Further to the Dental Team’s email sent out on the 16 April, we are now able to confirm that a number of the Urgent Dental Care hubs have a limited supply of PPE that will enable them to provide treatment for the most urgent patients. Generally patients that are shielded or at increased risk of severe illness will be treated in hubs run by our Community Dental Services with all other patients treated in hubs run by General Dental Service providers that are staffed by both their own practice workforce as well as those from other practices. The Dental Electronic Referral System (DERS) will automatically send referrals for shielded patients and those at increased risk of severe illness to the local CDS for the patient; dentists will need to select the closest GDS hub for all other patients. At any point should a hub not have the required stock of PPE they may need to temporarily stop face to face treatment, in which case the hub will redirect the referral to an alternate hub following secondary triage. Please do not advise patients the address of the hub you select on DERS as this may change or secondary triage may determine an appointment is not offered; this will ensure the safety of staff and patients at the hub as it will prevent patients that do not have an appointment from attending. Patients will be advised the hub address if an appointment is offered following secondary triage.
All referrals to the Urgent Dental Care System can only be made through the DERS (also known as Rego). Any previous referral arrangements are no longer to be used with immediate effect and any referrals made outside of DERS will be returned by the hub. The referral must be made by the dentist that undertook the latest triage and gave urgent care to the patient through AAA.
The Dental Team appreciate that practices will have a list of patients they have already provided telephone triage to but they ask that you do not make the referral on the basis of this and instead a dentist should contact those patients to obtain their up to date symptoms and assess whether they still require further treatment or whether AAA given previously has made their condition manageable. Should any of those patients still require urgent treatment, the dentist should make a referral on DERS.
Each hub will re-triage all referrals to confirm that the patient does need to be seen urgently and further assess their COVID-19 status. The Dental Team therefore ask that when a dentist makes a referral, they advise the patient that the provision of referral does not guarantee that they will be given and appointment and that they will have to go through another clinical assessment, due to the limited number of appointments during this pandemic. To manage patient expectation as to the treatment they may receive, please also advise them that where an appointment is given, the treatment that can safely by undertaken during the pandemic is very limited and may be temporary in nature.
To make a referral on DERS, the dentist should use their usual log in details. Where the dentist is making a referral from home they will need to log onto the following website https://ref.management/login to access the system; they have attached guidance on how to do this and the use of the secure key for accessing the site securely. They also ask that questions on the use of DERS are not made to the Dental Team as they will not be able to answer these and instead questions should be made to Vantage by telephoning 0207 993 5870. Once online if you have any further queries, you should ideally use the webform or the live chat function in DERS rather than phoning.
In addition to making a referral into the UDC system, DERS can now be used to email a prescription to the patient’s choice of pharmacy. The previous instructions sent on 16 April are no longer applicable and instead have been updated here to reflect the use of DERS to send a prescription to a pharmacy:
- Patients should be advised to purchase over the counter pain relief wherever possible rather than including this on a prescription, as this is impacting on pharmacy supply chains and increased workload to dispense
- FP10D must include the standard prescription details; ensure the medication dose and duration are clearly annotated
- Prescription must be signed and dated
- Check NHS.uk to see pharmacy opening hours as a number of pharmacies have reduced their hours and ask the patient which one they would like to use
- Prior to finishing the AAA call with the patient
– ensure they know the prescription may take some time to be dispensed at the pharmacy
– advise that if they or a member of their household is symptomatic or self-isolating, that they MUST NOT attend the pharmacy to collect the medication and should request a neighbour or friend to collect on their behalf; shielded patients and those at increased risk of severe illness (previously referred to as vulnerable patients) should be advised to ask someone else to pick up the prescription although in some cases the pharmacy may deliver
– the person collecting the prescription should check pharmacy opening times (all pharmacies are open Monday to Friday 10am to 12pm and 2pm to 4pm as a core minimum)
– the person who is collecting the dispensed medication must inform the pharmacy that their prescription has been sent to the pharmacy nhs.net email address from their dentist
– ask the patient to contact you if they are unable to obtain the prescription
- Once a pharmacy is agreed, you must ring the pharmacy to advise them that you will be sending a prescription and it will be on their nhs.net account awaiting action, noting that pharmacies are experiencing very high levels of demand at the moment
- If you are unable to contact the agreed pharmacy, then you will need to find another and inform the patient where the prescription has been sent
- Log into DERS using normal log in details
- Add patient details ie, name, address, telephone number DOB to create a record and unique reference number (URN) for the patient
- Select Prescription Pathway, follow the prompts on the screen to create a record of the prescription, selecting the appropriate medication, dose, route and frequency, ensuring it is the same as the written prescription
- Answer the prompts as to the patient’s COVID-19 status
- Download the App from the Apple App Store called ‘Rego Uploader’ (this is only necessary the first time you use DERS to send a prescription to a pharmacy), there is no cost to downloading and using this App. This will allow an image of the prescription to be uploaded onto DERS (as you would do for uploading an x-ray), the image does not stay on your phone/tablet so is fully IG compliant; follow the prompts on DERS and on the App to upload the image
- Complete the prescription notification by clicking on ‘send’, DERS will then send the prescription through to the chosen pharmacy via email to the pharmacy’s nhs.net account
- An email copy of a paper prescription does not fall within the definition of a legally valid prescription so the original FP10D should be sent to the pharmacy as quickly as possible as this must be received no later than 72 hours after the emailed copy
- Keep a record of paper prescriptions sent and confirmation of receipt by the pharmacy
The Dental Team have received increased reports from 111 that patients have been advised by their dentist to contact them. With the exception of patients that consider they have COVID-19 and require advice relating to COVID-19 symptoms (and not for dental advice), patients should not be advised to contact 111 as 111 are unable to give any additional advice than a dentist can using the AAA outlined below in our email of 16 April (and preceding emails).
They thank you for your ongoing support in providing remote urgent care via AAA to any patient that contacts your practice during this challenging time