coronavirus

FGDP(UK) and CGDent launch UK guidelines for safe return to general dental practice during Covid-19

As reported on Monday, FGDP(UK) and the newly formed College of General Dentistry (CGDent) have convened an expert task force to review the evidence base for dental practice during the Covid-19 outbreak and have launched the official guidelines ‘Implications of Covid-19 for the safe management of general dental practice – a practical guide’. Dental services are able to resume from Monday 8 June in England.

The UK wide task force panel includes 30 senior members of a number of organisations, including the British Dental Association, the Faculty of Dental Surgery of the Royal College of Physicians and Surgeons of Glasgow, the Faculty of Dental Surgery of the Royal College of Surgeons of Edinburgh, the Association of Dental Groups, the Association of Dental Implantology and the newly-formed British Association of Private Dentistry and has received support and input from groups across the profession including the British Society of Dental Hygiene & Therapy and the British Association of Dental Nurses. It supports dental professionals to take a risk and evidence-based approach to providing safe care in the current circumstances and allows the flexibility of setting minimum requirements whatever the national Covid-19 threat level.

Ian Mills, Dean of FGDP(UK), commented: “During the initial stages of the pandemic it was important that all but emergency dentistry procedures were paused. However, we are now at a point where the risk to the oral health of the population will be impacted unless practices are able to reopen, albeit with the correct protection for patients and the dental team. This guidance has been developed as a framework to enable the confident and safe return to practice, now and also into the future as the situation with Covid-19 continues to evolve. It is the result of the collaborative effort of a team of dedicated individuals from across the profession who have spent the last few weeks committed to reviewing the evidence, assessing the risks and finding a way forward.”

In line with other FGDP(UK) Guidance and Standards publications, the guidance adopts the ABC (Aspirational, Basic, Conditional) approach to measures with ‘basic’ measures being a minimum standard.

The guidance is divided into five sections – four of which reflect the patient journey and the fifth concerns general management of the practice. These sections are assigned a risk status and ABC based risk mitigation measures to ensure safe practice and include:

  1. Pre-appointment – including the important role of digital communication to minimise contact time
  2. Patient attendance (pre-treatment) – including the communication of new infection control and prevention procedures to patients along with changes to waiting areas
  3. During treatment – including recommendations for approaches to aerosol generated exposures (AGEs), developed using a model based on risk continuum and recommendations for appropriate levels of PPE
  4. After treatment – including procedures to protect patients and staff and the use of an appropriate fallow period following high risk AGEs
  5. Management/governance tasks – including risk assessments for all staff members and awareness of the need to encourage staff to monitor and support if they feel unwell

Onkar Dhanoya, Chair of the Task Group, commented: “These guidelines have been developed to address the specific needs of primary dental care. This includes the recognition that whilst safety of patients and team members is the priority, closure of practices is in itself harming patients, their oral health and psychological wellbeing. The use of the risk matrix tables within the guidance allows us to reflect the varied needs of practices and the fluid nature of the current situation.”

Roshni Karia, Junior Vice Dean, FGDP(UK), said: “The Covid-19 pandemic has brought uncertainty to a number of aspects of daily life. This guidance aims to help develop specific strategies for primary dental care with a realistic approach to what can be achieved in practice. It also provides guidance for supporting patients and staff who may be in greater risk categories. By working together as a team, we can all proceed with confidence and help to sustain trust in dentistry overall.”

For further information and to access a full copy of the guidance please visit https://www.fgdp.org.uk/implications-covid-19-safe-management-general-dental-practice-practical-guide and https://cgdent.uk/2020/06/01/safe-return-to-dental-practice-during-covid-1.

FGDP reveals UK Guidelines for a safe return to dental practice during Covid-19

Ian Mills

At midday on Monday 1 June 2020, Ian Mills, Dean of the Faculty of General Dental Practice [UK] (FGDP), broadcast a brief statement via the organisation’s Facebook page to announce that FGDP and CGDent have published the UK Guidelines for a safe return to dental practice during Covid-19.

