Friday 9 July 2021
England: Revised guidance on phased courses of treatment
The Office of the Chief Dental Officer (OCDO) for England has issued a revised note for the avoidance of doubt on phased courses of treatment. The guidance has been updated to incorporate further information about prevention and how the guidance can apply to the treatment of periodontal disease. The note sets out when it may be appropriate to phase treatment over up to three courses of treatment and the processes that should be followed to do so.
Scotland: Government responds to maternity pay concerns
Following the Scottish Government's recent change to the calculation for maternity pay, we presented examples from colleagues of how the new arrangements were negatively impacting some dentists. Our main concern was that dentists who work part-time, particularly those who have higher earning potential over fewer working days, would be financially worse off.
We have now received a
response from the Scottish Government, saying that the system has now been changed to prevent dentists from being disadvantaged by Covid support payments (85% of pre-Covid gross Item of Service income). Using the old system, a dentist would need to gross annual earnings of £166k to be eligible for the full maternity payment of £1,399 per month. We're pleased to see this new system should be a more achievable metric.
England: No immediate change to dental SOPs
The Prime Minister's confirmation earlier this week that there will be a relaxation of general pandemic restrictions in England from 19 July has raised many questions from members about how this will impact on dental practices. The simple answer at the moment is we don't know, for now however, current IPC guidance remains in place. We have been pressing for clarity from NHS England this week but there is no indication that there will be any immediate change in the Standard Operating Procedure.
Dentists and their teams are asking whether they can or should insist on the continued use of face coverings, and whether they should persist with social distancing. We are awaiting further Government guidance next week, with the Secretary of State for Health so far having told parliament that it would make sense for guidelines such as the two metre rule to continue in "some specific settings", including medical environments. We will continue to
update our FAQs when we receive further news.
In the meantime, the Scottish CDO confirmed yesterday that there would be a review of the overarching UK infection prevention and control guidance with an associated consultation in August with revised recommendations published in September 2021. This will include a revision of the dental specific appendix in line with the revised general IPC document. There will also be a risk assessment template for dental practices to support the implementation of any new guidance.
Thursday 8 July 2021
Scotland: Review of guidance underway
Tom Ferris, the Chief Dental Officer for Scotland, has written to NHS dental practices to advise that infection prevention and control (IPC) guidance is currently being reviewed with the aim to relax measures proportionately and safely depending on the level of Covid risk.
Currently work is under way, led by Public Health England but involving all UK countries, to examine government policy for people who have been vaccinated.
Recent revisions to the guidance already include: no fallow time for AGPs on members of the same household; a move back to pre-pandemic application of cleaning controls; and reinstating pre-pandemic application of waste handling.
We welcome the CDO's pledge to ensure dentistry is represented in all guidance discussions, as we are acutely aware of the stress being placed on the profession as a result of increased patient demand and the unmet backlog of dental care need. We will keep you updated.
Wales: Oral health in care homes is back on the agenda
Yesterday, Baroness Morgan confirmed that the care home oral health programme Gwên am Byth will restart and a new stripped down version launched to encourage more care homes to sign up for oral health support.
At a debate on dentistry in the Senedd, Owen Griffiths MS and Sioned Williams MS made clear that renewed engagement with oral health is long overdue, and called for Gwên am Byth to be restarted. Baroness Morgan, Minister for Health and Social Services, responded by praising the work done by the profession during this difficult time and announcing that the programme is in fact now resuming. A new stripped-down version of the programme will also be launched, to encourage more care homes to get involved:
"To widen access to the programme, I've introduced a simplified offer and approach that is intended to facilitate more care homes being able to meet the essential minimum standards and take part.
"This is called Essential Gwên am Byth… The simplified approach can be initiated in care homes that have not started the programme or have found it difficult to comply with the current all-Wales approach... The programme, including the offer of Essential Gwên am Byth, is now resuming… I hope that the simplified offer will enable all care homes to be a part of this programme, ensuring that some of our most vulnerable groups have access to the oral health they require."
Wales: Final letter from CDO Colette Bridgman
This week, the CDO for Wales Dr Colette Bridgman wrote to dental teams as her final address. In
the letter she touches on a number of topics including the promised reform of dental services in Wales.
England: Win for common sense in NHS dental contract case
NHS Resolution has directed NHS England to apply its discretion during the year-end reconciliation process to ensure a fair and proportionate outcome, in a recent tribunal.
The applicant and GDS Contract holder in question had fallen short of their annual UDA target by 30 UDAs using the most favourable of NHS England's reconciliations methodologies for the contract year 2019-2020. Whilst NHS England had set out ways of calculating a fair practice UDA figure for March 2020, the most favourable way brought about mitigation of just one UDA.
NHS Resolution noted in a message to Local Area Teams that a "fair, sensible and proportionate approach should be taken, and one where the application of common sense should take precedence." NHS England has been directed to look again at its decision and to exercise discretion to give an increased UDA total for the March UDAs. Additionally, NHS Resolution stated that the breach notice which had been served was not appropriate and should be reconsidered.
