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: Contract uplifts confirmed

Following consultation with the BDA, the Department of Health and Social Care has confirmed that contracts will be uplifted by 2.5% in England. The uplift will be paid in November and backdated to 1 April.

The BDA stressed, when the Chancellor announced his deal back in July, that an above inflation award represents a bare minimum any government can offer NHS workers’, adding that the ‘uplift does not begin to cover the huge increases in expenses practices have faced with PPE and meeting new cross-infection guidelines’.

Foundation Dentist salaries will be updated by 2.8%, as will Educational Supervisors’ grants. FD service costs have been frozen, which the BDA has strongly objected to.

This is the second consecutive year of above-inflation pay awards for dentists. The BDA remains clear that this must now be built on, as part of wider plans to maintain the long-term integrity of the service.

The BDA continues to campaign on behalf of NHS dentists.

NHS pension discrimination case update

In April 2015, public sector pension schemes were reformed, with most members moved from what have become known as ‘legacy schemes’ into new, ‘reformed’ schemes. Transitional protections were put in place to protect those within 10 years of their normal retirement age, allowing them to remain on legacy schemes, rather than be moved automatically.

In December 2018, the Court of Appeal found that these transitional protections unlawfully discriminated against younger members of the judicial and firefighters’ schemes as transitional protection was only offered to older scheme members. In July 2019, the government accepted that the judgement applied to all public sector pension schemes, and is taking action to remedy the discrimination.

On 16 July 2020, the government launched a consultation seeking views on its suggested remediation measures.

The government has proposed giving public sector scheme members a choice on which pension scheme they accrue benefits in for what is being called the ‘remedy period’ – the time between the 1 April 2015 and 31 March 2022. For this period, affected members can choose to have their benefits accrue in a legacy scheme or a post-2015 reformed scheme.

It has also proposed two possible methods for making this decision – members will either have to decide on their scheme within 12 or 24 months after 31 March 2022, or they will be asked to decide when they access their benefits.

In either case, those who have already drawn on their pensions will be asked to choose as soon as possible after 31 March 2022 – their choice will then be applied to their pensions retroactively. The government is also proposing that all active members are moved into the reformed schemes on 1 April 2022.

Wesleyan is a specialist financial mutual for dentists, and therefore has considerable experience advising people on public sector pensions.

Parminder Gill, advice policy consultant at Wesleyan, said: “Sunday saw the closure of the government’s consultation into its suggested approach to remedying discrimination in public sector pension schemes. This is shaping up to be the biggest change to public sector pensions in the past five years.

“Affected members are now eagerly awaiting further information on the government’s next steps.

“The proposed measures will have an impact on the retirement savings of millions – with potential implications for the size of their pensions pots and the amount of tax they will need to pay.

“Under the government’s proposed solution, members will be asked to choose on how they want their pension accruals to be calculated.  The ‘right’ answer will very much depend on the individual, but almost everyone affected will have a complex decision to make factoring in projected pension benefits, planned retirement age, their life expectancy and any impact on their Lifetime Allowance or Annual Allowance of moving from one scheme to another.

“The process of resolving this will take some time, and the final proposal to members could look very different. However, an update on the government’s intended way forward will provide those affected with more clarity around what this will mean for them and enable them to start factoring it into their retirement plans.”

BADN welcomes BSA survey on pay concerns

The British Association of Dental Nurses, the UK’s professional association for dental nurses, welcomes the survey by the NHS Business Services Authority on pay concerns during the Covid-19 pandemic in England.

As the introduction to the survey states “The expectation from NHS England & NHS Improvement (NHSE&I) during the Covid-19 pandemic is practice owners are required to ensure that all staff including associates, non-clinical and others are continued to be paid at previous levels prior to the pandemic.”

This expectation was also made clear in the various Letters published by the Office of the CDO England during the lockdown period.

However, many dental nurses were not paid at all during the March-July lockdown period; many were forced by their employers to take annual or unpaid leave for the whole period; and some who were paid are now being told they have to pay it back or work unpaid.  “There are innumerable variations on employers not having paid their dental nurses ‘at previous levels prior to the pandemic’” said BADN President Jacqui Elsden.  “Many decent employers, who have done the right thing by their dental nurse employees, find it hard to believe that some employers have behaved in such an unethical and unprofessional manner towards the lowest paid members of the dental team.  We are delighted that, after much lobbying of the OCDO and NHS England by BADN, the BSA is conducting this survey to discover the extent of the problem.  We hope that similar steps will be taken by the other three home nations.”

Dental nurses working in NHS or mixed practices who have not been paid their usual salaries during the pandemic can complete the survey here.

Mixed practices were able to furlough an appropriate number of staff proportionate to their private practice.  This survey is for those dental nurses working in mixed practices who were not furloughed.

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.

ADG: New figures show ‘dentists are deserting the NHS and poorest patients are paying the price’

The Association of Dental Groups has responded to the recent publication of the NHS Dental Statistics for England 2019-2020. The statistics reveal that overall, the number of dentists with NHS activity in England went up slightly – from 24,545 in 2018/19 to 24,684 in 2019/20.

But they also reveal significant regional disparities – with 65 NHS clinical commissioning groups seeing dentist numbers go down over the past year. At seven NHS clinical commissioning groups, dentist numbers declined by 20% or more from 2018-19 to 2019-2020.

