Coronavirus: your FAQs

We answer your frequently asked questions on COVID-19 and your dental practice.

Page last updated: 10:40 15 July 2020.

Dental practices are getting in touch with us to ask what to do if their staff or patients have or are suspected of having COVID-19, commonly referred to as the coronavirus. Read our live updates page for the latest information. Here are the answers to your FAQs, which we update as often as possible.

Coronavirus and the dental profession

1. What is the BDA doing to address my concerns?

This continues to be an unprecedented situation. We are lobbying the Government to ensure that your needs are represented at this difficult time. We are working to get you answers as fast as possible and keep you up-to-date with this ever-changing situation.

We've produced a series of helpful tools to help members through some of the more complex areas of the current crisis. We hope you'll find them useful. You will need to be logged in to access them.

Toolkit for returning to face-to-face care
Download our returning to face-to-face care toolkit to support dentists to reopen as safely and efficiently as possible. We have versions for dentists in England, Wales and Scotland.

Furlough calculator for mixed practices
Mixed practices can use this new tool to calculate the amount of money you are entitled to claim from the Government if you were to furlough some of your staff for a given period of time. To make it easier we've made a demo video on using the furlough calculator .

We have also drafted a letter for members with mixed practices to give to staff to explain the situation and seek their agreement to be furloughed workers.

Videos on financial support
Our webinar on financial packages, furloughing and retaining your staff, and paying associates in NHS and mixed practice is now available to watch in four edited videos. We have also made available the slideshow that our expert advisors referred to during the webinar.

Pay dispute resolution service for associates
Corporate bodies and practice owners with NHS contracts will continue to be paid on the condition (among others) that they pass on income due to associates. If you encounter issues, we will take them up on your behalf. See more about logging your pay dispute with us.

Remote consultation guide
We've put together guidance on how to conduct a remote consultation with your patients and avoid some of the common pitfalls.

Risk assessment
We created a risk assessment to support members in providing urgent care . We've also updated it with guidance on record-keeping for NHS practices and triaging.

NHS Mail account for private practices
It's important that private practices have access to an NHS email account. Without one, it will make it much harder for you to be able to make referrals to UDCs and issue prescriptions. To set it up you need to answer 14 questions on data management and security. Here's our guide on how best to answer these questions .

2. What is the BDA doing for private practices?

Protecting you, your patients and your practice's financial viability is our driving focus in these difficult times. We know that the crisis has brought many private practices near a financial cliff edge. The staggered re-opening of practices across the UK does not undo the financial impact the crisis has had on many businesses and so we’ll continue to campaign at a national and regional level to make sure your voice is heard.

3. What is the guidance on COVID-19?

England

The Office of the Chief Dental Officer England has published Standard Operating Procedures to cover a phased transition for dental practices towards the resumption of a full range of dental provision.

Updated guidance from NHS England states that from 15 June, dental practices are required to ensure that staff wear a surgical mask when not in PPE to reduce transmission risks.

It also states that if a staff member has been in contact with someone confirmed as a COVID-19 case, whether a co-worker or a patient, and contact with this person occurred while not wearing PPE, they should self-isolate for 14 days following Test and Trace requirements. Practices are also advised to make business continuity arrangements for staff absence due to self-isolation.

We encourage you to review our toolkit for returning to face-to-face care to support you and your team to resume practising as safely and efficiently as possible. This will give members the best possible advice on every stage of re-opening, so you can re-open with confidence.

Wales

The most recent Standard Operating Procedure (SOP) published by the Chief Dental Officer Wales covers aerosol procedures, as dentists are now allowed to offer more treatments in practice and the criteria for urgent care has been relaxed.

We have adapted our toolkit for members in Wales. It is to be used alongside the Welsh Government’s guidance to help dental teams complete Assessment of Clinical Oral Risks and Needs (ACORN) forms for patients, both routine and urgent. See our Coronavirus and NHS dentistry in Wales section below for more detail.

Previously issued documents include:

Dr Colette Bridgman, Welsh CDO, has confirmed that the return of dental services will be gradual, in line with the Welsh Government’s wider and cautious approach to easing lockdown.

Northern Ireland

A phased return for dental services in Northern Ireland is underway. The Acting CDO, Michael Donaldson, has issued a letter to all General Dental Practitioners on the re-establishment of dental services in Northern Ireland. The letter outlines three phases of re-establishment and indicates that guidance for practitioners on re-establishment will be issued in the coming days.

Phase two, the provision of non-urgent care, resumed on 29 June. Phase three, which includes aerosol-generating procedures, begins on 20 July. However if your practice can demonstrate that key conditions around infection and prevention control are met, you can move to phase 3 already.

Operational guidance for the phased return to practice in Northern Ireland has been issued. It covers practice and staff preparation, the patient pathway and enhanced cross-infection control procedures.

Scotland

Phase 3 of reopening began on July 13. Dentists are now able to see patients for routine care but any treatments requiring an aerosol-generating procedure (AGP) will still be referred to the urgent dental centres (UDCs).

