An update from Sara Hurley, Chief Dental Officer England

Sara Hurley, Chief Dental Officer for England, sent out the following NHS dentistry and oral health update on Friday evening, 27th November:

Dear colleague,

Every week I get the statistics on my desk which show how many patients we are seeing and what type of treatments we are giving them. I’m happy to report that access is steadily increasing and the initial evidence from over the summer shows that the majority of treatments we are offering are tooth saving. 

As you will have seen, since my last update, the NHS has moved to incident Level 4 and the government has announced the tiers communities in England will be in after the period of national restrictions ends on 2nd December. Our clinical priority remains the provision of urgent dental care. As we continue the transition to recovery of services and where practice capacity allows, we would increasingly expect practices to be actively recalling patients to resume interrupted care pathways and seeking to offer appointments to patients who normally attend the practice for care in terms of their risk. 

I recognise that there is a delicate balance in meeting patients’ needs against the restrictions of COVID. However, the statistics demonstrate the great efforts of the majority of practices in providing access and addressing a wide range of patients’ dental care concerns.

November is mouth cancer awareness month so it is a good opportunity for me to remind everyone that a patient with suspected mouth cancer is in urgent need and should be prioritised for a face to face consultation.

Sandra White, Public Health England’s lead for dental health has also written an important update on the use of antibiotics. Dental professionals have done sterling work in reducing the use of unnecessary antibiotics in the last few years and we must continue to do our bit to avoid the development of antibiotic resistance.

I’m also delighted that the amazing Peninsula Dental Social Enterprise has been named the South West Regional Winner in the Health Equalities Award category of the NHS Parliamentary Awards 2020. Their local MP nominated them after seeing the excellent work the practice has done to support those who are homeless in Plymouth. More detail on their achievement is below. In these updates to you, I want to share just some of the stories which show why we should be proud of what we’re doing. If you know of a colleague who deserves a shout out (and you all will) then please do drop me a line at ocdo-cdo-exec@nhs.net.

Sara

UK CDOs issue joint letter: Supporting the dental profession throughout the second Covid-19 wave

Tom Ferris, Chief Dental Officer for Scotland, Colette Bridgman, Chief Dental Officer for Wales, Michael Donaldson, Chief Dental Officer for Northern Ireland, and Sara Hurley, Chief Dental Officer for England, have together issued an open letter addressed to colleagues, titled Supporting the dental profession throughout the second Covid-19 wave.

The letter reads as follows: 

Covid-19 has been a challenge for the entire UK population. For dental teams, we understand the impact of asking you to scale back care in March and we appreciate your sterling efforts to resume service provision to support patients. We know that you continue to work tirelessly to address the backlog of care, all driven by our profession’s enduring common motivation – to deliver the very best care for our patients through this pandemic.

Unfortunately, as we all know, COVID-19 cases are rising again and there is already sustained additional pressure on parts of the NHS. Pressure will inevitably be exacerbated by staff shortages due to sickness or caring responsibilities. Due to the actions of the whole population of all four nations the initial peak of pressure will be significantly lower than it would have been, but it may well be prolonged throughout the winter period, with wide local variation and fluctuation in cases, requiring a sustained and prolonged response from all the healthcare professions.

In partnership with patients, we want dental professionals always to use their professional judgement to assess risk and to make sure people receive safe care, informed by the values and principles set out in our professional standards. The national SOPs remain your guides throughout this next phase of the pandemic and we expect all registrants to follow GDC guidance using their judgement in applying the principles of best practice to the situations they face.

This second wave will require healthcare professionals to be flexible in what they do. We recognise that some dental professionals may find themselves working outside their usual scope of practice and this can be stressful, and you may have concerns about both the professional practicalities and implications of working in such circumstances. The healthcare professional regulators, including the GDC, have already committed to take into account factors relevant to the environment in which the professional is working, including relevant information about resources, guidelines or protocols in place at the time. The joint statement issued by the healthcare regulators in March 2020 remains extant. https://www.gmcuk.org/news/news-archive/how-we-will-continue-to-regulate-in-light-of-novel-coronavirus

We are also determined to ensure the long-term prospects of dental professionals in training are not compromised by this prolonged health crisis. The GDC, together with the education bodies in the four nations, and Dental Schools Council are working on this.

It’s also important to look after each other during this time. We want dental professionals to feel supported and cared for at work, the pandemic is a difficult time for everyone and we’re all human.

Finally, we would like to thank every single one of you for your tireless efforts to support patients. We are very proud of the response of the dental profession to this challenge.

Sara Hurley confirms NHS dental services will continue during new lockdown

Sara Hurley, Chief Dental Officer for England, has issued her latest NHS dentistry and oral health update, covering recent announcements and links to current guidance and relevant publications. 

The update has been sent out “in light of the Prime Minister’s announcement that from Thursday [5th November] England will enter a period of further national restrictions until 2 December.”

The bulletin includes confirmation from Chief Dental Officer for England that during the period of tighter restrictions dental services will remain open for face-to-face care. This includes delivery of both aerosol generating procedures (AGPs) and non-aerosol generating procedures. Dental care is to be delivered in line with the principles set out Transition to Recovery SOP published 27 Oct 2020 and with regard to the recently updated national infection prevention control and the accompanying dental appendix. Priority remains focussed on patients who require access to urgent care, patients at higher risk of oral disease, and patients with outstanding treatment needs that cannot be delayed. All dental practices should continue to provide remote consultations with triage and advice as necessary options. Dental practices will be asked to maintain their support to their local UDC system (face to face as well as remote).  Co-ordination of the local UDC system lies with the NHS Local Area Team and all practices are encouraged to remain in close contact with their area teams.  The principles for UDC systems and provision of urgent dental care are set out in the revised UDC SOP published 27 Oct 2020

The CDO explains: “The government’s guidance states that “a number of public services will also stay open and you will be able to leave home to visit them. These include […] the NHS and medical services like GPs

“I can confirm that this includes NHS dental services. Therefore, during the period of tighter restrictions practices should remain open to treat patients in line with the standard operating procedure and with regard to the recently updated national infection prevention control dental appendix. Detail on both of these were shared in last week’s update and are repeated below.”

