16th September GG&C LDC Update

16 September 2020

September Weekend; Referring into UDCCs; Finishing RCTs; Vaccination Programme

    • Today’s Chief of Dentistry Update confirms that NHS 24 will be covering Monday 28th September and there will be an emergency dental service up and running.
    • If practices choose to be closed, please remember to change answering machine instructions for patients to call 111 for emergency dental care
    • In recent weeks GG&C Core Briefs and today’s Chief of Dentistry update have acknowledged that, as services scale up, ‘clinical bubbles’ and ‘social distancing’ in healthcare workplaces has become increasingly difficult.
    • The potential for coronavirus to spread between staff members is therefore very high.
    • It is therefore recommended that:
      • Staff maintain social distancing where possible.
      • Alcohol gel and hand washing is promoted in all clinical and non-clinical areas.
      • All staff wear a face mask while on the premises even in non-clinical areas.
      • All staff avoid sharing pens, phones, keyboards, computer mice etc
      • Breaks are staggered, social distancing is maintained when removing face masks to eat or drink.
      • Shared snacks and treats are avoided.
      • Communal surfaces, handles and equipment in staff areas, toilets, cloakrooms, corridors are regularly cleaned.
    • If a staff member is required to self isolate, track and trace or public health representatives will enquire about such protocols within the workplace.
    • If these protocols are robust, then it is less likely that they will  impose measures such as sweeping self-isolation recommendations.
    • Good protocols will therefore protect you, your colleagues and your business!
  3. NHS PPE
    • All practices should now be staffed throughout the working day to triage patients and provide urgent care as per Phase 2 of the CDO Remobilisation plan (as a minimum).
    • It is therefore expected that practices should be able to receive the deliveries of PPE during working hours.
    • If your doors are locked to maintain social distancing at reception, then please leave clear instructions on the door for deliveries.
    • If deliveries are being returned because nobody is around during the day, then the Health Board can only assume that we are not providing our contracted services… which is not a position any of us want to be in.
    • If you don’t need more PPE you must email the board and tell them, they cannot accept and store returns if you decide on the day you don’t want or need it.
    • PPE is extremely expensive to buy in yourself (and getting moreso) so please do make use of the free supplies before it all dries up!
    • The Chief Dental officer confirmed that GDPs will soon be able to assist in the delivery of the winter flu vaccination programme.
    • A participation fee of £250 and a fee-per-item payment per vaccination of £8.27 were announced. We are seeking confirmation that this would be in excess of Covid FSM top-up payments.
    • Today’s Chief of Dentistry update suggests it is more likely GDPs  in GG&C will be asked to help at central sites on a sessional basis rather than providing them within their own practice.
    • The LDC are in discussions with the OHD about how we feel this could be best managed.
    • Domiciliary care codes are not in SDR 147
    • However, the CoD update confirms that in the context of urgent care, where appropriate risk assessments and engagement with care how staff has been undertaken, it might be appropriate to provide domiciliary care.
    • It is worth discussing with care homes the possibility of bringing the patient to the practice given the wider vulnerabilities in care home settings
  6. UDCCs
    • The PDS are reporting a constant stream of inappropriate referrals  into UDCCs. For the avoidance of doubt:
      • All dental practices in GG&C should now be open during the working day so that patients can contact and attend for urgent dental care.
      • All nonAGP treatments should now be provided in practice unless the patient has suspected coronavirus.
      • AGPs can now be provided in practice for urgent dental care although this is not yet mandatory.
        • Practices providing AGPs are required to complete the webropol survey to inform the board and self-declare the relevant protocols are in place.
      • You should only now refer into UDCCs if:
        • The patient is suspected to have coronavirus and has a dental emergency or
        • An AGP is required and your practice is unable to offer AGPs.
      • If you are using the UDCCs you must have a nominated dentist available and working at UDCCs currently.
      • The Chief of Dentistry update states that, going forwards, GDPs who refer patients in to UDCCs will be required to book a slot to attend and provide the treatment themselves (or a nominated representative from their practice attends in their place).
      • If you will not be able to have AGPs up and running at your practice in the next week or so then it is imperative that you arrange an induction and IRMER training at a UDCC site by calling 0141 531 8120 
    • SDR 147 only has codes for extirpation (drainage) of root canals for urgent care. There is no code for completion of RCT.
    • However, PSD have clarified in their recent bulletin that if it is felt that there is a clinical justification to complete the RCT sooner than Phase 4 (either in one visit or returning for the second visit) then dentists should do so.
    • As there is no code, dentists should complete the urgent extirpation code and then include a note that the treatment has been completed in the claim observations.
    • GG&C LDC understands the difficult position you find yourselves in. Please do contact us if you wish to discuss any problems you are having. We are looking to arrange a Q&A for new associates in the coming weeks, let us know who you’d like to hear from.
    • Every dentist with a list number in GG&C can and should have an active LDC levy mandate.