A letter from the Chief Dental Officer and the memorandum to dentists was issued by the Scottish Government with further details about the return to dentistry.

We have also adapted our toolkit for returning to work for members in Scotland. It is designed to complement the SDCEP guidance, download it for practical advice on various issues, including indemnity, employment relations, and staff terms and conditions.

Previously, the National Clinical Director and CDO issued a joint letter to private practices and Healthcare Improvement Scotland (which is responsible for inspecting private practices) has issued guidance on reopening. The guidance stresses the importance of patient and staff safety, and of not contributing to an increase in the R number.

The Scottish Dental Clinical Effectiveness Programme (SDCEP) has published a practice recovery toolkit  which all practices in Scotland should use as the basis for re-opening during phase two of remobilisation.

Coronavirus and reopening your practice

4. How can I prepare for reopening?

Practices in England were allowed to reopen from 8 June and so, dentists all over the country have been working hard to prepare their practices to open as soon as physically possible since that date. The Office of the Chief Dental Officer England has published Standard Operating Procedures to cover a phased transition for dental practices towards the resumption of a full range of dental provision.

Updated guidance from NHS England states that dental practices are required to ensure that staff wear a surgical mask when not in PPE to reduce transmission risks.

Members can also download our toolkit for returning to face-to-face care. This toolkit aims to help teams implement the changes needed to gear up to providing appropriate treatments at appropriate times. It provides practical advice on every step of the process, including advice on:

Infection control, cleaning and PPE
How best to communicate the changes to patients
Employee management and training
NHS contractual arrangements.

Our aim is to support you in the practical application of widely agreed measures, so you can return to face-to-face care with confidence. This toolkit primarily applies to dentists in England, but may also be useful to dentists elsewhere. We also contributed to the FGDP (UK)’s work, so you will see similarities and alignment between the two pieces. We will update this toolkit as more information becomes available.

5. What about practices in Wales, Scotland and Northern Ireland?

Wales

Since 1 July dentists have been allowed to offer more treatments in practice and the criteria for urgent care have been relaxed. Practices can now be at heightened amber status and only offering non-AGPs, or in low amber status and offering AGPs as well, as long as they are set up and signed off by the relevant authority.

To support you in this, we have adapted our toolkit for members in Wales. It is to be used alongside the Welsh Government’s guidance to help dental teams complete Assessment of Clinical Oral Risks and Needs (ACORN) forms for patients, both routine and urgent.

Previously issued documents include:

For more information on changes to NHS dentistry in Wales please see section below.

Northern Ireland

The Department of Health has confirmed the new timetable for dental recovery in Northern Ireland. Phase two, the provision of non-urgent care, will resume on 29 June. Meanwhile, phase three, which includes aerosol-generating procedures, will commence on 20 July.

However, there is a fast track option available. If your practice can demonstrate that key conditions around infection and prevention control are met, you will be able to move to phase three on 1 July.

Scotland

Dentists in Scotland were allowed to return to routine non-aerosol generating procedures from 22 June. In light of this news, we published our new Toolkit for Scotland to help high street practices prepare for reopening.

6. What PPE is essential for re-opening?

Dental practices must have the correct PPE available to provide face-to-face care while community transmission of COVID-19 continues. This includes: masks, fluid repellent gowns, show covers, eye protection and gloves.

Facemasks make up one component of PPE. They are used most effectively in conjunction with eyewear, gloves, face shield and protective outerwear. For non-aerosol generating procedures (non-AGPs) fluid-resistant surgical masks (FRSM) Type II are advised and used with the wider PPE measures detailed below.

For AGPs the FFP2 respirator’s greater comfort makes it the mask of choice while providing sufficient protection for aerosols created in the dental environment. FFP3 (filtering face piece level 3) masks meanwhile provide greater filtration and potentially provide some marginal protection compared to an FFP2 mask.

Where, for cultural, religious or health reasons facial hair is present which will affect the seal of FFP2/3 masks, practices should consider as an alternative, the use of an FFP2 mask with a Type II fluid resistant surgical mask over the borders, in conjunction with a face shield/visor. A through risk assessment needs to be implemented at a local level if this suggestion is adopted. Another alternative is the use of a powered air purifying respirator (PAPR) hood. This does not require any fit-testing but wearers may have difficulty using loupes and other aids.

However, there’s more to PPE than masks. For more information on PPE and returning to face-to-face practice see our toolkit.

7. How can I obtain PPE and book fit-testing?

Some dentists are having difficulty securing a reliable and affordable supply of PPE. We’re also concerned by reports that dentists are having difficulties securing an appointment for fit-testing.

The Office of the Chief Dental Officer England has said that PPE for dentists is available from dental wholesalers for practices to purchase. This should include equipment necessary for aerosol generating procedures (AGPs) including gowns or coveralls, and FFP2 respirator masks.