The 68-page document is available via the FGDP website – https://www.fgdp.org.uk/implications-covid-19-safe-management-general-dental-practice-practical-guide – and supports dental professionals to take a risk and evidence-based approach to providing safe general dental care in the current circumstances. It was developed jointly with the College of General Dentistry, and with the involvement of a wide range of other national dental organisations.

The document can be accessed here.

“Our guidelines are developed primarily by general dental practitioners, and are aimed at colleagues working in general dental practice,” explained Mills, along with CGDent Trustee Mick Horton and Covid-19 Task Group Chairman Onkar Dhanoya. “This has been particularly important at this critical time, but we could not have delivered this guidance without the support and expertise of many colleagues who work across all fields of healthcare. We have faced a huge challenge over the last few months, both as a profession and as a nation as we deal with the COVID-19 pandemic. Many colleagues have been touched by tragedy, and the dental profession has had to face significant hardship as dental practices across the country battle to support their patients, their colleagues and their businesses. The level of uncertainty during the pandemic has led to fear, anxiety and at times anger, as we struggled to cope with the unknown. It was clear that the profession needed specific guidance to support a safe return to practice in the knowledge that they would be able to continue to provide high quality care for their patients.”

https://www.facebook.com/fgdpuk/videos/282776126440679/

Denplan partners with Wright-Cottrell to supply essential PPE

Denplan, part of Simplyhealth, has announced today that they are partnering with Wright-Cottrell, one of the UK’s leading dental distributors, to supply the previously announced £2 million worth of free Personal Protective Equipment (PPE) for its Denplan members. All PPE will have full certification and carry the CE mark/BSO mark to reassure members that the equipment received is of the highest quality and fit for purpose.

This announcement comes at a critical time for dental practices across the UK who are starting to receive guidance on when they can reopen their practices. Practices in England learnt on Thursday 28 May that NHS England and the Chief Dental Officer for England have now confirmed any practice that is appropriately prepared can provide patient care from 8 June.

Following Denplan’s announcement on Friday 22 May that they are making a significant investment in PPE, the company will be furthering their close working relationship with Wright-Cottrell in helping dental teams get back to work safely.

Denplan’s investment in PPE is one of a number of key measures that Denplan has made since lockdown to help their members with financial support, health and wellbeing tools, business and clinical advice, and CPD initiatives. It is also a demonstration of Simplyhealth’s long-term investment in the future success of the healthcare profession.

Catherine Rutland, Clinical Director at Denplan, said: “It is great news that practices in the UK have now learnt that they can start preparing to reopen. The need for enhanced PPE will be one of a range of new requirements for clinical practice to be able to reopen safely, at least in the short term. As a company, it is fantastic to be able to continue our support in helping Denplan practice teams get safely and efficiently back to caring for their patients and in particular, provide the essential PPE that they need to do this.”

Denplan are working closely with Wright-Cottrell to establish an efficient ordering process so that their members can access the essential PPE that they will need when clinical dentistry resumes.

Nigal Rutter, National Key Account Manager, at Wright-Cottrell, added: “We have a long-standing relationship with Denplan and many of their member dentists, so we were delighted when Denplan confirmed that we were their chosen supplier to provide PPE for their member practices. Over the years we have supported a range of events for Denplan’s clinical training programme and have sponsored all of Denplan’s charity events for the last two years. We look forward to this next stage in our partnership.”

Denplan are continuing their support for members to help them get back to work confidently by running a three day ‘Back to Work’ virtual conference from Monday 1st to Wednesday 3rd June. The three day event, designed in partnership with Dental Update, offers 12 hours of free CPD, and features 17 lectures on subjects entirely devoted to practising dentistry safely and effectively in the Covid-19 era.

This conference will directly follow the April and May series of Denplan/Dental Update webinars, and the combined total registrations for both lecture programmes is hoped to exceed 100,000 dental professionals.

