20th May GG&C LDC Update

20 May 2020

Phased Return to Practice; Mixed Practices; Covid Symptoms Update; GDC ARF

Today’s update from the GG&C Chief of Dentistry is available here. Today’s letter from the CDO: ‘Remobilisation of NHS Dental Services in Scotland’ is also now available. The LDC summary of the most relevant news affecting GG&C GDPs today is:

    • Remobilisation of NHS Dental Services in Scotland describes a phased return to practice. The phases appear to be indexed to the availability of PPE.
    • We strongly advise that you read the CDO letter for yourself. The plan contains more detail than we have come to expect and is worth your attention. The following is a very superficial summary of the plan.
    • PPE – GG&C LDC is of the understanding that PPE will be provided and rationed by NSS Scotland. We have been told that this limited provision seeks to strike a balance between the wider need for PPE in frontline services, whilst also recognising the generosity of practices in pooling their PPE at the peak of the pandemic.
    • Phase 1: There will be an increased offering of treatments at the Urgent Dental Care Centres, indicating a return to the Pre-covid SDCEP protocol for managing acute dental problems. Practices remain shut. More GDP redeployment is  to be expected in order to support this service and free up PDS and HDS colleagues to return to post. Practices will still providetelephone triage with AAA where possible, awaiting new protocols for triage and referral from GG&C in the coming days. Phase 1 will start when GG&C UDCCs are ready, the current triage protocol remains in place for timebeing.
    • Phase 2a: Practices start to open to see Non-AGP urgent care broadly in line with pre-Covid SDCEP protocols. One surgery is to be set up in each practice (maybe more in certain circumstances), still referring AGPs to UDCCs. This is expected to begin in early July and be largely in place by the start of August, dependent on PPE and National Covid-19 status.
    • Phase 2b: Builds on 2a but with the addition of some routine Non-AGP care (Exams and some treatments: Hand scales? Caries Excavation and Dressings? Denture Stages?)… dependent on PPE and National Covid-19 status.
    • Phase 3:  “Phase 3 envisages a limited introduction of AGPs to dental practices, this will be dependent on evidence of risk and possible mitigation.” This is likely to be many months away based on the staging of Phases 1 and 2. Rumours are floating around about ‘all treatment under rubber dam’ or ‘downgrading of PPE required for AGPs as test and trace is implemented’. These are currently rumours and the LDC sees no benefit in second-guessing the CDO guidance. Specifically, we would advise against panic-buying up the PPE that our colleagues on the frontline sorely need, especially when we are months away from opening… other services need it right now. Again, the CDO clearly states that NSS are sourcing the appropriate PPE on our behalf to assist in the initial phases.
    • The LDC will continue to work with the various organisations to ensure these arrangements are as robust and as fair as possible.
    • Funding – The CDO indicates NHS funding in some form will be maintained long-term to ensure sustainability of NHS dental practices.
    • Return to Practice Toolkit – SDCEP will soon be releasing guidance on returning to practice, thank you to everyone who completed the survey to inform the guidance.
    • In light of the CDO letter, today’s Chief of Dentistry Update makes it very clear that he expects that practices in GG&C with any NHS commitment should stay closed as per the CDO’s plan.
    • It explicitly states: “The advice to practices holding a list number with NHS GG&C that have combined practice inspections carried out is to follow the attached Chief Dental Officer guidance and remain closed at this time other than for telephone triage. Wholly private practices should take advice from Health Improvement Scotland in consideration of moving towards Phase 2 re-opening.”
    • To clarify, the LDC interprets this to mean that if a practice has an NHS list number and  therefore receives an NHS practice inspection (as opposed to one provided by Health Improvement Scotland) then the practice is considered ‘Mixed NHS/Private’ and should therefore remain closed as per the CDO guidance.
    • An announcement from the GDC states that they have decided not to refund part the ARF and will not be setting up any payment plans for the annual retention fee in light of the Covid-19 pandemic.
    • Every dentist with a list number in GG&C can and should have an active LDC levy mandate.
    • It is important to note that if you have moved practice or changed list number your mandate is no longer active and you should sign a new one with each change.
    • If you are not sure if you are supporting the LDC then please email the LDC and ask. Alternatively, you can just complete another mandate (duplications are picked up at our end and there will be no ‘doubling up’ of levies). The process is entirely online and takes no more than a minute.

GG&C Chief of Dentistry Update 20th May
CDO Letter: Remobilisation of NHS Dental Services in Scotland
GG&C Chief of Dentistry Update 18th May
GG&C Triage and Referral Form 18th May Version