PPE

SDPO raises concerns over out-of-date PPE in Scotland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

Dental Protection reassures members of support if unable to wear a fit-tested mask

Dental Protection has reassured its members that their membership and ability to request assistance is unaffected if they are unable to wear a fit-tested mask and that they can seek assistance from Dental Protection in the usual way. This reassurance follows several queries from dental professionals contacting Dental Protection in recent weeks concerned about their inability to wear a fit-tested mask for a number of reasons.

There may be legitimate reasons why it is not possible to wear a fit-tested mask, including for health reasons or because it is not possible to achieve an adequate seal when wearing a mask. Dental Protection recognises that for a variety of cultural and religious reasons, removal of facial hair and beards is not an option and in turn means passing a fit-test is not possible.  

The primary purpose of PPE, and in particular RPE masks, is for the dental professional’s own safety. For those who are employers, they would also need to consider the safety of their employees if they cannot pass a fit-test. Dental Protection recommends that members identify the overall risk to themselves, their team, and patients in situations where the fit-test has failed and ensure steps are taken to mitigate the risk.

Raj Rattan, Dental Director at Dental Protection, said: “We know our members are facing a number of challenges related to the reopening of practices and resuming of face-to-face care. We would like to reassure members that their membership and ability to request assistance will not be affected by the inability to wear a fit-tested FFP2 or FFP3 mask.

“The primary purpose of PPE and in particular RPE masks is for dentists’ own safety,” he continued. “We recommend that employers identify the overall risk in all situations where the fit test has failed and ensure steps are taken to mitigate the risk. These are challenging times, and as a profession, we may not know what the future looks like, but I can assure you that Dental Protection will be there our members.”

Scottish practices to reopen, but face financial oblivion without government support

The British Dental Association has responded to confirmation from the First Minister that services will recommence from 22 June, warning that a combination of higher costs and lower patient numbers could prove fatal for services in Scotland.

Practices will be able to offer non-urgent care. Dates for routine care, including aerosol-generating procedures (AGPs) are yet to be confirmed.   Wholly private practices, which comprise 23 out of the roughly 1,000 Scottish practices, have been open for some weeks now.

Shortages of Personnel Protective Equipment (PPE) are expected place to real limits on patient numbers. While the authorities recently distributed more than three million individual items of PPE to dental practices volumes are only sufficient to enable practices to see around 10 patients a day.

The return of routine dental care south of the border has seen a majority of practices operating at less than a quarter of their former capacity, to ensure social distancing and infection control protocols are met. Barely 8% of English practices report they can maintain their financial sustainability on this basis, and BDA has said long term support will be needed to keep the service in Scotland viable.

The BDA has also pressed the Chief Dental Officer to extend to key worker status to dentists and their teams once they reopen. Access to childcare has proved a major barrier to practices reopening in England.

David McColl, Chair of the Scottish Dental Practice Committee, said: “We finally have a date for the return of face-to-face care, but it arrives after weeks of waiting for clear guidance. Practices should never have been left in limbo, but now face even greater challenges as they reopen their doors.

“Dentists have been looking forward to welcoming our patients back into our practices, but already we are hearing from colleagues who simply can’t afford to reopen, given the limits of the current Government support package. Without meaningful help increased costs and lower patient numbers could prove fatal for practices across Scotland.”

Dentists: PPE the elephant in the room as reopening plan unveiled in Northern Ireland

The British Dental Association (BDA) Northern Ireland has welcomed the new timetable for restoring high dentistry but warned ongoing Personal Protective Equipment (PPE) shortages could easily jeopardise any progress.

The Department of Health has confirmed Phase 2 for recovery of General Dental Services, which will allow dentists to provide non-urgent care, will begin on 29 June. Phase 3 which will permit dentists to carry out aerosol-generating procedures (AGPs) is scheduled to start from 20 July.

AGPs, involving the use of high-speed instruments, represent the majority of dental treatments. Dentists performing these procedures are expected to use full PPE, similar to those used in hospital ICUs.