The HSE website has advice and training materials on fit-testing respirator masks. Fit-testing is required for FFP2/3 masks to determine if a particular size or model provides an acceptable fit for each team member who will be wearing them. It needs to be conducted by a trained fit tester to verify that the respirator device performs as intended.

See this nationwide directory of fit-testers and list of approved training providers .

8. What if my staff do not want to return to work?

We recommend that you communicate with staff in an open and cooperative manner at this difficult time.

Health and Safety at Work legislation says to take reasonably practicable measures to ensure staff safety. To that end, we recommend you have clear rules on how dental practices should operate in place. Members can download our toolkit on returning to face-to-face care for support and advice.

If you have taken these steps and clearly communicated them to your staff, but they refuse to return to work, then you may be able to consider disciplinary action. We advise members to take advice before taking any disciplinary action as employees may have legal protection.

If employed NHS staff do not wish to return to work, see question 21 below for more information.

9. Should I screen staff for COVID-19?

We recommend you consider implementing a daily health screening check point and log for all employees entering the workplace. Our daily screening log can be used to document this. Dental staff should pay special attention to their own symptoms and stay home or be sent home immediately with symptoms of COVID-19 (fever, cough, sore throat, headache and muscle soreness, which may be accompanied by nasal symptoms).

This is one of the many steps we recommend practices take to ensure they are operating as safety as possible for staff and patients. Members should see our toolkit on returning to face-to-face care for a comprehensive overview of the practical steps we recommend.

10. How can I explain the situation to my patients?

We have pulled together some easy-to-understand advice for patients. Share this with your patients to help them to understand the challenges of re-opening, the need for PPE and social distancing in the dental practice.

Coronavirus and the dental team

11. How can I prepare staff for re-opening?

In order to re-open as safely and efficiently as possible, staff should be given time to:

Get used to the idea they will be returning to work
Understand the risks relating to COVID-19 and what the practice is doing to control those risk
Undertake any online training the practice may want staff to complete to get ready for new policies and procedures in place at the practice
Attend the practice for fit-testing of masks (where required non-clinical staff do not need fit-tested masks)
Ensure they have arrangements in place to look after any dependants at home
Seek further medical advice as to whether they can return to work (if, for example, they have a particular medical condition).

For further advice on how best to deal with staff concerns and manage staffing issues, members should see our toolkit for returning to face-to-face care.

12. Who should self-isolate and what should they do?

Dentists and their teams will be providing emergency care should follow government guidance on whether it's safe for them to do so .

We believe members of the dental team over 70 years of age should stay at home.

Members of the dental team under the age of 70, but with an underlying health condition (such as asthma, diabetes, heart disease), are at increased risk. Guidance says people in this category can go to work, but they should stay at home as much as possible. People in this category should not be forced to return to work in a dental practice. The risks should be assessed in each case. The risks can be reduced if there is space in the practice to maintain social distancing and/or if people with increased risk can avoid taking part in AGPs.

Advice has been published for pregnant women who are working in the NHS and other work settings. Women who are less than 28 weeks pregnant should practise social distancing but can continue working in a patient-facing role, provided the necessary precautions are taken. Women who are more than 28 weeks pregnant, or have underlying health conditions, should avoid direct patient contact. It has also recommended that pregnant women, regardless of gestation, should be offered the choice of whether to work in patient-facing roles during the pandemic.

Staff should also stay at home if they, or a member of their family, have coronavirus symptoms (the latter group should self-isolate for 14 days following the family member's diagnosis). Others will also have been advised to self-isolate. Staff staying at home for these reasons should be treated as if they are on sick leave.

The UK Government has said that statutory sick pay (SSP) should be payable from the first day of the sickness period. Employers with fewer than 250 employees will be eligible to reclaim two weeks' SSP for each employee who has been affected by COVID-19. This has not yet been formalised in emergency legislation, but it may include a clause allowing it to be backdated. Ensure you keep records of any absence due to COVID-19 to be able to claim this back from the government.

We recommend that you communicate with staff in an open and cooperative manner at this difficult time. Members can download our toolkit on returning to face-to-face care for support and advice.

13. What if one of my staff or associate dentists is pregnant?

Employers have a legal duty under the Management of Health and Safety at Work Regulations 1999 to assess the risks to employees who are pregnant. There may be some aspects of work at a dental practice where, even with additional PPE, the risk of catching COVID-19 is higher at work than it would be outside the workplace. The practice has an obligation under those regulations to ensure pregnant members of staff do not have to do such work.

There is a small, theoretical risk that participating in aerosol generating procedures (AGPs) could lead to an increased chance of contracting COVID-19 from a patient. We therefore suggest that pregnant employees in the first two trimesters are not required to participate in work that includes AGPs.

Advice has been published by the Royal College of Obstetricians and Gynaecologists advising a more precautionary approach for pregnant women in their final trimester. The guidance suggests such women should avoid patient facing roles. As the guidance currently stands, we advise practices with pregnant members of staff in the final trimester to find work for them which is not patient- facing in a clinical setting. Where that is not possible, the employer is obliged to suspend them on full pay until the start of the employee’s maternity leave.

