This is a challenging time for dentists. Here we have collated advice on the financial impact of the COVID-19 outbreak and the mitigation measures which have been introduced:
Associates who are worried they cannot meet their current personal household expenditure can also apply to the
BDA Benevolent Fund for financial assistance.
In late March we secured commitment from NHS England that practice owners would be required to ensure that all staff including associates, non-clinical and others continue to be paid at previous levels.
We know that the vast majority of contract holders have done the right thing and continued to make payments to associates and other staff. Some pay disputes have been resolved fairly but many are now stuck awaiting a framework to enforce action.
It’s unacceptable that vulnerable associates are being made to wait for this matter to be addressed.
NHS England advises associates with concerns about not receiving previous NHS earnings, or indeed having their contract terminated, to bring this to the attention of their local NHS area team. The local area team is the body responsible for the management of NHS dental contracts.
To further address the issue we proposed a temporary legislative solution to ensure that we were able to use more than words to influence a practice owner not making appropriate payments. We know that discussions have been taking place with the Department of Health and Social Care, but we’ve told NHS England we need resolution of this issue now so that we can make sure that all associates are treated fairly.
Until we hear back from NHS England, our attempts to resolve associate members’ situations are hampered. Please be assured that we will keep up the pressure and update those who have logged cases when we have information. The moment we have a way forward we will resume this service.
The NHS has said that it will continue to pay NHS contract payments to NHS practices in England and Wales, and to NHS dentists in Scotland and Northern Ireland.
There are a number of conditions that apply to the continued contract payments. Those conditions include:
- Practices don't seek other assistance which would be duplicative
- All available staff may be required to be redeployed.
England and Wales
Neither England nor Wales will be paying 100% of the contract payments. In England, there will be an agreed and fair reduction for any variable costs associated with service delivery (e.g. in recognition of reduced consumable costs and lab bills). In Wales, the government will pay 80% of the NHS contract value.
The rules of the scheme are that practice should continue to pay associates at previous levels.
The Department of Health is making Financial Support Scheme payments totalling 80% of a dentist’s average monthly Item of Service income (including the contributions patients would have made) each month with no change to any health Service allowance or Continuing Care or Capitation Payments. Patient registration has been extended by three months. In return, dentists and other staff are asked to assist the wider Health Service.
Dentists are able to access wider Government support in direct proportion to their percentage Health Service/Private split. Duplication of support is not permitted.
The Scottish Government has advised dentists/Dental Body Corporates (DBCs) that they will receive 80% of their average monthly item of service income (including the contributions patients would have made). There will be no changes to Continuing Care or Capitation Payments and they will protect NHS commitment status. In return, dentists and other staff are asked to assist the wider NHS.
Dentists/DBCs are able to access wider Government support in direct proportion to their percentage NHS /Private split. Duplication of support is not permitted.
Some associates will not volunteer for wider NHS duties or be available to help at the practice. Some of those will have good reason to self-isolate. For others, it will be a question of personal choice. It is quite possible that, if people choose not to help out, the NHS will look to recover sums paid to practices during this time. If practices are struggling to meet their commitment to demonstrate support for NHS care, one option for practices is therefore to withhold some money due to associates under the terms of the NHS help until it is clear whether there will be any such clawback.
Practice owners making any such withholding should:
- Be clear about what their overall obligation is as a practice to support the NHS (for example if the practice derives only 50% of its income from the NHS, it is not obliged to make all staff available)
- Discuss with the associate why they are considering withholding money
- Listen carefully to the associate's personal circumstances and arguments against withholding, and
- Give the associates a written statement showing what money is being withheld, why it's being withheld, and stating that the money will be paid to the associate promptly once if it become clear the NHS will not be clawing back any contract payments to the practice because the associates did not redeploy.
More about the furlough staff and mixed practice payments.
A recent court case on vicarious liability in dentistry may impact you, particularly if you have an NHS contract in England or Wales. Dentists in Northern Ireland and Scotland, while not immediately impacted by this decision, should also be aware of the precedent which it may set for cases taken in their jurisdictions.
James Goldman has outlined what associates need to know about vicarious liability. This includes information on cover for vicarious liability, your associate agreement, clinical audits and dealing with complaints:
“It is reasonable for a practice owner to require an associate to agree in the associate agreement to pay for losses caused by the associate through negligent treatment or bad conduct. Such terms are often in what lawyers call 'indemnity clauses'. However, you should look very carefully at any such indemnity clauses.”
Counselling and emotional support
This is an incredibly stressful time to be an associate dentist. If you’re feeling stressed or burnt out, please know that you are not alone.
counselling and emotional support service is available to members to help you deal with personal and professional problems that could be affecting your home life or work life, health and general wellbeing. This confidential helpline is open to all members 24/7, 365 days a year.