4. Should I use the NHS COVID-19 app?
It is not a legal requirement to do so, but you may find the NHS COVID-19 app a useful way to monitor your risk level. If using the NHS COVID-19 app, the Government recommends that you pause the contact‐tracing function on the app when you are in dental surgeries. The app should not continue tracing your contacts during this time because you are working in highly specialised environment, trained in infection prevention and control processes, and wearing medical grade PPE as required.
You should also be aware that notifications from the app to self-isolate are not legally binding. You are only legally obliged to self-isolate if told to do so by NHS Test & Trace.
See guidance on
how healthcare workers can use the NHS COVID‐19 app for more information. Please distribute all relevant guidance to your staff.
In Northern Ireland the
Health and Social Care Board contact tracing app is in operation.
5. What if a patient has COVID-19?
If dentists are providing direct care to a patient with COVID-19 and are wearing the correct PPE in accordance with the current IPC guidance, they are
not considered a contact for the purposes of contact tracing and isolation, and are not required to self-isolate.
6. Must patients wear face coverings?
Current SOPs should be followed, this includes asking patients to wear a face covering. However, a patient should not be refused access to care if they are unable to wear a face covering.
For these patients, practices should ensure that they can take all reasonable steps to identify practical working solutions with the least risk to all involved. For example: offering the patient a mask, if the patient is willing to wear one; booking the patient into a quieter appointment slot; seeing them in a separated area, or providing care via a remote appointment.
If a patient is deaf or has hearing loss, you are advised to temporarily lower your face covering while maintaining social distancing. These patients should not be turned away and this is the safest way to communicate with someone who relies on lip-reading or facial expressions.
7. What if a staff member has COVID-19?
If a member of staff has coronavirus, they should follow the
stay at home guidance in their area.
In England, NHS staff who have received a positive COVID-19 test result are only required to self-isolate for 5 days, if they test negative on days 5 and 6 and are medically fit.
This means that if you test negative on the morning of day 6 and you tested negative 24 hours earlier, you can return to work on day 6 under the following conditions:
- You do not have any COVID-19 symptoms
- You do LFTs every day for the remainder of the 10-day isolation period (if any subsequent LFT result is positive, the person should continue to isolate and should wait 24 hours before taking the next LFT)
- You should take these LFTs at home prior to going to work
- You must comply with all recommended infection control precautions.
If any of the above cannot be met, the staff member should not come to work and should follow the stay at home guidance for the full 10-day period.
If your LFT test result is still positive on the fourteenth day, you can stop testing and return to work on Day 15. However, a practice can undertake a risk assessment of staff who test positive between Day 10 and Day 14 and who do not have a high temperature and can get them to return to work, depending on the work environment.
Standard sickness procedures should also be followed. Staff should contact the practice immediately 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.
If a COVID positive member of staff is providing care to a patient and wearing the correct PPE, they are not considered a contact for the purposes of contact tracing and isolation, and are not required to inform the patient for self-isolating purposes.
However, if a COVID positive member of staff comes into direct contact with a patient whilst wearing no PPE, inappropriate PPE or a PPE breach occurs, the patient must be contacted.
The member of staff should also submit the details of close contacts to the NHS Test and Trace service, which would then let any colleague or patients know if they have been in close contact with a person who has tested positive for COVID-19 and should self-isolate.
8. What if a staff member has contact with a COVID-19 case?
England, if a member of staff is providing care to a patient and wearing the correct PPE, the patient is not considered a contact and the staff member is not required to do anything.
Outside of that situation, if someone in the dental team comes into contact with a confirmed COVID positive case it depends on their vaccination status:
If they ARE fully vaccinated, they will be able to continue in their usual role subject to:
- Them not having any COVID-19 symptoms
- Them arranging a PCR test via the NHS Test and Trace service and having a negative result (however, if a staff member has had COVID in the past 90 days, they should not have a PCR test and should only undertake daily LFTs for this purpose)
- Them taking LFTs antigen test every day for the 10 days following their last contact with the case before leaving home for work
- Them complying with all relevant infection control precautions and PPE guidance.
If they ARE NOT fully vaccinated, they should stay at home (as advised by Test and Trace) but normally for 10 days (but see the Day 6/7 early release conditions under Q8 “What if a staff member has COVID-19?”
If you are in Wales, Scotland or Northern Ireland please refer to local guidance on self-isolation.
Northern Ireland a letter from Chief Medical Officer, Sir Michael McBride, provides
updated guidance on the management of health and social care workers that have had close contact with positive COVID-19 cases. If someone in the dental team comes into contact with a confirmed COVID positive case and they are fully vaccinated (have had two doses of an approved vaccine, and have received a booster dose at least 14 days prior to the date of their exposure to the confirmed case) they will be permitted to return to work as long as they meet the following requirements:
- They have taken a PCR test after their exposure. This PCR should return a negative result. Staff should not attend work while awaiting the PCR test result
- If the PCR test is negative, the staff member can return to work but should take a daily lateral flow test (including on the same day they receive the negative PCR result) until the tenth day after the last date of contact with the positive case. The lateral flow should be taken before leaving for work each day
- If a staff member has had a positive COVID-19 PCR test in the past 90 days, they should not have a PCR test unless they develop symptoms. Instead, they should take a lateral flow test (LFT) as soon as possible and before attending the workplace. If it's negative, they can return to work and follow the rest of the guidance - including continuing with daily LFTs.
This checklist is a simple, easy to follow format for
employers to make risk assessments on a case-by-case basis and minimise disruption.
In Scotland, healthcare staff are now exempt from the requirement to self-isolate for 10 days as long as they are vaccinated, remain asymptomatic, return a negative PCR test and undertake daily lateral flow testing. If staff are not fully vaccinated, or are symptomatic, or return a positive PCR test they must self-isolate for 10 days.
Staff staying at home for these reasons should be treated as if they are on sick leave. The 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. Ensure you keep records of any absence due to COVID-19 to be able to claim this back from the government.
However, this is not the case if you are pinged by the NHS app and told to isolate. The app is advisory and there is no legal requirement for you to isolate, but
the Government strongly recommends that you do.