Sunday 12 April 2020
09:30
Practices weeks from collapse without rapid action from government
As featured in today's Sunday Times, large parts of the UK’s dental service are at risk of imminent collapse without urgent steps to support small business.
A BDA poll suggests 70% of practices can only maintain financial viability for a maximum of three months. Those providing predominantly private care are worst affected.
Dentist leaders are pressing for the full rates relief offered to the retail and hospitality sectors to be extended to all high street practices, and for pledges to simplify and expand the government loan scheme to be expedited.
All self-employed dentists, particularly those working in private practice, need access to the support outlined by the Chancellor.
Friday 10 April 2020
19:00
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.
We'll be back to update you with more news and progress next week.
Have a safe and healthy Easter.
11:10
Why the Chancellor's plan doesn't work
In a very personal account, Associate dentist Sarah n explains why it's unfair that the Government’s package for helping those who are losing their income during the Coronavirus pandemic doesn’t apply to most self-employed dentists.
"Regardless of how people choose to work and earn a living, we all deserve support in these unprecedented times".
Read Sarah's blog: Coronavirus: Why are self-employed dentists getting no financial support?
10:40
We urge the Chancellor the reassess plan for the self-employed
In an open letter to the Chancellor we have stressed that failure to offer concessions to self-employed workers could decimate the high street dental service. Over three-quarters of dentists will receive no support from the Treasury scheme, with some left with zero income for the foreseeable future.
We are calling for:
- the earnings threshold to be raised or removed
- support to be extended to practitioners operating as limited companies who currently receive no support, regardless of their income level.
Our Chair Mick Armstrong has said: “The Chancellor needs to think again, and set out a fair approach for the self-employed. The dentists losing out are not the super-rich. They are frontline health professionals, who don’t know where their next pay cheque is coming from, or if they will have jobs to return to.
“Unless we see action many will face hardship, and a service millions depend on may never recover.”
09:25
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
- Redeployment
- Paying staff (conditions for NHS payments and furloughed workers).
Thursday 9 April 2020
17:35
Meeting the Health Minister: Trying to solve the lack of urgent care in England
Our Chair, Mick Armstrong and I met the Health Minister, Jo Churchill again today to discuss a number of urgent issues. In a virtual meeting with colleagues representing other primary care professions, we focused on the troubling lack of progress in setting up the urgent dental care system in England.
The Minister has asked to meet again to discuss this on Tuesday, immediately after the Bank Holiday weekend. We also discussed the need for dentists and teams working in urgent care and other roles to be able to identify themselves as key workers in the absence of NHS identification. NHS England are tasked to come up with a solution to this issue. We also raised patient charges and fines during the pandemic.
17:30
Department of Health in Northern Ireland drops abatement of capitation payments
We have secured confirmation from the Department of Health in Northern Ireland that capitation payments will not be abated, including from the first month of the scheme. This follows another day of lobbying by the BDA in respect of the GDS Financial Support Scheme (FSS).
The scheme announced by the Department earlier this week originally proposed to abate capitation by 20%. This was then reduced to 10% yesterday, until it was confirmed today that they are removing abatement altogether. This is important progress. We will continue to focus on achieving a reasonable outcome on the other unsatisfactory aspects of the scheme which have deeply concerned practitioners.
15:10
Northern Ireland: Following up on concerns over funding
Yesterday, we wrote to the Department of Health to outline NIDPC’s significant concerns with the published Financial Support Scheme and associated FAQs. The response we have received from Paul Montgomery at the Department of Health commits them to fully consulting with BDA NI/NIDPC as the scheme develops, and specifically, for our input on behalf of those practitioners whose circumstances may have changed considerably from the stated reference period.
This morning, Richard Graham, Chair of NIDPC also held a telephone call with Colm w MLA, Chair of the NI Assembly Health Committee to brief him on the issues general dental practitioners have with the Financial Support Scheme. Issues discussed included: the need for the scheme to be flexible to take account of individual circumstances; the importance of having an appeals process; and recovery.