14. How can I support BAME staff?

Emerging evidence shows that black, Asian and minority ethnic (BME) communities may be disproportionately affected by COVID-19. Organisations should ensure that line managers are supported to have sensitive and comprehensive conversations with their BME staff. They should identify any underlying health conditions that may increase the risks for them in undertaking their roles. These conversations should also, on an ongoing basis, consider the feelings of BME colleagues, particularly regarding their physical safety and mental health.

It is also important to note in this context, that PPE fit-testing requires men to shave their beards. Men who do not wish to shave their facial hair for religious reasons are currently being advised to wear a PPE hood instead and tuck it into their gown.

15. What if a staff member has coronavirus?

If a member of staff has coronavirus, they should follow government advice and standard sickness procedures should be followed. Staff should contact the practice and update them on when they will be able to return. They will either be entitled to sick pay or, depending on the terms of their contract of employment, statutory sick pay.

Check your contracts of employment and the practice's policy on sick pay. They will need to self-isolate for seven days after which symptoms should have abated, if they are not getting better they should seek medical advice and keep the practice updated.

At present, we do not know whether staff with coronavirus can also be furloughed workers receiving 80% of their pay. We cannot yet confirm whether staff sickness absence may impact on financial help from the NHS. We think it would be unfair if it did and are pushing for answers.

16. What do I need to know about redeployment?

Many dentists and dental staff are volunteering for redeployment. Many others are working in urgent care settings, or providing remote advice. Some dentists are taking the opportunity to work in different arenas and learn new skills.

We recommend that you read our financial impact page for more information and use our Redeployed Duties and Training Log on a daily basis to keep track of your work, as you may need these records later. We also urge members to contact BDA Health Assured if you find your mental wellbeing is under stress during this challenging time.

As practices reopen, they will want associates and other members of the team to return to work. Those who are volunteering should therefore make arrangements to return to work at their practice. We recommend you discuss the situation with your practice and reach an agreement. Though it should be noted that we are still waiting to find out the contract terms on which the NHS will pay dental practices to reopen and start providing NHS dentistry.

Coronavirus and practice management

17. NHS England contracts and abatement: what do I need to know?

Abatement is an agreed reduction in the NHS contract payment for any variable costs associated with service delivery. The NHS has said it will honour contract payments, but it is reducing that overall figure to take off the costs not spent. Practices need to know this abatement figure in order to understand their NHS income. The abatement is applied to the whole contract not at the individual performer/associate level.

Abatement to be applied to most contracts from 1 April up until 8 June will be 16.75%. This figure is based on an approximate assessment of variable costs that will not have been incurred when practices were closed to face-to-face care (such as laboratory costs and materials). The abatement for this period will be enacted through reconciliation over the period to 31 March 2021. We expect it to be reclaimed by commissioners gradually over the second half of the financial year.

For practices that have operated as urgent care centres during that period, there will be no abatement for the time they have been providing urgent care. That different approach recognises the extra costs for UDCs, on set-up, protective equipment and potentially staffing.

For the period from 8 June onwards, when practices have begun to provide face-to-face care again, 100% of contract value will be paid, with no abatement. This recognises the additional costs of providing care during the current period, again for example in terms of PPE. Practices are expected now to be making all possible efforts to be delivering as comprehensive a service as possible to patients.

Practices will not be measured on the delivery of Units of Dental Activity during this period. However specific assurances will be requested that individual practices are open for face-to-face care, are adhering to contractual hours with reasonable staffing levels for NHS services in place and are performing the ‘highest possible levels of activity’, with no undue priority being given to private activity over NHS activity.

Practices will need to deliver at least 20% of usual volumes of patient care activity to receive their full contract value. Importantly, we have agreed with NHS England that the definition of patient care activity includes all clinical contact that dentists or dental care professionals have with patients either face to face, by telephone or video consultation counted by the BSA via completed courses of treatment or via the COVID-19 triage portal.

The period to be assessed will be all clinical contact that dentists or dental care professionals have with patients either face to face, by telephone or video consultation from 20 July to 16 September 2020. This will be compared to the number of courses of treatment only, provided by the contractor in the equivalent period in 2019. Remote advice and care is included in the calculation for 2020 but not for the equivalent period in 2019. If practices are unable to meet the 20% threshold, then they will be required to revert to payment based on UDAs.

This above arrangement is temporary and we are working with NHS England to establish a revised mechanism for the later part of this financial year as activity gradually increases.

Practices are required to ensure that all staff continue to be paid at previous levels. This includes not just to dentists and dental hygienists, but also dental therapists, dental nurses, non-clinical and administrative staff. All practices will be asked to provide assurance over their continued engagement of staff, and to give an explicit declaration that they have not gained any windfall profits.

This abatement is not routine and will only apply in this pandemic when face to face activity within a practice has to cease. In a non-pandemic situation if a practice has to close because of fire or flood then force majeure provisions apply and UDAs may be carried forward. This would not have been helpful in a pandemic situation where during the abatement period there are no UDA targets.