Read more here.

New Covid-19 infection prevention and control dental guidance published

The Department of Health and Social Care (DHSC), along with Public Health Wales (PHW), Public Health Agency (PHA) Northern Ireland, Health Protection Scotland (HPS), Public Health Scotland, Public Health England and NHS England, has released new Covid-19 infection prevention and control dental guidance.

This newly published UK IPC Guidance has been developed for dental settings, and has been considered and incorporated into the latest revision of the office of CDO’s SOPs, which will be published imminently.

Whilst this guidance seeks to ensure a consistent and resilient UK wide approach, some differences in operational details and organisational responsibilities may apply in Northern Ireland, England, Wales and Scotland.

It is also noted that this guidance is of a general nature and that an employer should consider the specific conditions of each individual place of work and comply with all applicable legislation, including the Health and Safety at Work etc. Act 1974.

The guidance is available to read here.

NHS England updates Urgent Dental Care Guidance and Standard Operating Procedure

NHS England and NHS Improvement have issued updates to the Urgent dental care guidance and standard operating procedure and Dental standard operating procedure: Transition to recovery documents, along with a letter from Chief Dental Officer Sara Hurley.

“It is 12 weeks since dental practices in England were able to resume face to face dental care,” Sara Hurley begins in her latest communication. “Thank you for all your efforts in broadening access to dental care and supporting the collective NHS focus on a return to full operating capability across the whole of healthcare.”

To support practices as they continue to expand the range of treatments offered, the latest Covid-19 dental guidance update incorporates validated evidence and expert consensus. These publications serve as a framework for identifying and mitigating the risks to dental staff and patients.

“Updates include: Covid-19 screening questions to be asked in line with the case definition for possible Covid-19 and isolation requirements including quarantine advice for those entering or returning to the UK,” says Hurley.

To read Sara Hurley’s letter in full, click here.

The Urgent dental care guidance and standard operating procedure can be accessed here.

The Dental standard operating procedure: Transition to recovery document can be found here.

CDO issues letter regarding nominations from the dental profession for national honours

Sara Hurley, Chief Dental Officer for England, has issued an open letter regarding nominations from the dental profession for national honours:

I am writing to request your support in acknowledging those individuals who merit state recognition.

We are now looking ahead to Birthday 2021 Honours and I would appreciate it if you can take the time to nominate those colleagues who you work with who have made an outstanding impact in dental care and the improvement of oral health.

Nominations can cover specific activities or a life time achievement. Status or seniority isn’t important – what matters is what the person has done and the impact they have had on people’s health and care over a sustained period of time.

I would ask you to note that the workforce of the NHS is predominantly female. As such the Health Honours Committee is looking to reflect this in its awards. In addition, the Committee is actively looking for deserving recipients of the British Empire Medal (BEM). This is awarded to those who have made a significant difference and gone beyond their day job, at any level. It is particularly apt for individuals at the beginning of their careers or even still in training. Deserving candidates may have carried out innovative work over a short period of time (3 to 4 years). Their endeavours may relate to their professional arena or voluntary work with a local community in need. The hallmark is of their contribution is frequently exemplary dedication and quiet perseverance.

Recent correspondence from DHSC states:
– People who fit the Prime Minister’s priorities for Honours:

  • Create jobs and economic activity across the country and support a global, outward looking Britain;
  • Support children and young people to achieve their potential, whatever their background;
  • Aid social mobility, enhancing life opportunities and removing barriers to success;
  • Give their time to improve their local community; and
  • Work to tackle discrimination in all its forms.

The Prime Minister is keen to recognise activity which supports diversity and social mobility.

– Women, people from black and minority ethnic backgrounds and young people
– Frontline NHS workers and those in under-represented professions or occupations
– Those working in areas outside the South East.

When crafting your nomination, please remember it is not about replicating an individual’s CV. There is a fine art to composing and developing a successful nomination. As well as articulating the evidence of merit it is vital to adopt the right tone and language. The Honours Committee often asks for details on the number of patients, public, health care workers impacted by the nominee. The online Department of Health: Honours nomination form and guidance – Publications – GOV.UK.is useful to help develop your draft. We have attached a copy of this along with the latest Honours Citation form.

Your nomination will need to be with england.cdoexecutive@nhs.net no later than close of play Tuesday 25th August 2020 Nominations should ideally have the support of recognised bodies/individuals and be signed-off by the Chairman/Chief Executive of the employing/educational organisation.

Further development of text and evidence may be required to pass muster with the variety of mandatory honours boards that filter nominations ahead of any final endorsement. Whilst success is not guaranteed every time, for those with significant achievements there is no expiry date and the opportunity to revise and re-submit at a future date always remains an option worth pursuing.

Thank you in anticipation of your assistance and receipt of your nominations in due course.

With thanks and best wishes.
Yours sincerely,

Sara Hurley

For guidance on completing the form from DHSC  a sample citation and the latest honours template can be found here:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/766815/honours-process-guidance.pdf