We have set out to ensure that members’ experiences during the COVID-19 pandemic are heard and lessons are learnt.
The Scottish COVID-19 Inquiry is investigating the strategic response to COVID-19 in Scotland and will present its findings and make recommendations to Scottish Ministers.
We were honoured to give evidence to the Inquiry. We spelled out the facts. Here’s what we had to say.
Decision makers must not forget the singular impact the COVID-19 pandemic had on the dental sector in Scotland.
Dentistry took a greater hit – when it comes to capacity – than any other primary or secondary healthcare service. Well over a year’s worth of dentistry has been lost.
We saw the suspension of routine care at lockdown and on resumption we were dealing with Aerosol Generating Procedures. The associated operational challenges included the wearing of enhanced Personal Protective Equipment, and the need to accommodate physical distancing and fallow times.
Yes, in part this loss of capacity was part and parcel of the nature of our work. But in others this was the direct result of political choices. The net result was that lower patient volumes were seen during the pandemic right through to the present day, and we still face an historic backlog, higher levels of need and widening oral health inequality.
As a trade union we had to safeguard the functioning of dental services. We wanted to ensure the safe delivery of dental services for staff and patients, at a time when an emerging evidence base required the need for agility in the face of unprecedented ambiguity. This agility was required not only by us but by everyone involved with the provision of dental services.
Throughout the pandemic we endeavoured to safeguard the functioning of dental services by explaining to leaders and the Scottish Government the pandemic’s direct impacts on dentistry, aiming to ensure they understood the challenges faced by dentists, and in the hope that any decisions that would affect dental services would be clinically led.
Dentists had to balance their desire to provide care for their patients, with making all the necessary arrangements to reassure dental teams, our patients and the general public that their safety was the highest priority.
The financial impact on dental practices – of being required to cease all services, then resume them on a limited basis – cannot be overstated. However, we were able to negotiate a support package intended to ensure the sustainability of NHS dental practices during the pandemic.
The stark financial situation which faced many mixed NHS/private and wholly private dental practices in Scotland was a significant concern throughout the pandemic. We consistently called for additional financial support to be made available, to ensure the viability of these dental practices.
In any future pandemic, officials must recognise the impacts on private dentistry too. Failure to maintain the viability of these practices would have implications across the whole dental system.
Scottish Government should also recognise and address the fact that the current payment model for NHS dental services will inevitably cause practices to be at risk of insolvency if there is another temporary suspension of services for safety reasons.
During the pandemic decisions had to be made at pace within a rapidly evolving landscape, with the evidence base in relation to COVID-19 and its management from a public health and a dental perspective ever changing. However, too often we failed to see timely and clear communication from the Scottish Government, with the dental profession.
This approach cannot be repeated. It is essential that future pandemic planning and preparation is comprehensive, considering contingencies for all aspects of the health system, including dentistry.
Any future response must recognise that dentistry is delivered through mixed NHS and private provision, and that financial measures must provide adequate support to both sectors.
There must also be appropriate planning and procedures put in place to ensure robust, consistent and reliable supplies of PPE for dentistry in the event of any future pandemic.
There should be consideration of ‘future proofing’ dental practices and testing the sector’s resilience and preparedness for a future pandemic now, so that this is not left to the 11th hour.
Scottish Government must ensure robust communication and timely engagement with the dental sector. This should be a key component of any future pandemic planning, along with appropriate training of dental teams.
In future pandemic planning, dentistry cannot be treated as an optional extra. Our teams are made up of key workers, providing an essential service to millions.
Pandemic planning and preparation must be comprehensive and include dentistry which is a vital part of the health service but, due to its contracted nature, is sometimes perceived as being detached from the NHS. Scottish government and health boards must recognise dental services as an integral part of NHS services.
Dental care is healthcare, and we must have appropriate processes and capacity in place to safely maintain vital services.
We hope that our evidence will shape any future pandemic response and ensure that dentists have the support they need.