We'll be speaking to Department of Health and Health and Social Care Board representatives tomorrow morning, to reiterate the concerns we highlighted to the Department yesterday, and to push for further changes. We're continuing to campaign on your behalf.
14:50
Risk assessment template updated
Members can download version five of our pandemic risk assessment guidance. New additions include reference to the GDC’s guidance and a link to the record keeping document published earlier today.
14:20
Clarity around financial support for mixed practices in Scotland
The Scottish Government has issued a memorandum that clarifies that mixed dental practices that receive NHS support funding can also apply for support from other government sources to cover the private element of their income. These latter claims should be proportionate to the amount of private dentistry delivered.
13:30
Record keeping during the pandemic
Keeping accurate and reliable records of patient interactions is always advisable. Members providing treatment during the pandemic can use our record keeping template to assist them.
09:00
Calling for zero work-caused fatalities due to COVID-19
We are joining forces with the Society of Occupational Medicine, the British Medical Association and the Doctors' Association to say that, with safe systems of work and PPE, no worker should die of work-acquired COVID-19.
Chair of the BDA Board, Mick Armstrong, has said: “Too many NHS workers are being sent to the frontline inadequately protected. We desperately need a joined-up approach to PPE. Irrespective of official guidelines, all health professionals should be able to access the best available kit.”
Wednesday 8 April 2020
18:40
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
- Redeployment
- Paying staff (conditions for NHS payments and furloughed workers).
18:30
England: Redeployment guidance for dental teams
NHS England has published guidance on redeployment for the dental team. This includes suggestions on potential duties and roles for members of the dental team, alongside the extension of NHS negligence cover for those redeployed to hospitals or GP practices. The guidance also recognises our position on the redeployment of clinical academic and hospital-based dentists.
An NHS salary will be payable for solely private practitioners or those returning to the dental workforce. We expect further information to follow regarding the funding arrangements for those funded through UDA contracts.
17:35
Making the case for dentists to HMRC
We met with HMRC today to discuss NHS payments during this period of shutdown. We are relieved to see HMRC confirm that, if dental practices are required to pass on NHS payments to associates, any non-contractual payments made by practices to associate dentists and other individuals will be considered a neutral factor in determining employment status for the duration of the Job Retention Scheme and Self Employed Income Support Scheme.
We also raised the difficulty that many private dentists and practices are facing with HMRC. We will follow up with further information and pursue this route amongst many others to make the case for support for private dentistry.
17:15
NHS dentists in Scotland: Sick leave as a result of coronavirus
Scottish Government recently informed all NHS Scotland Board Chief Executives and Employee Directors that all new starts in the service would be entitled to a month of sick leave on full pay. However, following consultation, it has now been decided that, where staff fall sick with Coronavirus and need to be absent from work, such staff should be treated as if they have five or more years’ service and therefore have access to up to six months’ sick leave on full pay.
16:55
Sources of financial support for dentists in Scotland
We have pulled together a summary of the sources of financial support currently available to dentists in Scotland during the pandemic crisis. The Scottish Government will shortly clarify the situation regarding mixed practices, and we will continue to press for additional financial support for private dentists.
16:25
Guidance on prescribing during COVID-19
The Scottish Dental Clinical Effectiveness Programme (SDCEP) has published guidance on drugs for management of dental problems during the COVID-19 pandemic. It lists the drug regimens that dentists are most likely to remotely advise or prescribe for their patients. It is a supplement to their guide on Management of Acute Dental Problems during COVID-19, which was published last week. Both documents are available on the SDCEP website.
16:00
Northern Ireland: Concerns raised with Financial Support Scheme
Richard Graham, Chair, NI Dental Practice Committee has written to the Department of Health to outline NIDPC’s significant concerns with the published Financial Support Scheme and associated FAQs.
