coronavirus

BDA joins health unions to publish blueprint for the safe opening up of the NHS

Fast, comprehensive and accessible testing, and the ongoing, ample supply of protective kit are among measures that must be in place for the NHS to be opened up safely as the UK begins to ease the lockdown, say health unions today.

The 16 unions – including the British Dental Association, UNISON, the Royal College of Nursing, the Royal College of Midwives, the Chartered Society of Physiotherapy, Unite and GMB – have drawn up a nine-point blueprint, which also calls for salaried staff -including hospital and community dentists – to be paid properly for every hour worked. The unions want to ensure that – as out-patient clinics and operations resume – the NHS continues to operate a safety-first approach.

The unions represent more than a million staff working in the NHS across the UK – including dentists, porters, nurses, radiographers, physiotherapists, midwives, 999-call handlers, cleaners, healthcare assistants and paramedics. They all want to avoid a repeat of the personal protective equipment (PPE) supply problems experienced earlier in the pandemic. These shortages sapped staff confidence, causing widespread and unnecessary anxiety, say unions. Access to readily available PPE is especially important as employers in other parts of the economy begin to open up their workplaces and source protective kit for staff, say unions.

The blueprint also suggests that, over the next few months, trust managers deploy many of the 40,000 staff who’ve returned to the NHS to relieve areas experiencing staffing shortages. Their presence could allow overworked staff some much-needed time off, say unions. While the priority remains saving lives, and keeping health workers and patients safe, unions are calling on the government to ensure staff working through the pandemic get proper overtime and are paid for every hour they’re at work.

Unions want NHS employers to work with them so that the high value the public has placed on staff is reflected in pay talks, due to take place later this year. There can be no return to pay freezes and austerity, say the unions.

Chair of the BDA’s England Community Dental Services Committee (ECDSC) Charlotte Waite said: “Community dentists have been at the forefront of setting up Urgent Dental Care Centres in England and have often gone the extra mile working long hours, to ensure patients in need have the care they require. This blueprint offers a firm foundation for many overstretched colleagues who have stepped up admirably to support the national effort.

“All of my colleagues want the reassurance of a good supply of appropriate PPE, that reopening clinics will be safe for both patients and staff and that the efforts NHS dental staff have made and will be making during the COVID 19 crisis, is fully recognised in the coming pay round for doctors and dentists.”

Chair of the British Dental Association’s Central Committee for Hospital Dental Services (CCHDS) Peter Dyer said: “Hospital dentists have been fully engaged in the wider pandemic efforts across our trusts. Colleagues are either offering a skeleton dental service for those in need or have redeployed from ICU to geriatric wards. In March we wrote to the NHS offering the full support of employed dentists across hospital and community dental services and dental academia in the battle against Covid. We felt it was the right thing to do and are proud to have done so. This blueprint demonstrates what is important to dentists, ensuring safe working practices, full PPE and ensuring that a return to patient clinics means a safe return for all staff in hospital departments and their patients.”

Inside Pandora’s Box: Pandora Dental explores the way forward for dentistry during the pandemic

Pandora Dental, an association of independent dental surgeons founded in recognition of the need for evidence-based best practice and guidance during the Covid-19 pandemic, has hosted a webinar titled ‘Dentistry in Crisis: The Way Forward’, disclosing its findings so far in regards to current concerns and proposed solutions moving forward.
 
Dr Mark Cronshaw, Pandora Dental’s President, led the webinar, first of all mentioning that his own practice in Cowes on the Isle of Wight has been closed since March. As well as a lack of available tests and there being some time before a vaccine is available, Cronshaw discussed the cross infection hazards prevalent in dentistry – not only via everyday means such as speech, but the heightened risks posed by procedures that spread blood and saliva, including AGP.
 
Pandora began as a WhatsApp group between several dental professionals that has grown to a membership of 160. The organisation has explored several solutions to allow dental practices to reopen safely, including revised PPE protocols, conducting risk assessments, revising clinical procedures, ensuring clean air, and adopting a number of other novel approaches that may be found. One such novel approach provides a thermal and photosensitive solution in which UV-C reportedly kills the virus in 10-20 minutes (https://www.bbc.co.uk/news/business-51914722). Hypochlorous acid was also offered as a possible cleaning solution.
 