We are pleased with this decision coming from NHS Resolution and it tells NHS England to use its discretion to make sure that its policies do not cause unfair outcomes
If you think your contract should have been reconciled differently last year to ensure a fair and common sense outcome from the reconciliation process then, like our member, consider an appeal. BDA Expert and Extra members can contact advisory services for help with their applications. Call 020 7935 0875 or email email@example.com.
England: How can dentistry "learn to live" with COVID?
Dentistry needs help if we're going to "learn to live with COVID-19". Shawn Charlwood, Chair General Dental Practice Committee, today outlines why we need a clear plan from government and real support, on everything from patient access to workforce sustainability:
"Back in March 2020, we supported a precautionary approach in the face of a novel virus. In July 2021, we need to balance the risks from COVID with clear threats to the long-term sustainability of the service and patient access."
"Monday 19 July won't have much impact on dentists or the millions struggling to access our services… We need a roadmap for safest and fastest route back to something resembling normality."
Northern Ireland and Scotland: Fair COVID payments for maternity leave dentists
In a recent blog Shareena Ilyas, Co-Chair of the BDA Equality, Diversity, and Inclusion Committee, explored the issue of unfair COVID-19 payments for dentists taking maternity leave.
"Dentists taking maternity leave have found themselves disadvantaged by how the government has calculated the financial supports designed to mitigate against COVID-19 disruption. We've been working to target this unfairness and fighting for resolutions across the UK, as well as supporting these dentists who were effectively being penalised for having children.
"We've seen some success in Scotland and Northern Ireland in particular, as we seek to support all members who have been affected during this stressful time."
Wednesday 7 July 2021
Scotland: Locum dentists now qualify for £500 COVID payment
Following the First Minister’s announcement in November, the Scottish Government issued guidance to GDPs explaining how to receive the £500 one-off COVID payment. Until today, locum dentists were unable to have a claim made on their behalf by a single appropriate service provider. As of today,
locums can also claim this bonus. We welcome this addition which ensures locum dentists working in Scotland are acknowledged for their efforts.
Challenging plans for inaccurate, unethical dental checks on migrants
We have urged Home Secretary Priti Patel to think again on plans to introduce dental checks to establish the age of Channel migrants. Dental X-rays are not an accurate method for assessing age.
Furthermore, it is inappropriate and unethical to take radiographs of people when there is no health benefit for them. X-rays taken for a clinically justified reason must not be used for another purpose without the patient's informed consent and must be carried out without coercion and in full knowledge of how the radiograph will be used and by whom.
The new Nationality and Borders Bill, tabled yesterday, will give the Home Secretary the powers to introduce methods of assessing age via regulation. “This is a retrograde step from Priti Patel,” BDA Chair Eddie Crouch has said, “in 2016 the Home Office ruled out dental checks for migrants, which we considered inaccurate, inappropriate and unethical.”
Dental regulation - where are we now?
Will there be a reduction in the involvement of dentists in dental regulation? Reduced support for ill registrants? A change in approach to administrative removals? A super-regulator for healthcare?
A major consultation by the Department of Health and Social Care (DHSC) has now closed. This was aimed at setting out a blueprint for the UK’s health regulators, and it looked at governance arrangements, registration, education/standards and fitness to practise.
The intention is to allow regulators more flexibility to adjust to a changing world, but what is this likely to mean for dentists and dentistry? Shareena Ilyas's recent blog takes a look at where we are now, and what's promising and concerning for dentistry.
Northern Ireland: Feedback sought on Duty of Candour proposals
The Department of Health is consulting on policy proposals to introduce a new Statutory Duty of Candour for individuals and organisations involved in providing health and social care in Northern Ireland.
Caroline Lappin, BDA Northern Ireland Council Chair, has reflected on this as an important opportunity to move towards a culture of candour and openness rather than fear, and has asked for
your feedback on these important proposals.
Health and Care Bill published
Health and Care Bill was published yesterday by the new Health Secretary Sajid Javid.
There are a number of provisions within the bill that will have a direct effect on both the structure of NHS dentistry and the nation’s oral health in the coming years. These include:
- A move from competition and towards integration of health services
- Changes to the laws underpinning healthcare regulation
- A 9pm watershed for TV and on-demand advertising for junk food
- Shifting power to roll out water fluoridation from local authorities to the Secretary of State.
We have made clear to Mr Javid that dentists need support to live with COVID-19, and we will ensure that dentists’ voices are heard and improvements are made, as the Bill progresses through Parliament in the coming months.
Tuesday 6 July 2021
Scotland: Details of ventilation funding for NHS practices
The Scottish Government have today outlined
further details of ventilation funding available to NHS dental practices. To apply, practices need to complete a form via their NHS Board and only claims occurred during 1 April 2020 to 31 March 2022 will be accepted.
In response to our queries on the draft proposals, the Scottish Government also provided clarity on a number of points:
- Ventilation standards are defined as 10 air changes per hour.
