Friday 13 March 2020
Face mask shortages
We’ve been in regular contact this week with government officials and the industry to try to ensure a continuing supply of face masks to practices as we know there have been significant problems. A process has been set up to enable suppliers to get hold of stocks held by government and get them out to practices. This is likely still to involve some rationing.
Business impact
Across the four countries of the UK, dentists are worried about the potential impact of the coronavirus on their businesses. Some patients are reluctant or unable to attend for treatment and staff may be forced to take time off. It’s a particularly bad time for the virus to hit, at the end of the financial year when practices are desperate to hit NHS targets, and in England and Wales, get through their Units of Dental Activity or face clawback.
We’ve made clear the real concern within the profession on this issue to all four of the UK administrations and are arguing for a lenient and sympathetic approach. We are discussing with NHS England how ‘force majeure’ will be applied in these circumstances. That is a contractual provision which allows for deferment of activity where practices are unable to meet targets for reasons outside of their control. Pandemic is listed as one of the reasons for force majeure to kick in. However, deferment of activity alone will not solve the problem, particularly if we see an extended period of impact. We are making the case for alternative approaches and will keep you posted on how we get on with those discussions.
On-going dialogue with governments
Within all four countries, there is on-going dialogue with officials about the impact of the coronavirus. In England, we are part of an NHS England primary care clinical stakeholder forum. NHS England has produced a Standard Operating Procedure for primary dental care settings. This is a live document that will be updated regularly. We have fed a series of comments into the document so far and will continue to do so to make sure it is as clear as it can be.
That framework is due for an update today to reflect official advice around identification of cases and self-isolation so keep an eye out for that. If you spot anything in the framework that doesn’t make sense, let us know and we will feed into NHS England.
In Northern Ireland, we are actively pressing the Executive to introduce financial mitigation measures. In a letter to the Health Minister this week, we set out the potentially extremely serious financial implications faced by general dental practitioners. The CMO and senior HSCB officials have assured us the Department is, “committed to maintaining the same level of Health Service dentistry after Coronavirus, as before”.
Regulatory burden
We’re in regular contact with the healthcare regulators, whether individual or place based. The Care Quality Commission in England has said that they will focus activity where it is needed most to ensure people receive safe care. At the moment, routine visits are continuing, but the CQC has asked for ongoing discussion about the impact of inspection on providers.
For the time being, practices are largely striving to deliver business as usual, albeit in very difficult circumstances. The Prime Minister’s briefing yesterday didn’t move the official advice in relation to pandemic that much further. But there may come a time soon when we will all be advised, or even mandated, to restrict movement and activity.
In healthcare settings, that may mean a reduction in treatment, possibly even emergency-only provision at some point. Again, we are seeking to clarify with officials what such circumstances would mean for dentistry. We may need to think laterally about our approach, for example, whether there are opportunities for dentists and teams to redeploy into other roles, utilising their clinical skills for patient benefit. Again, this is very much a live issue.
Wednesday 11 March 2020
The budget
The Chancellor has pledged to offer ‘whatever it takes’ to support NHS services responding to the COVID-19 outbreak. This includes a £5bn emergency response fund. So far, we know that:
Small firms will have access to business interruption loans of up to £1.2m. This is potentially good news for dental practice owners worried about the impact of COVID-19. However, the details remain unclear so we’ve asked government officials for clarification
Deferred tax payments may also be agreed with HMRC, if you are in financial difficulty
Statutory sick pay will be paid to all those who are advised to self-isolate, even if they don't have symptoms
Firms with fewer than 250 staff will be refunded for sick pay payments for two weeks, again we’re seeking clarification on the detail
Benefits will also be quicker and easier to access for self-employed. Contributory employment and support allowance (ESA) will be claimable from day one, rather than day eight. The minimum income floor for universal credit will be removed. The requirement to physically attend a job centre will be removed – everything can be done on the phone and online.
See more on our 2020 budget coverage.