For more details on the Back to Work conference and how to register visit https://conference.dental-update.co.uk/

Dental services to resume in England from 8 June

In a letter sent to all dental practices in England, chief dental officer Sara Hurley and the director of primary care and system transformation Matt Neligan have confirmed that dental services can resume from 8 June, so long as necessary infection prevention and control requirements are in place and PPE is available.
 
The British Dental Association (BDA) has welcomed news the government has given the green light for the restoration of routine care services in England, but has cautioned that practices will need to move at different rates depending on availability and fitting of PPE, their ability to enact ongoing social distancing measures and time to implement appropriate cross-infection control.  

The BDA notes that this could see varying levels of treatments made available with immediate effect, with individual practitioners exercising their professional judgement on the pace of change. The BDA has also expressed the view that steps should be taken to integrate dentistry into the wider government strategy on PPE supply led by Lord Deighton.

Dentist leaders have also warned the whole business model that the service is based on could change unalterably upon reopening, with social distancing and cross-infection control reducing capacity and potentially access levels by as much as two thirds. The BDA is continuing to press for the NHS contractual framework to reflect the new reality and for additional support for private dentistry, including a business rates holiday – already offered to leisure and retail sectors – to be expanded to dental practices, alongside other support to mitigate against reduced patient numbers.

BDA Chair Mick Armstrong commented: “A return of high street dentistry we will be welcome news to millions of patients left with few options during lockdown, but key questions remain. It is right to allow practices to decide themselves when they are ready to open. Dentists will be keen to start providing care as soon as safely possible, but we will need everyone to be patient as practices get up and running. Dentist can open their doors but won’t be able to provide a full range of care without the necessary kit. Longer term practices can only stay afloat with ongoing support, while social distancing continues and the costs of providing care are sky high. Opening the floodgates risks raising false expectations, unless government is willing to step up and help.”

Gabriela Pueyo, General Manager of Bupa Dental Care, which has been operating a number of Urgent Dental Centres across the UK on behalf of the NHS, said: “We are delighted that we can begin to re-open our 400+ dental practices in England from Monday 8th June  after the government announcement today. This is a vital move to prevent long term damage to our patients oral health and dentistry as a whole. We are busy preparing practices, including introducing a new Patient Charter and additional measures to continue keeping patients and staff safe.”

The letter confirming the reopening of dental practices on 8 June begins with a thank you to all for contributions during the peak pandemic period and the commitment to supporting the national response. It states that the goal for patients and professionals is to resume the safe and effective provision of the full range of care in all practices, as rapidly as is practicable and that NHS England has been working with the British Dental Association, wider professional representative groups and the dental industry to reach this consensus on the commencement of reopening services.

It also touches on financial and contractual arrangements and offers advice for the sequencing and scheduling of patients. The letter can be read in full here.

A prompt to prepare from OCDO England

The Office of the Chief Dental Officer (OCDO) England has issued a ‘promot to prepare’, offering considerations applicable for safely reopening primary dental care settings. 

While the risk of Covid-19 transmission to staff and patients arising from clinical proximity and the unique aerosol generating procedures involved in dentistry remains a key factor in the temporary suspension of routine dentistry, dental care cannot be postponed indefinitely. Therefore, a sustained reduction in Covid-19 transmission risk will provide an opportunity to safely resume some elements of dental care. 

In preparing for the resumption of routine dental care, practices may wish to consider patient priorities, practice pace, proximity and levels of protection required for the safe delivery of dental care. The prompt to prepare considerations released have been produced by dental practitioners for use in primary care settings to provide guidance, which is due to be published by recognised professional bodies. Dental teams are advised to ensure that they regularly update their knowledge and understanding of the published Covid-19 Public Health England guidance and its application in a dental setting. 

The guidance is laid out in what has been termed a ‘Consideration Pathway’. Practice considerations outlined cover patient flow and practice floorplans, communal areas, supplied and equipment. To ensure safety of staff, training, screening, work schedules and guidance on health and wellbeing is considered. Factors explored for patient care include communication, care plans, and travel to and from the practice. 