While Pandora is run by dentists primarily for dentists, hygiene therapists, nurses, managers, receptionists and other dental staff, the association is extending its support to the UK government, regulators, dental laboratories, manufacturers, distributors, educational organisations, specialist financial services, and the press. Some progress has already been made as Pandora has led research groups, preparing reports for various bodies, such as the DoH, RCS, and PHE. Pandora has also sourced PPE, negotiated discounted equipment purchases, and supported its members by assiting with business interruption insurance queries. In addition to developing links with government, preparing SOPs, consulting with indemnity providers and gaining support from several academics, the association is leading a media campaign to increase the awareness of solutions that will enable practices to resume.
 
Key concerns raised over the current state of the profession, according to Pandora, are that patients may be too anxious to attend appointments with Cronshaw mentioning how the media has played a role in implying dentistry may be ‘dangerous’ when it comes to the spread of the disease. Another major concern is over a potentially stressed and unhappy workforce, with a poll conducted by Pandora between 5-7 May finding that more than 49% are now considering leaving dentistry altogether, compared to just 12% prior to the outbreak. Stress, finances, limited treatment options, enhanced PPE and increased protocols were all given as reasons for those considering leaving the profession. However, with correct PPE and enhanced cross infection control measures in place, 84% answered that they would feel safe to return to work.
 
Other concerns raised include the logistics of access to essential supplies, the economics associated with compliance, future costs for the NHS, and the ‘time bomb’ of patients currently undiagnosed and going untreated for diseases such as mouth cancer.
 
Going forward, Pandora Dental is looking to change perceptions by equipping the public with the right knowledge so that they feel comfortable returning to their dentist. In addition, the organisation will work to make sure that staff are fully prepared for their return to work, possibly on 1 June, while also providing help with risk assessments and audits, defining treatment decisions, and ensuring unity across the industry, from nurses, hygienists and lab technicians to managers, receptionists and industry partners.
 
Speaking as part of a small panel, Professor Mike Lewis noted that air cleaning systems were of particular interest to him, as they will ‘remove other particles, including those from cleaning chemicals, as well as the virus’. He described them as ‘a must’.
 
Meanwhile, Dr Adam Nulty, who has been overseeing Pandora’s scientific research, explained that the group is working to create a positive, pragmatic approach to resuming practice, stating that they will keep their evidence simple and easy to understand. He added that the approach taken will ultimately not be too much of a stretch above existing protocols.
 
‘We are working with the entire industry,’ concluded Cronshaw,’ and would like to spread our message to remain positive.’
 
For more information, visit http://pandoradental.org.uk/

National dental organisations join forces to agree return-to-work guidance

National dental organisations have joined forces to agree guidance for UK general dental practices on returning to work as the coronavirus pandemic eases. The Covid-19 Future Planning Task Group, convened by the Faculty of General Dental Practice UK and College of General Dentistry, brings together senior members of a number of organisations, including the British Dental Association, the Faculty of Dental Surgery of the Royal College of Surgeons of England, the Faculty of Dental Surgery of the Royal College of Physicians and Surgeons of Glasgow, the Association of Dental Implantology and the newly-formed British Association of Private Dentistry.

Dental care professionals are represented to ensure all members of the dental team are able to contribute to this vital piece of work, and the Task Group includes patient representation as well as significant professional experience and expertise in a range of areas. These include infection prevention and control, practice management and emergency medicine during the Covid-19 pandemic, and further individuals and organisations will be added or consulted over the coming weeks.

Minimising the risk of Covid-19 transmission within and outwith general dental practices as a result of re-opening will bring significant implications for patient care and practice management. The group aims to support and enable a return to practice as soon as it is safe to do so, focussing on key areas to address, identifying or developing practical solutions, and feeding into national planning.

It is highly likely that the measures necessary to safely resume general dental practice will carry substantial financial implications, which will have a profound impact on both NHS and private practices. The increased burden on the NHS will be considerable, and it is clear that the safe treatment of the oral health needs of much of the population will only be possible with significant additional public funding.

The general dental profession has already returned to work in many countries, and the group will draw upon the research, advice and resources already published around the world, as well as those within the UK, adapting and adding to them as necessary to create guidance which is relevant and applicable to primary dental care throughout England, Scotland, Wales and Northern Ireland as soon as possible.