Owing to shortages – and the need for kit never previously required – the BDA has estimated the cost of PPE alone, ignoring other treatment costs, for treating a single patient has increased by up to 6000%. Costs for kit were around 35-45 pence pre-pandemic, and could now stand at £20-30 depending on exact PPE requirements and usage.

Dentists are currently reliant on commercial wholesalers and have experienced severe and ongoing PPE shortages. The BDA believes the integration of dental services into the wider government supply chain will be a prerequisite to any plan to restore routine care. No decision has yet been taken on whether dentists will have access to the central government supply of PPE.

The return of routine dental care in England has seen a majority of practices operating at less than a quarter of their former capacity, to ensure social distancing and infection control protocols are met. Barely 8% of English practices report they can maintain their financial sustainability on this basis, and BDA has said long term support will be needed to keep the service in Northern Ireland viable.

Richard Graham, Chair of the BDA’s Northern Ireland Dental Practice Committee, said: “We finally have a timetable. Dentists need time to prepare, but PPE remains the elephant in the room. Practices face not only shortages but crippling increases in costs for vital protective kit. We can put out the welcome mat, but without access to government supply chains, we will be in no position to treat patients. But we will need help to survive the new normal. Without long term support, sky-high overheads and fewer patents could be the final nail in the coffin for the service in NI. We trust the Department will step up to the plate.”

Dentists: PPE costs will cripple service, as millions set to go without care

Dentistry now faces financial meltdown, with costs of delivering care skyrocketing as practices  reopen, says the British Dental Association.

The cost of PPE only, ignoring other treatment costs, for treating a single patient using Aerosol Generating Procedures (AGPs) – using high speed instruments like a drill – was around 35-45p pre pandemic, and could now stand at £20-30 depending on exact PPE requirements and usage.

Higher end PPE is now required for AGPs that form the overwhelming majority of dental treatments, that involve the use of high speed instruments that can carry viral load into the air.

Industry sources estimate that the combination of intense competition and pressure on global supply chains for PPE and the PHE guidance for enhanced PPE required across non-AGP and AGP activity, means that PPE costs per patient could increase by around 7 times (or 700%) for non-AGP activity and around 60 times (or 6,000%) for AGP activity when compared with pre-COVID -19 activity.

Surgical face masks (type IIR) have increased in price from around 6-8p each pre-Covid to around 60p each today. New Public Health England PPE requirements for higher end PPE are requiring kit never previously needed, including respirator masks, and fluid resistant gowns required for both the dentist and a nurse. FFP2 masks are now ranging from around £4-£5 each, and disposable fluid resistant gowns around £5 each.

Practices face growing risk of financial collapse. With practices facing higher costs, and radically reduced patient numbers, practices report they will struggle to remain open. Only 8% of those polled by the BDA estimate being able to maintain financial viability based on anticipated patient numbers and added costs post lockdown.

Dentistry is currently reliant on commercial wholesalers for kit like masks. The BDA is pressing for urgent access to the government supply chain for PPE, and for the temporary VAT cut on PPE – that closes on 31 July – to be extended, and potentially to become permanent given widespread use across the UK economy.

PPE shortages are affecting the majority of high street dentists, with only 35% currently having the necessary PPE to resume face to face patient care. Levels of capacity in most practices reopening are less than 25% of pre-pandemic levels, potentially leaving millions without access to care.

The BDA has said it is now inevitable that patient access across England will fall significantly below levels seen in former access ‘hotspots’ such as West Yorkshire, Cornwall and Cumbria. Dentist leaders anticipate only a tiny fraction of the nearly 40 million courses of treatment delivered by NHS in England last year to be possible under current conditions.

BDA Chair Mick Armstrong said: “Dentists have little prospect of meeting the backlog built up during lockdown when we face PPE shortages and crippling increases in costs. Dental practices are businesses and the sums no longer add up. A service running on empty will barely be able to scratch the surface of even urgent cases. Normal service can only resume for millions of patients if government is willing to step in.”

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/

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.