We are chiefly concerned with the decision to remove any appeals process for practitioners facing unique circumstances, the inclusion of an open-ended threat of possible payment recovery following the pandemic and the proposal to abate capitation payments by 20%. Richard and Tristen Kelso, National Director of BDA Northern Ireland, spoke to Acting CDO, Michael Donaldson, today to reinforce these concerns.
We will update you when we have more information.
13:43
Scottish Public Dental Service: Appraisals postponed
The Scottish Government has confirmed that appraisals of Public Dental Service dentists are being postponed due to the COVID-19 pandemic. We are seeking confirmation that mandatory training is also suspended at this time. For more information on how the Coronavirus outbreak affects employed dentists, see our FAQs.
11:45
Private practice: Pressing the Chancellor for solutions
We continue to press the Chancellor to extend financial relief measures, to include those who are self-employed or operating as private limited companies. This morning we joined with other professional associations representing 80,000 members in the healthcare space to call on the Chancellor to take your concerns seriously and pressed for the following solutions:
- Allow the 2019/20 tax returns of 2019 graduates and those new to self-employment to be considered for the Self-Employed Income Support Scheme (SEISS)
- Remove the £50,000 profit cap on eligibility for the SEISS
- Allow limited company directors to receive a grant of up to £2,500 of their monthly salary to bring them in-line with the employed and self-employed schemes
- Release government constraints to enable healthcare regulators to provide relief on their fees
- Include medical service providers within the Expanded Retail Discount Scheme.
11:20
Your mental health is a priority
This is a stressful and challenging time for many. We encourage you to reach out for support and to look after your mental health. Members are advised to access to our 24-hour counselling service, which can help you deal with any personal and professional problems that could be affecting your home life, work life or health and general wellbeing.
The NHS has also launched a hotline to support and advise healthcare staff during the coronavirus pandemic. The phone line will be open between 07:00 and 23:00 every day, while the text service will be available around the clock. Staff can call 0300 131 7000 or text FRONTLINE to 85258.
11:10
One-to-one advice over the Easter weekend
Members with access to our one-to-one advice services can call between 10:00 and 16:00 on Friday 10 and Saturday 11 April. We’re extending our opening hours over the bank holiday Easter weekend to answer your questions.
09:55
Working in an urgent dental centre during COVID-19
This weekend urgent dental centres (UDCs) opened in five locations across Northern Ireland to provide safe dental treatment during the COVID-19 outbreak. Philip McLorinan has described for us what it's like to work in one of these clinics and shared tips on what you should expect and how you should prepare.
Read about Coronavirus: A first hand account of working in an urgent dental centre in Northern Ireland.
Tuesday 7 April 2020
17:30
Discussing PPE and urgent care with the CDO and Health Minister
Our Chair, Mick Armstrong and I had a virtual meeting this afternoon with the Health Minister. Jo Churchill and CDO for England, Sara Hurley, as well as with colleagues from NHS England.
In the meeting, we raised our on-going concerns about the existing guidance on, and supply of, personal protective equipment (PPE) and also progress in relation to the establishment of urgent dental care centres in England. The Minister seemed to understand our concerns, and we are expecting clarification on PPE advice in relation to dentistry later this week, as well as a revised Standard Operating Procedure.
NHS England has committed to sharing information about the network of urgent care centres as soon as possible.
We will continue to pursue these issues with them and update you when we can.
14:50
Coronavirus: Dentists are stepping up
In a climate of relentlessly harrowing news and depressing facts, it's the goodwill and altruistic actions of individuals that are providing the antidote that we all need. In our new blog, three remarkable dental professionals share what they're doing to continue to support their patients, communities and frontline healthcare staff.
Read about the fantastic work being done by dentists to support the response to COVID-19.
Monday 6 April 2020
19:40
What's happening this week
Financial support for dentists
This week, we are continuing to focus on support for private practices. We secured good news for mixed/private practices in England over the past week, however, exclusively or predominantly private practice has not seen the same level of progress.