Dentists instruct Brown Rudnick LLP to advise on business interruption cover

The British Dental Association (BDA) has today announced that it is taking urgent legal advice in respect of the vast majority of insurers not paying insurance claims of dentists for business interruption during the Covid-19 pandemic.

The Association has instructed international law firm Brown Rudnick LLP to examine insurance policies affecting dental practices. It is now working with grass roots BDA members who have organised on social media to gather relevant evidence on the full range of polices in the sector.

Legal advice will shape the guidance that the BDA will be offering a profession that has been blindsided by a lack of effective insurance response during a period that has seen routine care suspended and cash-flow for many practices fall to zero.

The BDA notes that the Financial Conduct Authority (FCA), having stated on 15 April that most policies with basic cover would not respond to Covid-19 losses, now seeks “legal clarity” on business interruption insurance in an attempt to provide certainty for businesses and insurers.

The BDA has acted following uncertainty over whether the FCA move will help or hinder practices given the breadth of policy wording covering the different sectors of the UK economy and the urgent cash crisis facing businesses. This has been made more acute in light of the indication that a court hearing will not take place until July.

Dentist leaders have also indicated they hope that instructing Brown Rudnick now will give them a better understanding of their legal position and allow them to consider representations to the FCA as part of the regulator’s recently announced course of action. Following the conclusion of that process, an understanding of the legal position will give the BDA a strong foundation upon which to engage with insurers and the FCA.

The government has remained unwilling to extend the Business Rates Retail Discount of 100% currently offered to leisure and hospitality sectors to dental practices, to ease potentially crippling losses in the sector. BDA polling has indicated over 70% of practices report they can only remain financially sustainable for the next three months.

British Dental Association Chair Mick Armstrong said: “Many dentists who took out policies to guard against the unexpected have been left with no support during this pandemic. The FCA has begun its own legal process to weigh up policies covering almost every business sector in Britain. However, it is clear this will now take months. We’re not prepared to be a passive observer, and wait on a ‘One Size Fits All’ court determination that could leave the practices that millions of patients depend on dangerously exposed. To that end, we have instructed an experienced international financial services law firm to review the insurance policies bought by dentists across the country from all providers. We need to know if there are realistic options to get practices the insurance payments that they desperately need, and that they thought they were signing up to.”

British Orthodontic Society answers the AGP question

The British Orthodontic Society has  published a document on its website (https://www.bos.org.uk/COVID19-BOS-Advice/Recovery-Phase-Advice/What-is-an-orthodontic-AGP) that considers what constitutes an Aerosol Generating Procedure (AGP) in clinical practice.

Director of External Relations, Peter McCallum, and Director of Clinical Governance, Joe Noar, have said, “Key to the return to work is confirmation of what constitutes an Aerosol Generating Procedure (AGP). It is clear that AGPs should be avoided wherever possible, however, if it is necessary to carry out a procedure that may create an AGP then the appropriate level of Personal Protective Equipment (PPE) must be worn.

“The British Orthodontic Society (BOS) has reviewed the evidence available and produced this guidance and these recommendations. BOS is not a legislative body and does not produce regulations that require to be adhered to. These can only come from the regulatory bodies in England, Northern Ireland, Scotland and Wales. However, BOS does have a duty to inform, educate and protect members of the public, clinicians and staff during the delivery of orthodontic care. This guidance constitutes best practice.”

Race against time to deliver Covid-19 training modules

Dr Rob Dyas

Hundreds of dentists and dental care professionals have signed up to a brand new training resource to support dental teams in England going to work in Urgent Dental Care (UDC) centres. Due to standard Aerosol Generating Procedures (AGP), the dental profession is among the most vulnerable of all healthcare groups but, as UDCs start to go live in England, dental teams have been uncertain how to establish what is best practice in both triage and treatment of patients.

What was required was online training. A group of dental professionals working in all sectors of dentistry combined their skills and knowledge to create the training which is now available on the ProDentalCPD platform.

Chair of North Yorkshire & Humber Local Dental Network, Simon Hearnshaw, explained how the training modules evolved: “Dental teams need to be aware of protocols that are crucial in providing necessary urgent care that is safe for teams and their patients. It was a matter of thinking outside the box and for the dental profession to provide its own solution to the challenges that lay ahead. We are all in this together, but it was a race against time.“

Dr Hearnshaw contacted Rob Dyas, a Yorkshire-based oral surgeon and founder of ProDentalCPD, who said he “jumped at the chance” to be the training provider. At the time, Dr Dyas said, he was recovering from Covid-19, which he believes he and his dental nurse caught from a patient in the days before lockdown.