- HEPA filters are not recommended as a universal mitigating solution, however, they might be used as a short-term mitigating solution where other ventilation solutions are not available.
- The figure of £1,500 per surgery was based on the results of a survey which indicated that existing investment has commonly ranged between £500 and £2000, and showed that among those who had previously carried out an upgrade, the most common category for intended future spending is '£1001 - £2000' (40%).
- The Scottish Government will make a contribution to the costs of the initial equipment only, like the funding model for disinfectors and defibrillators.
- Funding will not cover waiting rooms.
We welcome this clarification from the Scottish Government, as we continue to campaign on this vital issue on behalf of all dentists in Scotland.
Confidential counselling and emotional support
We provide all members with access to Health Assured, a comprehensive confidential service designed to help you deal with personal and professional problems that could be affecting your home life or work life, health, and general wellbeing. Members can access the helpline 24/7, 365 days a year. Support includes:
Life support: Unlimited access to counselling for emotional problems and a pathway to structured telephone counselling for you or your dependents and for you face-to-face counselling sessions at your convenience.
Legal information: Advice for you on any issues that cause anxiety or distress including debt management, accountancy, lawsuits, consumer disputes, property or neighbour disputes.
Bereavement support: Health Assured offers qualified and experienced counsellors who can help with grief and related stress plus a team of legal advisors to help with legal issues.
Medical information: Qualified nurses are on hand to offer advice on a range of medical or health related issues. They can't diagnose but can offer a sympathetic ear and practical information and advice.
CBT online: We recognise the value of self-help tools in dealing with a range of issues, which is why we have a range of CBT self-help modules, informative factsheets and invaluable advice videos from leading qualified counsellors.
NHS England: Further changes to UDA reports on Compass
Last week, NHS BSA announced that providers can now access the Q1/Q2 report by calendar month on Compass. A performer version has just now also been made available. The report can be found in the Activity folder named 'Activity Report for Quarters 1 and 2 (Calendar month)'.
We expect this to be useful as performance against the 60% threshold is monitored on a full month basis, and this change will allow practices and associates to more accurately monitor how they are doing.
Scotland: Plan for activity measurements suspended
The Scottish Government has suspended their plan to introduce activity targets to ensure practices qualify for COVID financial support. The CDO for Scotland, Tom Ferris,
clarified the suspension in a letter to all NHS dental practices last week.
We welcome the shelving of these restrictions and have continually argued against the Government’s plan to use gross Item of Service as the sole measure of activity. This will help prevent further pressure being placed on practices who are already struggling and working under challenging conditions.
The average level of activity across the sector is approximately 50% of pre-COVID levels. Practices will begin to receive a monthly notification of their activity levels, starting with the July/paid August PSD schedule, allowing them to monitor activity levels. The Government and NHS Boards will then focus on practices which are delivering less than 20% of pre-COVID activity.
Monday 5 July 2021
Queen recognises NHS staff on its 73rd birthday
73 years ago today, the NHS was born.
Thanks to all our members and their teams across the UK who deliver high-quality care to their patients every single day.
Awarding the George Cross to the NHS today, the Queen said:
“This award recognises all NHS staff, past and present, across all disciplines and all four nations.
“Over more than seven decades, and especially in recent times, you have supported the people of our country with courage, compassion and dedication, demonstrating the highest standards of public service.
“You have our enduring thanks and heartfelt appreciation.”
England: Patients' signature requirements delayed until 31 August 2021
Following successful BDA lobbying, the requirement for
the reintroduction of patient signatures has been delayed to 31 August 2021 to fit in with wider COVID restrictions remaining in place.
Friends and Family Test data will be reintroduced sooner. July will be the first month you need to formally count the Friends and Family Test responses and submit the data in August. The data will then be due to be published after three months' collection (July, August, September data), and then published every month after that.
Restrictions on patient signing and the FFT were paused from November 2020 to aid cross-infection control and the requirements in place for dental practices to restrict the spread of Covid.
NHS England: Changes to UDA reports on Compass
NHS BSA have announced that providers can now access the Q1/Q2 report by calendar month on Compass. The report can be found in the Activity folder named 'Activity Report for Quarters 1 and 2 (Calendar month)' and a performer version will be available by the end of this week.
We expect this to be useful as performance against the 60% target is monitored on a full month basis, and this change will allow practices and associates to more accurately monitor how they are doing.
Recruitment and the right to work in the UK: BDA advice
Many practices employ staff from within the European Economic Area (“EEA”). Until now, freedom of movement has meant that establishing the right to work for this group of individuals has been reasonably straight forward for employers.
However, people from within the European Economic Area (except Irish citizens) now need to provide proof of their immigration status to show their right to work in the UK.
Practice owners must now establish whether a candidate has the right to work in the UK before employing them, to avoid a civil penalty or, where an individual is knowingly or reasonably believed to be employed without immigration permission, criminal liability.
To find out what you need to know, members can access our
advice on recruitment, Right to Work checks and correct HR procedures