David McColl, Chair of the Scottish Dental Practice Committee, details the work of the committee in recent weeks to ensure NHS practices remain viable during the COVID-19 crisis.
Since the Coronavirus outbreak, we have repeatedly urged the Scottish Government to secure appropriate funding to keep dental practices viable.
NHS practices
We have argued that funding for NHS practices during the COVID-19 crisis should be seen as an investment in NHS dentistry for when the pandemic is over.
"The new package confirms 80% of the average income from items of service and patient contributions."
It was with immense relief we share that the Scottish Government issued a revised funding package for NHS dentists on 30 March. The new package confirms 80% of the average income from items of service and patient contributions. It should offer dentists the reassurance they need and allow their practices to remain viable. We are pleased that the Government heeded our concerns, and are grateful to the CDO and his team for their efforts to secure this funding. It should help to ensure the sustainability of NHS dentistry in Scotland.
The road to this funding package wasn't easy. Our campaign to secure new funding measures for dental practices began on 4 March, when we met with Joe FitzPatrick, the Minister for Public Health, Sport and Wellbeing, and Tom Ferris, the Chief Dental Officer. During this meeting we discussed the potential impact of COVID-19 on dental practices, and the CDO indicated that he and colleagues were looking into these concerns.
Over the following days, the situation deteriorated rapidly. We received reports of dental practices closing and an increasing number of calls from anxious dentists. We pressed the Scottish Government daily to publish its clinical guidance and financial mitigation measures as a matter of urgency, and SDPC provided input into an initial draft at short notice. The Scottish Government issued a PCA and a CDO guidance letter on 17 March. These provided some much-needed clarity and reassurance to dentists. However, the crisis continued to escalate, and we continued to press the Scottish Government on the financial sustainability of dental practices with a large percentage of fee-paying patients, and the provision of full COVID-19 PPE equipment for dental teams.
The call to immediately cease all routine dentistry and the use of aerosol-generating procedures then arrived in a further letter from the CDO on 23 March in which he outlined new measures. The letter also sought to reassure dentists that the CDO was working to source additional NHS funding to address concerns on practice sustainability. However, we and many members of the profession continued to be greatly concerned. SDPC urged the Scottish Government to consider – as an equitable solution – revising the financial mitigation to 80% of gross Item of Service income and patient contributions for all practitioners. Dentists from across the country also contacted the CDO to implore him to reconsider the funding package. The new financial measures are a result of this tireless work.
We are now seeking urgent guidance for practices on how the NHS funding package relates to the HMRC commitment that furloughed staff will receive 80% of their salary. We also need clarification from Practitioner Services on existing treatment plans and how the NHS funding package will work for Associates who have recently moved practice, and dentists who have recently returned from maternity leave.
Mixed and private practices
"We're very concerned about the financial viability of mixed and private practices in Scotland."
We're very concerned about the financial viability of mixed and private practices in Scotland. We continue to investigate what other sources of funding may be available to these practices. We're liaising with colleagues across the UK and seeking clarity around essential issues such as the criteria and process for furloughing staff in mixed practices. We will issue this guidance as soon as we have it.
We will continue to do everything we can to ensure dental practices survive this crisis so we are there for our patients when the pandemic is over.
David McColl
Chair of the Scottish Dental Practice Committee
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