's clinical, professional or managerial. For Clinical Audit groups should use a Clinical Audit facilitator to help them choose a topic and design their audit. There are facilitators in each of the Board areas. Contact details and more information can be found on the BSO website.

 


 

13:56

 

Sign up to our up-coming webinars

 

Our popular series of COVID-19 webinars continues, with up-coming webinars on a variety of subjects. Don't miss out, register your place today:

 

 


 

13:05

 

England: PPE reimbursement for NHS dental practices

 

NHS England are working to develop a process to reimburse primary care contractors for the additional PPE they have purchased to meet the COVID-19 infection control requirements from 27 February 2020. Information on the process and cut-off dates for this reimbursement exercise will be announced shortly, and you should register with the PPE Portal to ensure you can continue accessing PPE free of charge.

 

COVID-19 PPE is classed as the PPE that providers are required to use over and above Business-as-usual (BAU) use, due to COVID-19 infection control guidance, rather than what would have been used pre-pandemic. Any PPE obtained from a source other than the PPE Portal after the cut-off date(s) will not be reimbursed. We will update you once more information becomes available.

 


 

11:24

 

Improving ventilation to increase capacity

 

Since the outbreak of the pandemic, dentists have been concerned about ventilation in practices and the transmission of COVID-19. After yesterday's publication of new guidance on fallow times and AGPs, a practice owner in Yorkshire tells us how he upgraded the ventilation in his practice and the impact that it has had on their capacity. 

 

"Installation work began three weeks after we were allowed to return to face-to-face care in June… Our fallow time is now down to 20 minutes and we are seeing four times as many patients than we were after lockdown. The recommendations from the recent SDCEP report, published in September, followed by the new standard operating procedures this week reassure us that this was the right approach to take."

 


 

Tuesday 27 October 2020

17:29

 

England: Revised SOPs see changes to masks and fallow time 

 

NHS England has issued revised Standard Operating Procedures (SOPs) for dentistry during the COVID-19 pandemic. These new SOPs follow on from the recent rapid review into COVID-19 and aerosol-generating procedures, and incorporate the recently published COVID-19: infection prevention and control dental appendix.  

 

Regarding fallow time and Aerosol Generating Procedures (AGPs), the revised SOPs say that where a surgery's ventilation system can achieve 6 to 9 Air Changes/Hour (ACH), a baseline post AGP downtime of 20 minutes is recommended. Where there are 10 or more ACH, a baseline post AGP downtime of 15 minutes is recommended.

 

The SOPs also confirm that FFP3 masks are recommended for AGP procedures. However, the Office of the CDO has also indicated that where there are existing stocks of FFP2 masks, it is understood that it may be necessary for practices to continue to use these until staff are successfully fit tested and supplied with the appropriate FFP3 mask.

 

Practices/providers are advised to have a plan in place to demonstrate to the CQC the steps they are taking to complete the transition to FFP3 masks for AGPs in a timely and safe manner. We understand that FFP3 masks are to be made available via the NHS portal.

 

Our toolkit for practices in England is being updated to account for these changes. We will update you once it is available for you to download.

 


 

16:03

 

Diversity and the reduction of oral health inequalities

 

In a recent blog, the managing director of a dental practice in Earlsfield, South West London, tells us why diversity and representation is important in dentistry, and how it can support the reduction of inequalities.

 

"Some of our patients had never been to regular check-ups or seen the hygienist before, the preventative side of care is all new to them. It's great to see them trusting us and trying it out… I'm pleased that our work is contributing to an expansion of those from a range of different backgrounds and walks of life seeking preventative care, which in turn is promoting a reduction in oral health inequalities." 

 


 

13:09

 

Dealing with difficult patients 

 

We are seeing reports of some patients complaining about or refusing to cooperate with social distancing and mask wearing in dental practices. There may be various reasons for this, such as medical issues or a general unhappiness with the restrictive nature of the rules. Unfortunately, as the weather gets worse this winter, and people continue to be asked to wait outside dental surgeries, these complaints are likely to continue. 

 

If this situation arises in your practice, we encourage you to calmly explain to patients that the practice must follow government guidelines. Tell patients that compliance is essential for patient and staff safety, and that the practice's insurance cover may also depend on it. The practice's visible signs of compliance such as screens, hand sanitising, social distancing signage, mask wearing and PPE use will demonstrate your own commitment to following the rules, most of which is a legal requirement to be a COVID-safe workplace. This is a difficult situation for all concerned, but we hope that by staying calm and reminding patients of the reasons for the inconvenience, you can avoid any negative incidents with patients. 

 


 

Monday 26 October 2020

16:30

 

Supporting your mental health and wellbeing

 

Studies show high levels of stress and burnout amongst UK dentists, with GDPs showing some of the highest levels of stress. That's why we're providing and highlighting some of the resources available to support you:

 

Three things you can do for your mental wellbeing: Former BDA president Roz McMullan worked to support the mental wellbeing of frontline staff during the crisis. Here she reflects on the level of stress dentists are under and looks at three strategies for mitigating it.

 

The mental health crisis in dentistry: what needs to happen: Former BDA Chair, Mick Armstrong sets out the case for action on preventative measures to ensure dentists' wellbeing is safeguarded during and after the pandemic.

 

BDA members can also receive counselling and emotional support through our Health Assured programme. Calling this confidential helpline can help you deal with personal and professional problems that could be affecting your home or work life, health and general wellbeing. It's open to all members 24/7, 365 days a year. 

 


 

15:30

 

Scotland: Further information on the return to full NHS treatment

 

We have warned of the increased pressure on dental practices and their financial sustainability following the release of further details on the return to full NHS treatments from 1 November.

 

We recognise the growing anxiety about an increasingly two-tier dental system in Scotland. However, now is not the time to expand the range of dental services, as virus transmission rates are increasing significantly.

 

The Scottish Government has also issued a revised Statement of Dental Remuneration (SDR) as a temporary measure for the next phase of reopening. We argued that a return to the pre-COVID SDR is not appropriate at this time, and we look forward to working with the Scottish Government to develop a suitable long-term funding model for NHS dentistry.

 

While we welcome additional funding announced by the Scottish Government, we remain concerned about the sustainability of many practices who may not be able to meet the prescribed activity levels due to extenuating circumstances, such as staff shielding and illness reducing activity within the dental team.

 


 

14:30

 

BDJ: Research and opinion on COVID-19 and dentistry

 

Make sure you're up-to-date on the latest research and commentary regarding COVID-19 and dentistry. The BDJ's collection of Coronavirus content brings together collection of letters, editorial and articles from the British Dental Journal, BDJ In Practice, BDJ Team and Evidence-Based Dentistry to make this easy for you. All the articles are free-to-view and the collection is updated regularly as new content is published.