The issue of abatement affects general dental practitioners providing NHS services. It does not affect Community or Hospital dentists.

18. When does the furloughed workers scheme close?

The furloughed workers scheme closed to new entrants on 30 June. Now only practices will only be able to furlough employees that they have furloughed for a full 3-week period prior to 30 June.

Another change to the scheme is that practices can now bring furloughed employees back to work on a part-time basis. If your practice qualifies to claim under the scheme, you now have the flexibility to decide the hours and shift patterns of their employees – with the government continuing to pay 80% of salaries for the hours they do not work.

19. How can I change the terms of employment contracts?

Practices may wish to alter the terms of employment for their employees. This might include: changing the hours that staff work, including breaks, changes to terms about clothing and uniform, and changes to pay or other benefits. There are two ways in which practices can change the terms in an employment contract, either in agreement with the member of staff or through dismissal and rehire. Advice should be sought on both options, members can find out more about the options available to them in our toolkit for returning to face-to-face care.

20. How can I negotiate changes to associate contracts?

Changes are best made by agreement with the associate concerned. Where changes are agreed, those changes can take effect quickly and easily. However, associates may be unwilling to agree to those changes unless there is a benefit to them. Associates are more likely to agree to temporary changes that will be reviewed after a period of a few months. We believe it is in both parties’ interests to negotiate sensible changes. We ask practice owners to make temporary, rather than permanent changes; at least until the situation becomes clearer. And we ask practice owners not to try and force changes that are too onerous or disadvantageous to associates. Members should seek advice from our practice support team before they take action on contract changes and review more information on the options available to them in our toolkit for returning to face-to-face care.

21. Do I pay employed NHS staff if they're not working?

If an employed member of staff refuses to return to work despite risk assessment indicating it is safe to do so, there is no right to continued payments from NHS England and this is considered an employment matter for the practice.

However, NHS England have said that if employed members of staff have asked to stay off work for caring responsibilities, or because official guidance says they should not be working, they should be eligible to receive NHS income.

Contract holders can claim under additional government support schemes in relation to their proportion of private revenue. Therefore if appropriate for workforce needs, practices might wish to consider whether to furlough staff unable to work for these reasons and bring into work those able to do so (in proportion to the practice NHS commitment).

22. Will there be clawback due to the shutdown?

At present, we do not believe there will clawback, however we are seeking clarification on this. We are also waiting to find out the contract terms on which the NHS will pay dental practices to reopen and start providing NHS dentistry. We advise you to review the section on NHS dental services provision on our Financial Impact page for the latest on this. 

We're answering many calls from members on staff and associates pay, members can access our answers to these questions here . We also recommend that members watch our advice webinar on financing and furlough .

23. What are you doing about business interruption cover?

We are taking urgent legal advice in respect to insurers not paying insurance claims made by dentists in regard to business interruption during the COVID-19 pandemic.

We have instructed law firm Brown Rudnick LLP to examine insurance policies affecting dental practices. It is now working with our members to gather relevant evidence on the full range of polices in the sector. This legal advice will shape the guidance that we will be offering a profession that has been blindsided by a lack of effective insurance during a period that has seen routine care suspended and cash-flow for many practices fall to zero.

The Financial Conduct Authority (FCA) has begun its own legal process to weigh up policies covering almost every business sector in Britain. We were the first trade union or professional body to directly engage with the FCA following the failure of most polices to pay out for losses incurred during the pandemic. While we welcome the news, we have expressed concern that the FCA's ‘one size fits all’ approach will fail to address the specific needs of our members. We are pushing for clarity on whether challenges affecting dentists will be taken into account by the court.

Members can watch a recording of our webinar with law firm Brown Rudnick LLP on the legal issues relating to business interruption policies and the pandemic.

24. Dentists can't access business rate exemptions, what are you doing about this?

New measures were introduced in the 2020 Budget to give business rate exemptions to retail businesses. Dental practices were not included in this. We believe that in the context of the business disruption caused by the COVID-19 outbreak, it is essential that this exemption be widened to include dental practices. We've made representations to the Government to that effect and we will update you on any progress made.

25. What support can mixed practices receive?  

We have been pressing the Government for clearer answers on the support available to mixed practices. We welcome confirmation from both the Treasury and NHS England that mixed practices can make full use of the furlough scheme in proportion to their private activity, without endangering their NHS funding. This is now known to be the case in all four nations and will be a relief to many mixed practices.

For the most up to date information on what options are available to you, we recommend you see our financial impact page. We also recommend that members watch our advice webinar on financing and furlough . This is kept as up to date as possible. But for the absolute latest, see our live updates page.

Members with mixed practices, we've put together a tool to help you calculate how much you are entitled to claim as part of the furlough scheme. Watch this demo video to help you use our furlough calculator.

