28th August 2020
Today, the OCDO released its 6th letter of preparedness Reference: 001559, that includes links to the NHS UDC SOP Version 3 and the NHS Dental Transition to Recovery SOP Version 3.
The Issue 6 preparedness letter encompasses national updates for dental practices and for the South Eastern Regional Team. The update concerns the operation of urgent care hubs and explores the ‘fallow time’ requirement for post AGPs especially identifying when the time starts.
The ‘fallow time’ commences when the AGP ceases, not when the patient appointment ends. There is also some refreshed guidance on the length of the ‘fallow time’ determined by the room’s ventilation systems in place. Where there are ventilation systems in place with more than 10/12 air changes per hour the ‘fallow time’ reduces to 20 minutes.
Practices are reminded to contact manufacturers of their ventilation systems to verify the Air Changes per Hour (ACH) value and to check with the Environmental Health Teams to seek further advice.
The latest letter of preparedness covers other important topics:
- Revised Infection prevention and control guidance. See the Transition to Recovery SOP
- Shielding – risk assessment prior to onward coordinated care
- Health and Well-being support for dental workforce – risk assessment, supporting staff and NHS practitioner health services
The NHS has released a Dental Contract clarification fact sheet 2020/21 that more fully explains the definition of patient care and the requirement to meet the 20% threshold (schedule months 7,8 and 9).
For the avoidance of any doubt, patient care is defined as:
All clinical contact that dentists or DCPs have with patients either face to face, telephone or by video consultation and these contacts are counted by the BSA via completed courses of treatment or via the COVID-19 triage portal.
The management of additional services such as IMOS will remain within the SE Region but sadly there is no updated information on the management of orthodontic contracts or practices prototyping within the contract reform initiative.
There has been no further progress or communications from NHSE about expectations beyond September and that the 20% threshold is expected to be met between 20.07.20 and 01.10.20. There are special arrangements for contracts that are outside the 2019 reference period.
UDCHs are exempt from the requirement to deliver the 20% minimum but IMOS contracts are not and will be managed by the regional team.
There is a patient care guidance publication available from the NHS BSA and on the completion of COVID triage forms.
There is significant progress around the issue of practice staff (self employed or employed dentists, dental nurses, dental hygienists, locums, dental therapists, non-clinical and administrative staff) and associate pay with a declaration from NHS England & NHS Improvement that they will be working with the BSA to collect declarations about pay concerns via Compass and via an online survey form. Please look at the NHS BSA Compass page.
All those working in NHS dentistry should (as directed by the NHS) receive an equivalent level of remuneration for their work in the provision of NHS primary dental care services. During the Covid-19 pandemic this level of remuneration should be the same as if the pandemic had not occurred. The previous level (2019) is to be pitched at the figure of their NHS net pensionable earnings and if this is subject to any variation it must be through mutual agreement between both parties. Concise records of any negotiations must be recorded.
Practices should be providing AGPs and non-AGPs and any practice that has not gone through a programme of fit testing should do so without delay. Non-delivery of AGPs by contract providers will attract the attention of the dental commissioning team post September 2020.
It is appreciated that in some practices there may be risk assessment issues that may prevent some practices from returning to the provision of AGPs.
There has been some investigative work on the resilience of mixed NHS/private dental practices during the Covid-19 panfemic with 9 key recommendations.
The H&IOW LDC is engaging in a working group that will be looking into the care pathway for non-associated patients to tackle the current dilemma of overloading some UDCs and contractors from high numbers of referrals through 111.