We've sent out two surveys recently to identify the real impact that the Chancellor’s limit on support for the self-employed is having on private associates, and also the general business impact of the pandemic on private practices. We will be highlighting these problems this week in our campaigning work alongside other professions similarly affected. In Scotland, we are continuing to chase the CDO for confirmation that dental practices are eligible for both NHS and other government funding and hope to update you with good news
in coming days.
We will also be launching our new pay dispute claim service for associates. This is designed to help those whose corporate or practice owner is not passing on income due under the financial agreements made with governments. Watch this space for more on that.
Urgent care centres
We are in regular contact NHS England colleagues regarding the establishment of urgent care systems across the country. We know that some centres are active, some are ready to go and some a few steps behind. This has been a source of real frustration for dentists struggling to advise patients whilst the urgent care system gets properly going. It's quite a different story in Wales, with centres having already been verified by infection control specialists and quality assured. CDS dentists are scheduled, fully prepped and receiving patients.
PPE and aerosol-generating procedures
One of the key issues in setting up urgent care is the supply of appropriate personal protective equipment (PPE). Last week we voiced our concerns with the revised guidance that states ‘routine’ PPE is appropriate for the treatment of all patients (including those who are COVID-19 positive) if there are no aerosol-generating procedures. We are continuing to discuss the issue of what is an appropriate level of PPE in urgent care settings, and to raise fundamental questions about what falls under the definition of aerosol-generating procedures.
We are anticipating an updated standard operating procedure for primary care dentistry in England this week and hope that it will tackle these issues. In Wales the CDO has said today that there are supplies of PPE for all of the urgent care centres for the next few weeks and we have every reason to expect the supply line will continue after that.
Redeployment
New guidance for dealing with the redeployment of dentists and dental teams in England in support of NHS clinical delivery is due to be published early this week. Dental professionals will be asked to register their interest via an online questionnaire and will then be triaged based on a number of factors including recognised competencies, level of experience and location.
Questions for NHS England
Over the last fortnight, we have been asking you what questions you want answered from NHS England in regard to the pandemic response. We received pages of questions (thank you) and have consolidated them into a number of key themes ready to share with our colleagues at NHS England. We will start to publish the answers on our website this week.
17:35
Urgent care centres are imminent
Mick Armstrong, the Chair of the BDA Board, has written to members to ease concerns over the lack of urgent care currently available in which to refer patients. The NHS has promised that the establishment of urgent care centres is imminent and Local Dental Networks, Local Dental Committees and colleagues across general dental practice and community services are working tirelessly to get them up and running. However, the supply of personal protective equipment remains an obstacle.
"If dentists feel they must see a patient face-to-face for urgent care only in the interim, then our advice is to ensure they have the proper PPE and training and check their indemnity to ensure they will be covered. Keep direct contact to a minimum and avoid aerosol generating procedures in all instances. Our risk assessment guide will help".
If you have experience in setting up an urgent care centre we'd like to hear from you.
16:50
Reduce the Annual Retention Fee payments
We have called for the Annual Retention Fees (ARF) to be waived or at least reduced in a letter sent to Ian Brack, CEO of the General Dental Council (GDC). Waiving the fees, which are payable this year by dental care professionals (in the summer) and dentists (at the end of the year) would help ease the financial pressures faced by all registrants this year.
13:50
Practical guidance for members on assessing risk
Our COVID-19 risk assessment guidance for members (login required) has been updated with additional recommendations on record keeping. It is likely this guidance will change often so please keep an eye on this page for new versions.
12:08
Furloughed workers and NHS payments: An update
We have updated our advice on the Government's furloughed workers scheme. Our Head of Advice, James Goldman discusses the latest information and what it means for those who wish to furlough workers and still claim NHS payments.
For more on this please see our Coronavirus: Financial Impact content.