Self-employed people who earn less than £50,000 a year are able to claim money from the Government's Self-Employment Income Support Scheme (SEISS) . Most associates earn more than £50,000 a year and will not be eligible. Associates who are eligible should have been contacted directly by HMRC by now. There is a question about associates who do a mix of NHS and private work. Those associates should still be receiving NHS income from their practice. If they claim their loss of trading profit from the SEISS, this could be deemed as duplicative relief and could fall foul of NHS rules. The BDA is seeking clarification on this point and will update members as soon as we have further information.

26. Can I avail of multiple forms of government assistance?

Yes. We have lobbied all four governments for a clear answer on this and at present we know:

England: The Treasury and NHS England have confirmed that mixed practices can make full use of the furlough scheme in proportion to their private activity, without endangering their NHS funding. This will be a relief to many mixed practices, and comes after consistent campaigning on your behalf.

Northern Ireland: A full list of the business support measures that have been put in place in response to COVID-19, and the Department of Health have stated that they expect dental practices in NI will be eligible for support from both UK-wide and NI Executive sources.

Wales: The CDO has acknowledged the need for financial assistance for the private portion of mixed practices' incomes. The Welsh Government has now introduced two grants to support businesses in Wales through the Coronavirus pandemic. Grant Number 2 is relevant to eligible dental practices should their rateable value be £12,000 or less.

Scotland: On 9 April, the Scottish Government clarified 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.

Coronavirus and NHS dentistry in Wales

27. What's changing for NHS dentists in Wales?

From 1 July 2020, practices will receive 90% of their contract value. This will then move up to 100%, potentially from September. In return for this 90% of contract value, practices will work within the scope of the de-escalation plans, at present in the amber phase, and work through the back-log of patients as best as possible on a prioritisation of needs basis.

Practices can be in heightened amber and only offering non-AGPs, or be in low amber and be offering AGPs as well, as long as they are set up and signed off by the relevant authority.

Key to this offer of 90% is the move away from the UDA system, and its replacement with the UDAS, (units of dental assessment). This is a move from payment based on activity, toward payment based on patient need and number. This new model may stay after March 2021, and we all can shape it.

There is no patient number target up to March 2021 because of the challenges with social distancing and thus throughput. We have stood very firm on this in discussions with the Welsh Government.

We support the protection of the contract value and the move away from the activity treadmill and we welcome confirmation that there will be no patient number target up until March 2021. However, we appreciate that many questions remain and can only be answered with time. We are working to keep you as up to date as possible.

28. What do I need to know about ACORN?

The Assessment of Clinical Oral Risks and Needs (ACORN) is a risk assessment form and includes the things we should all be recording in any good examination. These are an important part of the move to the new UDAS system described above.

There are two versions, one for routine care and another slimmed-down version for emergency patients. Colleagues have rightly raised concerns about some data being recorded on the urgent form. We don't think that every urgent patient should be offered a routine assessment. The requirement is to complete the necessary data points on the FP17W. This must depend on the practice's capacity and ability to take on

new patients.

We recommend having a good audit trail of ACORN forms. Data points on patient risk and need are essential. Please also be aware, the ACORN forms will change occasionally, so please expect things to alter with time. We have raised this issue with the Welsh Government and asked for clarity for you.

29. What if I want to stick with UDAs?

You will know better than anyone else what is best for your individual practice, and you can stay with the UDA model if you wish. In making any choice, we encourage you to consider social distancing, provision of AGPs and patients throughput. UDA numbers will also be ghosted in the background, so practices will be able to see a comparison.

Please also note that there could be clawback if you stay with the UDA. Your UDA target would be 75% of the original. This target did not count for April, May and June. So when deciding whether to stay with the UDA model, you should factor in how much activity you can complete going forward, and whether it will allow you to meet your UDA target.

If you feel it is best for your practice to stick with the UDA system, letting your Health Board know would be a good place to start.

Coronavirus and dental education

30. How will dental education continue?

On 23 March, a joint statement on dental education was issued by the GDC, Dental Schools Council, COPDEND, the dental faculties and the Joint Committee on Postgraduate Training in Dentistry. There have been a number of follow-up statements since then. In summary, the current situation is as follows:

