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Updates from week commencing 6 September 2021

Read all the updates that took place throughout this week.

Friday 10 September 2021



England: Long-term NHS race equality strategy


The NHS in England is planning to design a race equality strategy and they are asking for views. Please consider responding individually about your thoughts on what this strategy should include in terms of your own experiences. The closing date is 12 September.





England: Letter to the Minister on SNOMED CT


We’ve written to Jo Churchill MP, the minister for dentistry, urging her to intervene to resolve the problems with the implementation of SNOMED CT.


Despite our efforts, there appears to be a continued difference in approach on implementation from the Office of the Chief Dental Officer (OCDO) and NHSX. The OCDO has reiterated its view that dentists must now begin using SNOMED CT and use codes available from the BSA, but in meetings with us NHSX has said that practices do not need to roll-out the coding system now and that time should be taken to develop a dental-specific codeset.


We’ve been engaging with both organisations as well as NHS England and the DHSC to seek a clear, fit-for-purpose codeset and practical guidance on how dentists are expected to use SNOMED CT. It is completely unacceptable that dentists, and ultimately patients, have been caught in between these different positions and lack of clear guidance. We hope that the minister will be able to assist us in resolving the matter.





Northern Ireland: Health Committee discuss HSC Bill - Listen again


The Committee for Health met in the Senate Chamber yesterday during which time the state of HS dentistry was discussed.


Committee for Health Meeting, Thursday 9 September 2021 - NI Assembly TV.


It was encouraging to see dentistry on the agenda again, and we recommend listening to the following sections:


  • Independent contractors: Paula Bradshaw MLA raises the question about independent contractors and the particular concerns dentists have over their future/unsustainable nature of GDS contract and having a seat at the top table. Listen at 00:48:50
  • DoH responds: Martina Moore responds to comments on dentistry. Listen at 00:55:30
  • Keep dentistry involved: Colm Gildernew MLA, Chair discusses why "all professions need to be in the room". Listen at 00:56:37





Are your NHS practice details up to date?


It is important for patients that NHS dental practices have accurate information on the NHS website. This should include opening times and whether the practice is taking on new patients. Check if your practice's details are up to date. If they are not, the NHS' online visual guide explains how to gain editing rights and update your profile.



Thursday 9 September 2021



Wales: Stopping in-year GDS clawback

We have successfully campaigned to stop Local Health Boards in Wales from financially penalising practices who in Q1 had not reached a stipulated threshold of 80% fluoride varnish applications for specified groups of NHS patients. We made our concerns clear to the two Deputy Chief Dental Officers, Warren Tolley and Paul Brocklehurst, about the illegal move by Swansea Bay University Health Board, and since then they’ve written to all GDPs and Health Boards to provide clarity on how the GDS contract should be handled with respect to this fluoride varnish measure.


This letter addressed the misunderstanding over the fluoride application metric within NHS and mixed practices, while also providing an update to the Standard Operating Procedures. Details were also provided in an annex for the assessment of routine and urgent cases that are seen under the NHS contract.


Swansea Bay University Health Board has now written to practices assuring them that their contract values have been reinstated and that any clawback will be repaid. We remain in continuing discussions with Welsh Government officials about the clinical evidence used for the measure of fluoride varnish application on children under three and on young children deemed at no risk of caries.





Wales: There must be no return to UDAs


We have raised with the two Deputy Chief Dental Officers, Warren Tolley and Paul Brocklehurst, that at least two Local Health Boards had intimated in recent written communications to practices that if they failed to meet certain GDS contractual conditions that UDAs might be imposed as a result. This was shocking to hear, given the recent announcement by the health minister Baroness Morgan that there would be no returning to UDAs as contract reform progresses. We have fought hard to remove UDAs from general dentistry in Wales and support the Welsh Government’s stance.


We will continue to fight for fair treatment of practices as the recovery year continues and to keep up pressure on LHBs to operate within the legal parameters of the recovery year conditions. Looking to the future of the GDS contract; the Welsh Government Dental Services Reform Strategic Oversight Group has been established to oversee the GDS reform programme. The group will start to meet soon. We will continue to play a key part in the contract reform process - we will keep you updated.





Dental politics: Building something from nothing


In her recent blog, associate dentist and BDA Scottish Council member, Carly Fraser explains how representation at a local level can have a huge impact on you and your profession.


Her experience of getting involved in dental politics – where there had recently been no dental representation at all – is a great demonstration of the good it can do, for you as an individual and your community. Through opportunities for connection, education and community, Carly has been able to help give a voice to dentists in her area, while also learning a lot and meeting new people:


“The Aberdeen section and the North of Scotland branch had been inactive for quite some time before they were re-established by my predecessor. This meant that for a long time there was no representation for dentists in our area, and dentists here didn’t have the same access to resources that dentists in other areas of the UK enjoyed. I got involved to help out, and it’s since taught me so much about my area of dentistry, introduced me to a huge number of people and given me a keener understanding of the issues facing dentists in Scotland.”