“In preparing for the activation of the broader public health conditions that both herald and safeguard our ability to resume routine dental care, ‘prompt to prepare’ offers considerations applicable to primary dental care settings,’ explained Sara Hurley, chief dental officer for England. “There will be inevitable changes with regards to pace, proximity and levels of protection that are required for effective risk management and the safe delivery of dental care. This is the time to review and make the appropriate adjustments to protocols, procedures and practice infrastructure for the safe and effective resumption of routine dental care. Further guidance will follow, these will cover urgent dental care and alternative (non-AGP) evidence-based care planning.” 

Henry Schein Dental helps dentists safely return to providing care

Henry Schein Dental UK has compiled a variety of measures that focus on the critical steps necessary to help dentists safely restart their practice and to ensure the health and wellness of patients and the dental team. The practice recovery programme aims to help dental teams prepare for the resumption of practice and offers a curated set of solutions ranging from practice safety and preparation, new protocol implementation, and patient communications.

In addition to the company’s comprehensive solutions portfolio, Henry Schein has created a checklist for how to plan your business bounce back, which can be found on the Henry Schein website. There is also a Covid-19 Resource and Education Centre that provides access to practical information as well as helpful webinars.

“At Henry Schein we are committed to helping our customers emerge strong from this difficult situation. We are here to help in fulfillment of our brand promise: Rely on Us. Our team is dedicated to working with dental practitioners to help establish a re-opening process and provide access to a wide range of products, services, and solutions to run an efficient practice while delivering quality patient”, said Patrick Allen, Managing Director of Henry Schein in the UK.

A key solutions offered as part of the new programme is the recently launched teledentistry offering, designed by MedPod, Inc. This clinical decision tool allows dentists to provide critical patient communication and monitoring as the COVID-19 outbreak continues. The cloud-based software platform gives providers the ability to conduct remote consultations for patients so that they can continue to operate their practice, while delivering virtual care to patients who may not have access to a physical office visit, or choose not to visit a clinical setting as a safety precaution.

Software of Excellence, a Henry Schein One brand, has created a new online event called the ‘Bounceback Virtual Dental Festival’ to be held on 26 – 27 May 2020. Currently, more than 2,500 dental professionals have registered the two-day event packed full of useful advice, information, and online networking, delivered by experts from across the industry, helping create a community through which dentists and practice owners can access ‘real-life’, practical support. Henry Schein Dental as well as the Henry Schein, Inc. affiliate MediHoldings will support the event. Proposed topics will include the adjustment to the ‘new normal’, managing teams and HR challenges, how to financially survive the pandemic, the importance of patient communication, making your practice a safer place, self and team empowerment, and implementing contactless arrivals and departures. Software of Excellence also offers regular COVID-19 related webinars to support dental customers on business related topics.

Denplan makes significant investment in PPE

Denplan, part of Simplyhealth, has taken a significant step today to show its commitment to the long-term success of the dental profession and their ongoing support for member dentists in the UK, and the care of their patients. The company has announced that it is investing £2 million to provide essential, fully-certified, personal protective equipment (PPE) to help its Denplan member dentists get safely back to work and protect and care for their patients.

As the UK’s leading dental payment plan specialist, Denplan has over 2 million customers with around 6,700 member dentists, as well as serving over 2,700 companies with Denplan employee benefit schemes. However, all dental practices have been closed for normal routine dental care since the Coronavirus lockdown started on 23rd March, which has created a significant impact on practices, their patients, and access to oral healthcare across the UK.

Although a definitive date is currently unknown, there is increasing speculation that practices will reopen in the near future now that the Covid-19 national lockdown restrictions are being eased in some sectors. Denplan has made the decision to invest in PPE now, as part of a number of support measures put in place since lockdown to help their Denplan dental practices survive in these difficult times, make sure they can reopen safely, and also to ensure that their patients are confident to start attending appointments again.