BDS face-to-face final exams will not take place. However, dental schools and universities are establishing online systems to enable final exams to be sat for undergraduate students in their final year of study. There is the possibility of various sittings, to enable those ill or self-isolating on the date of the final exam to complete their exam on an alternative date. Some individuals might be provided with a development plan by the dental school to take into their career. Those who are not ready to sit final exams will be informed by their school. The DSC have pulled together FAQs for final year dental and DCP students.
The DFT organisers believe that they will be able to offer a place to all eligible UK graduates. In line with the applicant guidance, priority is given to those applicants for whom DFT is the only route available to be included on the NHS Performers List, while applicants who can be included on the NHS Performers List without completing DFT will only be considered for DFT places if there are insufficient suitable applicants who have no alternative route for entry on the NHS Performers List. UK graduates do not have any other route to join the performers list and are therefore given priority in this system. However, place offers are sent out in batches, so those with a low ranking may only receive their offer in the next few days. This is the case every year as the allocation process goes through a rolling system, also taking into account that some individuals might decline places that are then re-offered. UK graduates should not currently feel concerned about the discrepancy between the total number of applicants and the total number of places. Concerns of shortages of 100-200 places are unfounded. If there are any shortages at all, the numbers will be low and HEE believes it will be able to address these.
For those currently undertaking foundation or vocational training in the UK, the organisations expected that foundation dentists would be able to complete their training with minimal, if any, disruption to timescales. We were unsure about how this would work in the absence of clear guidance and wrote to COPDEND requesting clarification. COPDEND has now responded and confirmed that guidance on the process for the final review of competency progression (FRCP) will be issued shortly.
With regard to specialty programmes, the dental faculties of the Royal Colleges have paused all examinations. An updated statement on their plans for the exams was published on 30 April 2020. The Colleges hope to restart these examinations from September 2020, hopefully in line with existing timetables although this might change in line with national guidance as it develops. While they hope to deliver the exams in the traditional way, an online format is in development depending on circumstances at the time. The delivery method should be confirmed eight weeks before the exam. In the meantime, information about the ARCP process this year has been uploaded to the HEE website .
In terms of DCP training, the GDC is in touch with education providers and awarding bodies about plans and considerations for running final assessments, potentially online, with the aim of minimum disruption for students.
Recruitment to Dental Core Training and specialty training had been on hold while a task and finish group considered the options for these processes which had already started. Guidance has now been issued clarifying the recruitment processes and timescales for DCT and specialty training for the current recruitment round. DCT recruitment will be based on a situational judgement test (SJT), and specialty recruitment on a self-assessment process. Applicants should by now have been contacted with further information directly. Further information on the FRCP process this year has also been uploaded to the HEE website.
The BDA wrote a letter to the Chair of COPDEND and the dental deans in the UK highlighting dental education issues resulting from the COVID-19 pandemic. We hope to meet with COPDEND in the near future to discuss these issues further.
The four statutory education bodies (HEE, NES, NIMDTA and HEIW) have issued a letter with high-level principles for restarting dental education and training after the summer. Separately, the Dental Schools Council (DSC) has published a report on the safe return to clinical placements during the pandemic.

As always, we encourage all dentists in postgraduate training to check regularly for communications and updates from HEE or the deaneries on the evolving situation.

31. Dental students: What if I have lost my part-time job?

Many dental students have part-time jobs to help finance their education or lifestyle. Due to the outbreak, many of these businesses have now been required to close on Government advice. This has the potential to adversely affect dental students’ incomes. The Government however has put in place a number of measures to support workers during this period.

It depends on the business you work for and your own individual circumstances, but it is generally best to first discuss the situation with your employer, if you have not done already. If there is a workplace trade union, it is also useful to discuss the arrangements with them.

If you work for an essential business that remains open (such as food retailers), you are likely to be able to continue working. Many have put in place special arrangements, such as additional Personal Protective Equipment (PPE) and enforcing social distancing, to help keep employees and customers safe, but if you do have concerns about the arrangements in place please raise with your employer or, where present, the workplace trade union representative.
For some roles, it will be possible to continue to work from home. If this is possible or you think it may be, discuss with your employers the arrangements that can be put in place, any changes to your normal duties and how you can work safely and securely with regards to your personal health and safety, data protection and other issues.
If it is not possible for you to continue working due to coronavirus, the Government has put in place a Coronavirus Job Retention Scheme that allows businesses to furlough staff; where employees are retained in employment with the Government funding 80 per cent of typical monthly wages. This scheme applies equally to those in part-time work and on zero-hour contracts. If you think your employer may wish to retain you on the payroll, you should discuss it with them and, where present, the workplace trade union representative.

If you are self-isolating or taking sick leave as a result of COVID-19, you are entitled to Statutory Sick Pay of £94.25 per week from your employer, if your earnings are above £118 per week. You can obtain a sick or ‘isolation’ note from NHS111 online.

If you are a dental student and are worried that you cannot meet your current personal household expenditure, remember you can apply to the BDA Benevolent Fund for financial assistance.

Coronavirus and employed dentists

32. Who should I talk to about redeployment?

Employed dentists are already being asked to undertake duties to help support their medical colleagues in the COVID-19 response. This will likely increase in the coming weeks.

Community/Public Service dentists
Community dentists should firstly be allocated by their local NHS to undertake appropriate primary care treatments. After this demand has been met then CDS dentists are welcome to volunteer for wider NHS redeployment.

Hospital dentists
Hospital dentists wishing to undertake other duties should make this known to their lead consultant/clinical director. Lead consultants/clinical directors should then liaise with their hospital medical director to determine the deployment of these dentists. We have communicated this position to the Association of Dental Hospitals and have asked the BMA to cascade this through their LNC network.