Dr Dyas continued: “I just knew we had to come up with interactive and evidence-based video training as the best way to learn. We have worked 12-hour days with our subject matter experts to create an eight-hour training package for the whole dental team. In addition to the online course, users get access to their own secure forum so they can share best practice and interact with colleagues. The group worked across several sectors including Public Health, Health Education and General Practice to develop the training.

“We have also set up a series of live webinars to support our colleagues. This is a living course which will need to change as regulations and guidance changes. We have never been here before. What is best practice today may not be best practice in a few weeks.  And Standard Operating Procedures could vary around the country. So this is going to be a training that continues to evolve.”

“I know personally a number of colleagues and friends who have been extremely ill with Covid-19. That and my experience has brought home to him how at risk dental teams are and important it is to protect colleagues working at the frontline.” 

Dr Dyas explained that LDCs had been making contributions of £150 towards production costs. “To get this training package out  as widely as quickly as possible to support dental teams, we are making it available free of charge at point of access, but are asking all LDC’s, dental organisations and dental corporates to make a small voluntary contribution. All proceeds above basic production costs will be donated to NHS charities.”

For details on how LDC’s and dental organisations can get Covid-19 and UDC course with premium features for free at point of access for their dental teams contact robert@prodentalcpd.com.

Dental Group know the drill when it comes to nailing a performance

Dentists, nurses, hygienists and administrative staff were amongst the singers, musicians and performers who made a success of a lockdown concert for staff with Scotland’s fastest growing dental group.

More than 150 Clyde Munro employees and suppliers took part in an online two-hour gig to connect with colleagues across Scotland and have some fun in a concert billed as ‘The Lockdown’.

Bosses with Clyde Munro have been looking at creative ways to keep up the morale of their 500-strong team, made up of dentists, practice and support centre staff, who are either working from home or furloughed during the Coronavirus pandemic.

The brains behind the operation was Clyde Munro founder, Jim Hall, who launched the business in 2015 with the acquisition of seven practices. He said: “The Lockdown concert was a great success and all of the acts were a big hit amongst their colleagues.

“Everyone was blown away by the talent of the performers, we couldn’t quite believe how many musically talented people we had hiding in our practices across the country.”

Entrepreneur Jim said the concert was conceived to bring the Clyde Munro team together in a virtual setting and to lift spirits while helping the team to enjoy an evening of music and singing with everyone participating via Zoom video call.

He added: “We wanted to help take minds off all the worrying stuff that is going on in the world even for a few hours – and judging by the positive feedback, we definitely achieved that.”

At the start of April, as the full extent of the lockdown started to sink in, Jim knew that keeping in touch with staff and maintaining a high morale would be essential to ensuring the business comes through the virus crisis in the best possible shape.

So he tasked his team to come up with fun events to keep staff connected, starting with an Easter Bonnet competition and culminating with the ambitious Lockdown concert on Friday 24 April. Participants even took part in meticulous rehearsals ahead of the big night.

Jim added: “The team really got into the spirit and many even dressed up as if they were going to a summer music festival which was great as it meant even those who were not performing, still got involved and contributing to the atmosphere. It was a fun night that people will remember for a long time.”

Clyde Munro comprises 40 practices across Scotland, with more than 200 dentists, 350 staff and 300,000 patients.

The group’s ambition is to become Scotland’s “local dentist”, operating an expanding network of family dentists across Scotland, with each devoted to providing the best dental care, while reflecting the needs and character of its community.

New steps to help businesses during the COVID-19 outbreak

On 17 March, the chancellor announced bold new measures intended to help any business that is seeing, or anticipating, financial disruption during the coronavirus pandemic. These were in addition to what had already been outlined in Rishi Sunak’s Budget, just one week earlier. As the situation continues to escalate, the government wants to reassure businesses and the UK workforce that it is committed to doing all it can to minimise the impact of COVID-19.