News this week from the BDA has emphasised the importance of getting dentists back to work and how private dentists are particularly exposed financially, and also the concern that access to healthcare is going to get even worse for patients with a widening oral health gap.

Romana Abdin, Chief Executive at Simplyhealth, said: “Coronavirus has affected all of us deeply, both at work and in our personal lives. As a company, we are incredibly passionate about our Purpose which is to provide access to affordable healthcare for the many which we have been delivering for 148 years. This investment, alongside the range of support measures we have provided since lockdown, demonstrates our Purpose in action, our continued support for our Denplan members, our commitment to the long-term success of the dental industry, and the provision of essential dental healthcare to our members’ patients.”

Denplan is currently in final stage discussions with dental suppliers in the UK to create a robust operational process to provide essential PPE equipment to their member practices. Qualifying Denplan member practices will be allocated a fund, based on their Denplan patient numbers, which they can use to order vital PPE equipment directly from the chosen supplier. This fund will allow Denplan practices to select from a range of PPE items to help ensure the safety of their patients and of Denplan dental teams.

Catherine Rutland, Clinical Director at Denplan, said: “This has been such a difficult time for the whole dental profession. Our aim is to support our members in returning to practice by providing the standard of guidance that they expect from us, to provide safe practice and the PPE to enact that. We have also been working closely with our members to provide clinical and business guidance to help them return to work once all official government guidelines can be adhered to safely. We have always strived to create a partnership with our members’ and have worked hard to ensure that we provide added value services from our clinical team and our dedicated business consultants to contribute to a successful dental practice for the long term.”

Denplan has introduced a number of other new measures to help support their Denplan dentists during the Coronavirus lockdown. These have focused on three key areas: to support practice sustainability and provide financial support through extended loans; secondly, supporting the health and wellbeing of dentists via free access to Simplyhealth’s 24-7 virtual GP and Employee Assistance Programme for practices; and finally, through ongoing CPD and professional development. This has included hosting a wide range of online lectures with expert guest speakers, and creating online versions of Denplan’s Tailor Made Training bespoke in-practice training programmes.

BDA blasts GDC as ARF remains unchanged during Covid-19 crisis

Following today’s announcement from the General Dental Council (GDC) that it will not make changes to the Annual Retention Fee (ARF) levels or introduce an emergency payment scheme to allow registrants to pay by instalments, the British Dental Association (BDA) has published an open letter to the Chair of the Council, Bill Moyes.

With the profession now facing grave financial uncertainty the BDA has lamented failure by the regulator to show flexibility to colleagues, some of whom have seen their incomes fall to zero. It has also called for much-needed transparency in the process for setting the ARF. The GDC retains a budget operating surplus and significant reserves.

BDA Chair Mick Armstrong said: “Despite recognising the dire financial circumstances in which many practices and individual registrants find themselves, the GDC has not seen fit to provide even token support, citing no fundamental change to the work it does and the little financial impact the move would have on registrants. Greater transparency into the reasoning behind this decision would have been the very least response registrants should have received. But the message we are left with is ‘we need all the money and whatever we could do won’t really help you much’.”

Meanwhile, a spokesperson for the GDC said: “The real solution to these issues is to achieve a safe return to treating patients – a goal we all share, and all have a part to play in. But while that remains uncertain, we still have to carry out our legal duties and we need to ensure that we have the financial resilience to do so. Our free reserves provide only limited cover and it would not be prudent to run them down. We know that the decisions not to reduce the ARF further, or to introduce an emergency instalment scheme, will not be welcome ones and they were not reached easily or lightly. But we continue to believe they were the right ones to take.”

GDC Chair Dr William Moyes issues ARF statement

The Chair of the General Dental Council, Dr William Moyes, has issued a message to all dental professionals regarding annual retention fees as the Covid-19 pandemic continues:

The impact of the Covid-19 pandemic continues to have a significant effect on our lives. I am very aware that the effect of the suspension of routine dental care and services is severe and that it has prevented you providing the patient treatment and care you want to – and in some cases has caused financial difficulties. We have been asked whether the GDC could respond by making changes to the Annual Retention Fee (ARF) paid by all dental professionals or by introducing an emergency payment by instalments scheme.