Academic dentists
Clinical Academic dentists wishing to undertake other duties should make this known to their Undergraduate Dean. Undergraduate Dental Deans should then liaise with Undergraduate Medical Deans and in turn hospital medical directors to determine the deployment of these dentists in the hospitals connected to the dental school. We have communicated to Dental Schools Council that this is our default position and have asked the BMA to pass this on through their LNC network.

33. How should I prepare for redeployment?

If you are asked to undertake other duties during the outbreak, this may include working in another dental discipline that you haven’t undertaken for a while or something completely outside of dentistry. You should take the following steps to make sure you are safe while undertaking other duties:

Step 1

Agree, with your NHS clinical director/line manager and their equivalent in the area to which you are to be redeployed, a task list or role specification. This task list will state clearly the tasks that you will be expected to do. Ensure the task list is clearly defined and ill-defined statements such as ‘any other duties’ are not included.

Step 2

If you are happy, in principle, with the task list provided, discuss whatever training is required for you to safely perform the duties. Get a firm commitment to the date of this training and opportunity to shadow a colleague based in the new area.

Step 3

Check with your indemnity provider that they will cover you for the new duties.

Step 4

Undergo the training and make notes of what you were taught. Recording on mobile phones may be particularly useful.

Step 5

Report for your new duties. Establish who will be providing operational supervision.

Step 6

Complete our Redeployed Duties & Training Log on a daily basis.

Step 7

Talk to other colleagues, not necessarily dentists, in the area in which you are working. Discuss any concerns you may have with your operational supervisor. Contact us if you feel under any pressure to act beyond your task list.

Step 8

Consider contacting BDA Health Assured if you find your mental health and general wellbeing is being challenged.

34. Will my indemnity cover me?

If you undertake wider duties to support the NHS, these will be covered by extended NHS indemnity. If you also hold a policy with another provider, you will need to confirm with them if your cover will extend to these additional duties. You may need to undergo training to be covered for any additional duties undertaken.

35. Are appraisals being suspended?

Very few dentists will be working their normal contracts and work patterns over the coming weeks and months. To that end, we have asked for appraisals and mandatory training for CDS dentists to be suspended for the next six months. Further guidance from the Welsh government regarding annual appraisals on the Dental Appraisal System. We have received confirmation that for CDS dentists in Wales these will be suspended until 1 October 2020.

Appraisals for Community Dentists in Northern Ireland have also been suspended until September 2020.

The Scottish Government have also confirmed the suspension of appraisals for PDS dentists.

Appraisals and mandatory training has been suspended until September 2020 for dentists employed in England under a Salaried Primary Dental Care Service terms and conditions. For hospital dentists in England and Scotland, appraisals have already been postponed.

We are seeking clarity on appraisals for hospital dentists in Wales and Northern Ireland.

36. Where can I go for support?

During this time, you may have to make clinical decisions that prioritise scarce resources. For guidance on the ethics of this, please see the FAQ we produced along with the BMA . This won’t answer every question you have, but we hope that it will support and guide you in making the decisions asked of you.

If you are looking for advice on a work-related issue:

Members employed on national terms and conditions within the salaried/community dental service, in dental schools, in the armed forces or a variety of other employed roles with in the NHS, please contact: employmentrelations@bda.org
Members working under hospital terms and conditions can contact the BMA for employment relations support: 0300 123 1233 (please quote your BDA membership number).

This may prove quite stressful and members should be aware that they have access to our 24-hour counselling service. We’re here for you and we encourage all those under stress to reach out.

Coronavirus and Dental Core Trainees

37. What do I need to know about redeployment?

We advise dental core trainees to review the following documents and to take the following eight steps to prepare for redeployment.

FAQs from Health Education England (HEE)

Links to resources for COVID-19 e-learning

Information on rotas management from NHS Employers and the BMA

If asked to undertake other duties during the outbreak, this may include working in another dental discipline that you haven’t undertaken for a while or something completely outside of dentistry. You should take the following steps to make sure you are safe while undertaking other duties:

Step 1
Agree, with your NHS clinical director/line manager and their equivalent in the area to which you are to be redeployed, a task list or role specification. This task list will state clearly the tasks that you will be expected to do. Ensure the task list is clearly defined and ill-defined statements such as ‘any other duties’ are not included.
Step 2
If you are happy, in principle, with the task list provided, discuss whatever training is required for you to safely perform the duties. Get a firm commitment to the date of this training and opportunity to shadow a colleague based in the new area.
Step 3
Check with your indemnity provider that they will cover you for the new duties.
Step 4
Undergo the training and make notes of what you were taught. Recording on mobile phones may be particularly useful.
Step 5
Report for your new duties. Establish who will be providing operational supervision.
Step 6
Complete our Redeployed Duties & Training Log on a daily basis to keep track of your work. This may need these records later.
Step 7
Talk to other colleagues, not necessarily dentists, in the area in which you are working. Discuss any concerns you may have with your operational supervisor. Contact us if you feel under any pressure to act beyond your task list.
Step 8
Consider contacting BDA Health Assured if you find your mental health and general wellbeing is being challenged.