I’d like to highlight the following:

Changes to Statutory Sick Pay

Perhaps one of the most key measures for small to medium sized enterprises (SMEs), including dental practices, was the move to bring forward legislation to allow them to reclaim Statutory Sick Pay (SSP) paid for sickness absence due to coronavirus. With every business seeing their workforce deplete – the latest advice is, if you live with someone showing symptoms, you must self-isolate for 14 days – this could be important. Criteria for eligibility will apply and the government is going to work closely with businesses during the coming months as this represents a big departure from how the system of SSP works currently. For example, an employee will not even need to present a doctor’s note – bold moves for unprecedented times.

Is it time to use Time to Pay?

All businesses and self-employed people with outstanding tax liabilities and who are in financial distress may be eligible for support through Time To Pay, a service from HMRC. If you think you could benefit, HMRC will look at each case individually, taking circumstances and liabilities into account. There is a dedicated helpline, but speak to your specialist dental accountant for advice first.

Loans and overdrafts

Also announced was the Coronavirus Business Interruption Loan Scheme. This will help businesses access loans and overdrafts, should they need to. To incentivise them to provide SMEs with finance, lenders will get a guarantee of 80% on each loan. Again, go through your options with a specialist accountant who will look at both the bigger picture and the minor details to advise if this could be a smart move for you.

Other measures

Also announced was an additional £2.2 billion for local authorities who pay little or no Business Rates because of Small Business Rate Relief (SBBR). Any business that does get SBBR, or Rural Rate Relief will therefore get a £10,000 grant to help with costs.

In short, the government made many promises to reassure businesses that the health of the economy will be protected as far as possible, while we face the biggest threat to the UK’s public health that we have seen for generations.

For all your business concerns and queries, speak to a specialist dental accountant like the team at Lansdell & Rose. We will be able to apply our years of experience of working with the dental industry to these difficult circumstances we’re facing.  

Working together we can find the best solutions to keep your practice working efficiently.

 

For more information please visit www.lansdellrose.co.uk
or call Lansdell & Rose on 020 7376 9333.

 

COVID-19 – how to minimise the impact on how your dental practice is running as a business

Lansdell & Rose are specialist dental accountants and want to do everything we can to support all dental practices during this uncertain time. We are offering sound, expert financial guidance and assistance, to help you maintain efficient and safe business operations and patient services.

With so much information our there, we recommend a clear, sensible, pragmatic and well-informed approach based on open communication between all members of the dental team. This is a worrying period for most business owners; dental practice owners must also ensure they continue to deliver exceptional patient care, while keeping things running smoothly. So let us share some of the load.

 

Start with the basics

 

  • Ensure there are extra precautions for anyone who is particularly vulnerable, such as pregnant women. Again, consult the government’s latest guidance.

 

  • Ensure everyone’s contact details/emergency contact details are up-to-date.

 

Take care of your team, including working from home

  • The government has recommended that people work from home, where possible, to curb the spread of the virus. Although this is not always possible for people who work in a clinical setting, if home working is agreed on, usual pay will apply. If you need impartial advice about how the team could be restructured, we can help. If you wish, or need to speak to an employment lawyer, we can introduce you to one, or to a HR advisor.

 

  • What I cannot stress enough is, to ensure smooth operations, give all dental team members the means to communicate with each other during this pandemic, whether they are in the practice or working from home. It is a worrying time for all of us, for many reasons, so ensure they can all speak freely with you, and each other.

 

On a contract, or self-employed?

  • Most dental practices will have both contracted employees and people who provide their services on a self-employed basis. Even in “regular” times there are different rules regarding things like reducing someone’s contracted hours, or making lay-offs. In these stranger times, you may even decide ­– or need ­– to close the practice for a short period of time and all rules are subject to change anyway. You must speak with an employment lawyer or HR specialist for specific, expert advice to keep within the law and ensure you are doing all the right things by your team.

 

  • Finally, communicate, communicate, communicate! Keep everyone in the loop and explain all your decisions fully.

 

Statutory Sick Pay (SSP)

  • The government has recently announced a package of changes to help all employers through this period, including bringing forward legislation to allow them to reclaim SSP paid for sickness absence due to coronavirus. Give us a call if you need anything explaining, or how these measures could benefit your practice.

 

This situation is fluid and fast moving and things are changing all the time. Keep informed, keep talking and contact Lansdell & Rose for guidance – we will do our best to help your business find a smooth path through this tough time, so you can continue to deliver the highest quality service.

 

For more information please visit www.lansdellrose.co.uk
or call Lansdell & Rose on 020 7376 9333.