Neil Carmichael, Chair of the ADG, said: “The figures are just the latest proof that the number of dentists working in the NHS is plummeting in many of the areas where they are most needed. In large parts of the country, dentists are deserting the NHS and it is the poorest patients who are often paying the price. That’s why we urgently need to increase the pipeline of new dentists here in the UK while also making it easier for overseas professionals to enter UK dentistry.”

 

The NHS Dental Statistics for England 2019-2020 can be accessed here: https://digital.nhs.uk/data-and-information/publications/statistical/nhs-dental-statistics

Workforce figures are taken from Table B1 in Annex 2 – Geographical breakdown of dental data.

They show that NHS Fareham and Gosport CCG, NHS Isle of Wight CCG, NHS Portsmouth CCG, NHS South Eastern Hampshire CCG, Southampton CCG and NHS Bassetlaw CCG saw a percentage difference of 20% or more from 2018/19 to 2019/2020.

ADG members consist of group providers of NHS and private dentistry across England and Wales. Find more information about the ADG on their website here.

SDPO raises concerns over out-of-date PPE in Scotland

The Scottish Dental Practice Owners Group (SDPO) has raised serious concerns that NHS dental teams in Scotland have been issued face coverings that may not be “fit for use”. The organisation reported that when practices received their PPE to begin aerosol generating procedures from Monday 17th August, some discovered that the FFP3 masks they received were “significantly beyond their expiry dates, in some cases by almost a decade”.

The SDPO even claimed that, in some cases, the original expiry dates had been covered with a new date of expiry label. To top it off, those dates had also passed, with the most recent being in 2019.

The SPDO said: “Preliminary inquiries to the mask manufacturer 3M suggest that they do not consider masks beyond their expiry date to be fit for use. Practitioners have serious concerns about the safety of masks of this age. How can masks this old be passed as safe when the manufacturer suggests otherwise? SDPO members are practice owners and must consider patient and staff safety. We lack confidence that the masks issued to dental practice staff are fit for use, and we are very concerned that NHS dental teams across Scotland have been issued with masks that may compromise patient and staff safety.”

However, a spokesperson for the Scottish Government stated: “Revalidating stock and extending the shelf-life of masks is standard practice to maintain pandemic stock levels and this was used in relation to FFP3 respirator stocks as announced in March. Any PPE which has been issued to NHS boards for onward distribution to dental practices and may have passed its original expiry date has been re-tested to ensure it remains safe to use. Such testing has been approved and reviewed by the Health and Safety Executive and to standards relevant to the PPE being tested. Critically, this PPE – supplied free of charge by our NHS – enables dentists to carry out urgent and emergency care while ensuring the safety of patients, dentists and all dental staff. Each board has a proactive programme of fit-testing for FFP3 masks under way with each practice requiring a fit test for a dentist and dental nurse; this is a rolling programme of work, there are around 1000 dental practices in Scotland.”

Expansion of services in NHS dental practices in Scotland

NHS dental practices are to re-introduce a range of procedures, such as the use of drills, on a limited basis in Scotland. Practices have been able to see NHS patients for certain types of non-aerosol routine care as part of Phase 3.

Now dental practices, if they are ready, will be able to provide aerosol generating procedures (AGP) on patients with urgent dental problems from 17 August. This move will be supported by the provision of enhanced Personal Protective Equipment (PPE) to dental practices which will require to be individually fitted to dental team members to ensure they work effectively.

This limited introduction, with care prioritised for patients in need of urgent care, replicates the arrangements in place in urgent dental care centres.

Chief Dental Officer Tom Ferris said: “NHS patients have been able to receive care and treatment including aerosol generating procedures through one of the 71 urgent dental care centres in Scotland. Now a limited range of AGP procedures will be available at NHS practices – this decision has been taken after carefully and thoroughly considering the balance between the overall risk of infection with the needs of patients to be seen by dentists.

“I am pleased that patients seeking such urgent procedures can now been seen at their NHS practice, and in turn, that practices can expand their services to patients.”

Background

AGPs are defined as any patient care procedure that results in the production of airborne particles, known as aerosols.

These are relevant to the spread of COVID-19 since transmission may occur through both direct air-borne infection and through contact with contaminated surfaces.

In urgent dental care centres dentists and the dental team are provided with enhanced PPE, including face-fitted masks.

Dental practices that wish to provide AGP care to NHS patients will be provided with a similar level of PPE.

The Chief Dental Officer and his team are in regular contact with NHS Boards to ensure dental practices have clear guidance on appropriate procedures for seeing patients. The Scottish Government have also been working closely with BDA (Scotland) in making the necessary preparations.

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

New dentist profiles to be included on NHS website

New dentist profiles are to be included on the NHS website to better meet the needs of patients, feature improved support for mobile and tablet devices, and meet modern accessibility standards. These will launch for dental surgeries from 27 July 2020.

Profile editors responsible for a dentist profile do not need to do anything as existing profile information will be automatically copied over to the new platform, while the method of updating a profile will also stay the same. Profiles editors will receive further information via email from the NHS website service desk.

The launch has been prioritised by the need to include Covid-19 signposting information for patients, which is difficult to implement through the current profiles. 

This work is part of a programme to continuously improve the care and experience offered to patients through the NHS website, the UK’s largest health website for the public.