Coronavirus – planning for dental practices in England – Letter to Sara Hurley

Dear Sara,

I am writing, on behalf of the Association of Dental Groups (ADG) regarding NHS planning in England for Coronavirus specific to dental practices.

Our members have carried out detailed planning for Covid-19 and put all the necessary clinical preparations in place based on your previous Standard Operating Procedures (SOP). Practices are working hard to ensure the continued delivery of dental care as commissioned and provide reassurance and advice to their local communities. However, it has been clear now for some time that events have moved on at pace and your SOP need to be urgently updated to retain the confidence of the profession during the difficult times ahead.

In particular, our members have raised a number of concerns especially around managing routine and emergency dental appointments, treatment involving aerosols and training for the dental workforce to support both patients diagnosed with Covid-19 and those unaware of their status (not tested). Guidance on delivering safe and effective emergency dental treatment for patients diagnosed with Covid-19 both in the general population and to the prison population is urgently needed.

Frontline staff have real concerns about their personal safety, for example with the supply of effective PPE. This may lead to a real risk of losing a significant proportion of our highly skilled workforce due to a lack of clear unambiguous communication. Consideration should be given to the introduction of testing for dental staff to ensure early return to work for those with possible Covid-19 symptoms. Every day that passes is raising further concern for those working on the frontline.

You will also know that dentists are facing significant reductions in activity across all practices, in addition to staff and clinician absence, patient cancellations, and non-attendance are creating significant challenge. This reduction in activity is likely to accelerate over the coming months and dentists are understandably extremely anxious about how their livelihoods will be impacted.

We propose that NHS England immediately adopts the guidance provided by the Chief Dental Officer in Wales such that targets are not monitored during the first quarter of the financial year 2021.

This would mean that in April, May and June 2020, a contract-holder will continue to receive their full contract payment as normal, and no further clawback will be required for these payments in the future.

This approach will ensure that fair and accurate payments are made for the work that would otherwise have been carried out, ensure all practices remain financially viable in the long-term, and maintain the goodwill of clinicians which will be essential for the provision of urgent care whilst this crisis lasts.

Specific questions have also been raised regarding the impact on the Epidemiology and OHI programmes. We understand that Scotland and Wales have both issued recent guidance.

Our overriding priority will remain to ensure wherever possible patients can continue to be able to access 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 welcome new guidance as a matter of urgency.

Yours sincerely
Neil Carmichael, Chair, Association of Dental Groups