Northern Ireland: Oral health included in Cancer Strategy


We have secured the inclusion of an oral health section in the newly launched 10-year Northern Ireland Cancer Strategy, which is currently out for public consultation.


Unfortunately, the majority of oral cancers in Northern Ireland are diagnosed at stage IV which has a significant impact on survival. The five year survival rate for oral cancer in Northern Ireland is approximately 45% overall, 66% for those diagnosed at stage I and only 25% for those diagnosed at stage IV. However, much of the public remain unaware of the risks.


Dentists and their teams have a vital role to play in ensuring oral cancers are detected early. That’s why, we campaign to raise awareness and provide essential resources to dental professionals, but more public awareness is needed. This strategy commits to raising public awareness of the risk factors and early signs of mouth cancer and the importance of regular dental check-ups for those at increased risk. This was the culmination of extensive engagement work with our key partners behind the scenes.



Wednesday 8 September 2021



What can dentists do to support LGBTQ+ patients?


What needs to happen for dental practices/dentistry to become more LGBTQ+ inclusive? Does a dentist need to know about a patient's sexual orientation or gender identity? What can you do to better help your LGBTQ+ patients? These are some of the interesting questions tackled in these still-relevant pre-pandemic pieces on the important issue of inclusivity:






England: Deadline for SAS contract decision approaches


SAS dentists have until the end of the month to decide if they wish to move to one of the new SAS contracts. NHS Employers in England has updated its guidance in light of the recent pay award of 3% through the DDRB process. SAS dentists may find the documents useful in their decision making about the transition to one of the new contracts. However, the window for expressions of interest closes on 30 September 2021, so be sure to contact your local Trust HR team before then to understand your personal circumstances.


Please note that once the window closes, the right to transfer to one of the new contracts may end so if you are interested do express an interest. Also, the British Medical Association has more information on the transition process on their website.





Scotland: Changes to payment for parents via surrogacy


After we raised the issue with Government, contractors in a surrogacy arrangement have now been retrospectively granted eligibility for payments.


This amendment applies to the changes made to the calculation of maternity, paternity, adoptive leave and long term sickness payments in June. We’re pleased to see the Government will backdate this change to 1 February 2021 to align with the previous changes made to the SDR. We will continue to press for change of behalf of the profession.




Professor Liz Kay inaugurated as BDA President


At the BDA presidential inauguration last night, professor Liz Kay took office as President for 2021-23.


Taking over the role from past-President Russ Ladwa, Professor Kay has vowed to keep up the work done over the past few years to pursue fairness in the profession, and to continue to tackle the problem of oral health inequality.


Professor Kay also serves as vice chair of the Medical and Dental Students Trust, served as oral health topic expert for NICE, and currently chairs a NICE guideline committee on epilepsies in children. She is also a non-executive director of an NHS Hospital Trust. Her scholarly work also includes over 250 scientific papers and journal articles, being principal author or editor of six textbooks, along with contributing several chapters to academic books.


“I am honoured to take up this role, notwithstanding that this is one of the most challenging times in our history. COVID has had a devastating impact not just on dentists’ livelihoods and wellbeing but also on our patients and has exacerbated pre-existing inequalities and access difficulties.


“The BDA has been working hard to raise awareness of all these issues, which are dear to my heart; I look forward to being part of this and meeting dentists around the country in the year ahead.”



Tuesday 7 September 2021



England: Funding pledge leaves unanswered questions


The Prime Minister has described today's £36 billion boost for frontline services as the "biggest catch-up programme in the NHS's history" yet there is no clarity that dentistry will see a penny of new investment. The change means:


  • A new Health and Social Care Levy on working adults, alongside an equivalent rise in dividend tax, is expected to raise £12 billion per year
  • Overall NHS capacity will increase to 110% of planned activity levels by 2023/24, meaning more appointments, treatments, and operations.

We are urgently seeking clarity on what this will mean for dentistry. Dentistry's recovery will hinge on fair investment.





Scotland: Programme for Government published


Today, the Scottish Government published its Programme for Government. We look forward to meaningful negotiations with the Scottish Government in the coming weeks, and we've taken the opportunity to clearly reiterate our previous calls for:


  • Better communication with the patients and the profession, for example, it should be made clear that the removal of dental charges for young adults does not signal a return to business as usual and patients should know that practices will continue to prioritise urgent cases.
  • The 3% pay award for dentists to be applied to GDPs' overall remuneration package to avoid front line staff potentially being left out of pocket and practices struggling to invest to improve care.





Scotland: Grant for electric motors and 'red band' handpieces


The Scottish Government have released further details regarding the £7.5 million which will be provided to general dental practices to buy electric motors and speed increasing 'red band' handpieces.


We now know that practices can make a single, retrospective claim related to the purchase, renewal or upgrade of up to three electric speed adjusting hand pieces and/or an electric motor, which can allow the handpiece to be operated at speeds of less than 60,000 rpm per surgery. The payment is up to a maximum allowance of £2,500 per surgery, depending on the practices' NHS commitment percentage. Claims can only be accepted for expenditure that occurred during the period 1 April 2020 to 31 March 2022. NHS Boards will provide instruction to practices on their local processes for making a claim. Members have already raised a number of queries about this funding, which we have relayed to the Government.


