Coronavirus Letter to Sara Hurley

Dear Sara,

Coronavirus – ADG response to NHS England Issue 3 Preparedness letter 25/03/20

I am writing, on behalf of the Association of Dental Groups (ADG) regarding NHS planning in England for Coronavirus specific to dental practices. Our Board and members met by telephone conference call yesterday afternoon to discuss the new guidance issued by your office.

Our members are grateful for the updated guidance on Standard Operating Procedures (SOP) and the proposals for financial stability during the period of the outbreak which provide certainty for the next month, and we fully appreciate the demands on your office at this time. Of course, you will know that both the ADG and BDA members have many questions regarding the details over a longer period and a first response has already been submitted jointly with the BDA yesterday evening.

We understand that many of these questions will take time to clarify. In the meantime, I would like to focus on four broader enquiries.

Urgent treatment centres
The establishment of urgent treatment centres is an ongoing piece of work and some regions are more advanced than others. Our members are keen to assist where possible in this and if we can facilitate contact through our network of clinical directors please could we have an appropriate point of contact(s)for them to do so. We have already had offers to make provision from our members in different parts of the country.

Contractual matters
Many issues have already been raised in the joint correspondence yesterday evening. Our members are grateful for the reassurance guidance gives for March and we wait for responses to the further detailed questions. However, clarity is needed on the definition of “March 2019” UDA cut off positions and what data source will be used? This information is urgent for accurate payment of associates. We would be happy to work with you to explain clarification needed in detail.

The other important question many of our members have is how will the restrictions on access to Government support for practices with an NHS contract work for mixed practices? If a practice has a sizable private element – on the face of it having the NHS contract prevents access to furlough funding. Will they be able to claim for Government support in relation to their private income, where this funding would not be duplicative of NHS funding? If this is not to be the case, it is very likely that some contractors will see no other option than to hand back their NHS contract, having a long-term impact on access. The importance of clarity here is urgent as it has even raised anxieties about ongoing maternity claims for staff funded by Government.

We know that many in the profession have already made offers of support to assist where they can. However, if staff are unable (due to ill health/self-isolation) or unwilling (due to concern for their health and family health) to continue working in urgent treatment centres or to be redeployed elsewhere in the NHS, will the practice be penalised? If an associate declines redeployment does this effectively become a contractual matter between the practice and the individual?

Provision of PPE
Despite the statement made by the Secretary of State at the start of the week that “Every GP practice, dental practice and community pharmacy has now had a PPE delivery.” members have reported continued shortages. Guidance and clear procedures to ensure effective infection control within urgent treatment centres will be needed – including frequency and level of ‘deep cleaning’ to enable us to keep clinical colleagues safe and ensure compliance. Further information is needed on access to appropriate levels of training and supply of FPP3 masks and other PPE alongside testing to support our workforce in identifying those that have covid19 immunity.

Our overriding priority will remain to support the effort to ensure patients can continue to be able to access urgent and emergency NHS dental care and that continuity of high-quality treatment and care is preserved to at this difficult time. We remain ready to assist in any practical way we can to provide this continued care and reassurance over the coming months.

We would be grateful for your clarity on these issues at your next opportunity. Going forward wherever possible the BDA and ADG will submit our queries jointly for ease of response.

With best wishes,

Neil Carmichael, Chair, Association of Dental Groups
cc: Carole Reece – Head of Dental and Optical Services Commissioning.