The Council has thought carefully about the options available to us, but we have decided not to make changes to the ARF levels or to introduce a payment scheme. These are not decisions we have taken lightly, and I know they won’t be welcomed by some of those we regulate, so I want to be clear about the reasons why we have made them.

The work we have to do, which is laid down in law, has not fundamentally changed. We are required to remain financially stable and to meet our statutory obligations to ensure the public are protected and confidence in the professions is maintained.

Nearly all our incomes comes from the ARF collection. By revising our regulatory approach and increasing our efficiency, we have been able to secure greater value for money and reduce the ARF – and we hope to continue along this path. But we don’t want to make changes now that we can’t sustain, and which might lead to inefficiency and increased costs in the future. We are looking hard at the way we deliver our services, both during the current emergency and beyond. One example of that is that we have rapidly developed ways of running hearings remotely. That could eventually lead to a permanent reduction in our costs, and if it does, that reduction will be reflected in the fees we charge in future. 

For the time being though, significant uncertainty remains about the months ahead and it is just too early to predict what is going to happen – to the sector as a whole or to the GDC. So, it would be imprudent to make changes which might not be sustainable, or which have the potential to add further risks or cost to what we do.

In looking at the options available to us, we were also aware that even changes with very significant negative impacts on the GDC would make only a small difference to the level of the ARF. Only the government is in a position to provide financial support to the professions and they have chosen to do so both through NHS contract arrangements and by more general support to employers and businesses. I am very aware that the benefits of that have been felt unevenly, particularly by those outside the scope of NHS contract support, but the level of the ARF is not an effective way of addressing that issue.

I very much want to see a return to healthy, safe and successful dental services, as I know you do too and I look forward to your being able once again to offer your patients the full range of care and treatment they need.

– Dr William Moyes, Chair, General Dental Council

Henry Schein Dental helps dental professionals expand access to care with telehealth offerings

Henry Schein Dental UK has announced the expansion of the company’s service portfolio with the addition of a teledentistry offering, developed by Medpod Inc. Medpod is an expert in digital health and a trusted health care solutions partner with extensive clinical research and medical technology expertise.

The new offering is a clinical decision tool that allows dentists to provide critical patient communication and monitoring as the Covid-19 outbreak continues. The cloud-based software platform gives providers the ability to conduct remote consultations for patients so that they can continue to operate their practice, while delivering virtual care to patients who may not have access to a physical office visit, or choose not to visit a clinical setting as a safety precaution.

“Oral health and overall health are closely connected, and we want to ensure that patients’ oral care is not neglected during this global pandemic and have therefore expanded our solutions offerings to teledentistry,” said Patrick Allen, Managing Director of Henry Schein Dental UK. “As we continue to practice social distancing to slow the spread of the coronavirus disease, access to remote patient care is critically important. By incorporating a teledentistry solution into the practice, it can help to monitor the health and welfare of a patient, during this challenging time, while also maintaining a close, personal contact. This new offering reinforces our commitment to deliver the solutions our dental customers rely on.”

With Medpod’s cloud-based software enabling teledentistry, dental practices can offer remote consultations, triage dental emergencies and any further investigations to be performed in person, and ensure post-procedure follow-up via a web-based platform on any smartphone, tablet, or computer. This also allows dentists to determine the patient’s level of discomfort, prioritise cases, and makes it easy for patients to access their dentist in a more effective way than a phone call. For dental practitioners, Medpod’s software offers live, two-way video communication, and integrates live-streaming of HD audio/video, and a highly flexible user interface into one easy-to-use, care delivery and patient management system.

For more information, please visit http://www.henryschein.eu/medpod or send an email to medpodeu@henryschein.com.