Although extra support and funding for general dental services is welcome, we call on the Scottish Government to communicate clearly that the introduction of this grant does not signal a return to business as usual. Patients should be aware that practices still have COVID-related protocols to follow and continue to see only a fraction of pre-pandemic patient numbers.





Installing the new BDA President


Tonight’s presidential installation ceremony will see our outgoing President, Russ Ladwa give his valedictory address. He will also pass the BDA ceremonial jewel to incoming President, Liz Kay, who will give her presidential speech. Many members have signed up to attend online. If you’re a member, you can join them by registering today.





HMRC and associates: No change on self-employment

HMRC has for many years accepted that associate dentists are almost always self-employed. Its guidance has included mention of our associate agreement in its employment status manual, but as of April 2023, this paragraph will be withdrawn.

The withdrawal of this guidance will have no impact on the self-employed status of the majority of associate dentists. Indeed, HMRC has told us that this is a change to their guidance, not a change to the self-employment status of associate dentists. They have simply stopped making reference to third party advice in their own guidance. The National Association of Dental Accountants and Lawyers, the experts on the dental sector, also say the change in guidance will have minimal impact.


We can continue to rely on the current guidance (ESM4030) until April 2023, and HMRC will not be using the withdrawal of the guidance as a reason to open retrospective enquiries into periods prior to 6 April 2023.


Find out more:






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.



Monday 6 September 2021



England: Isolation of fully-vaccinated staff if a household member has COVID - an update


We continue to get a lot of queries about the difference between government advice on self-isolation for "double-jabbed" staff coming into close contact with COVID positive individuals and NHS England's position.


We can now confirm that the advice below is for practices with an NHS commitment; 100% private practices can choose to follow the wider Government advice, or to follow the NHS advice. However, such practices would need to be able to justify their decision making process.


The wider Government advice is that fully-vaccinated individuals do not need to self-isolate (assuming other precautions are being taken) if a household contact tests positive; however, the NHS advice is that staff will be asked not to come to work for 10 days.


Where this is causing some disruption to the provision of dental services, it may be appropriate for the staff living with a positive COVID-19 case to return to work, in line with Government guidance, in a risk-assessed way. This should be done through a process agreed with an appropriate senior decision maker (e.g. DPH) and conditions will include:


  • If staff absence creates a significant risk to the health or safety of patients or service users, health and social care staff who have been identified as a contact of a case of COVID - may be able to attend work rather than self-isolate if they are fully vaccinated (more than 14 days after the second dose)
  • This must only occur in exceptional circumstances and where additional safety measures can be upheld. The decision must also be subject to a practice risk assessment process which should involve "the senior clinical leadership, commissioner and local Director of Public Health"
  • These staff members should only attend work after having a negative PCR test and daily negative LFD antigen tests

We have produced a risk assessment form which allows practices in England to consider whether a full vaccinated member of staff, who has been identified as a COVID contact, may attend work.





Scotland: Concerns for practices over recent NHS launch


It is unacceptable that dental practices in Scotland were given less than one day to prepare for the abolition of NHS dental charges for 18-25 year olds on 24 August. Today we have written to the Cabinet Secretary for Health and Social Care to express our concern and dissatisfaction.


We have called on the Scottish Government to deliver a clear message to the public that this change does not mean a return to “business as usual”. Practices will still continue to prioritise urgent cases for some time. In our letter we have also queried the Scottish Government’s assertion that the new arrangements would reduce practices’ administration costs, with colleagues advising that the opposite is likely to be the case.


We intend to engage with the Scottish Government over coming weeks to discuss a more sustainable funding model and activity measure following publication of revised infection prevention and control guidance.


We will keep you updated on all progress.





England: Seeking urgent clarity on SNOMED CT requirements


We have been seeking urgent clarification from NHSX, the body responsible for SNOMED implementation, and the Office of the Chief Dental Officer as to the requirements for practices to use SNOMED CT.


Since March, we have been engaging with NHSX, as advised by the Minister Jo Churchill, to resolve the outstanding issues as to how practices would begin using SNOMED. In our meetings, NHSX has been clear that it did not regard it as necessary for dental practices to implement SNOMED from 1 September 2021 and that instead it wished to take the time to work with BDA to develop a subset of dental-specific codes that would be appropriate for use.


It is disappointing that there is conflicting information from the two bodies. We have urged them to issue a clarifying statement and will continue to press for this.





Dental careers: Leaving UK clinical dentistry


What if the job you studied so hard for no longer feels right? To the point that you want out? Or what if personal circumstances mean that it just isn't feasible anymore. How easy is it to leave - and what opportunities are there for a dentist who doesn't want to practice dentistry - or dentistry in this country?


Our two guests shed a lot of light on this very complex situation.


“Sometimes we really overcomplicate things, whereas in reality if we just simplify it, all I really wanted was to not be in the career I chose when I was 17.”


Listen on Apple podcasts, Google podcasts, Spotify or search “Chairside” on your chosen podcast platform.