24th June GG&C LDC Update

24 June 2020

Phase 2 Implementation; Urgent Dental Care Definition; SDR Triage Codes; Phase 3 Start Date

The 24th June GG&C Chief of Dentistry Update is now available here.
A letter from the CDO notifying us of the Phase 3 start date is available here.

    • On 15th June the CDO sent out a PCA to accompany an emergency SDR in preparation for Phase 2.
    • On 18th June the First Minister officially moved us into Phase 2 of the SG Routemap and in a letter on the same day, the CDO confirmed this meant that practices could start to open from Monday 22nd June.
    • We can now see nonAGP ‘Urgent Dental Care’ patients in our own practices whilst referring AGP ‘Urgent Dental Care’ patients to UDCCs.
    • In GG&C, practices can open after submitting their completed Webropol ‘Self-Declaration’ that they have appropriate protocols in place.
    • Today’s CoD letter confirms that practices who are awaiting approval for a second surgery can still open a single surgery in the meantime.
    • Mixed practices who intend to offer private dental care in a second surgery should still notify the Health Board before doing so.
    • Essentially everything that appears in the new interim SDR is accepted as ‘Urgent Dental Care’. The nonAGP treatments that GDPs can provide in practice are detailed in sections I to XI. The AGP elements (available in UDCCs only) are in section XII(b).
    • There has been much confusion about the term ‘urgent’ as it has been used in a number of contexts, for example:
      • Urgent Dental Care Centres
      • SDCEP Categorisations: Red (Emergency), Amber (Urgent), Green (Routine)
      • CDO Phasing which references ‘Urgent‘ and ‘Routine’ dental care
    • The following explanation hopefully helps define urgent dental care In terms of what can be referred to UDCCs and what we are able see in practices during Phase 2.
    • We are no longer using the prioritisation flowchart detailed in SDCEP guidance ‘Managing Acute Dental Problems during Covid-19’.
    • We have reverted to using the prioritisation categories detailed in the 2007 SDCEP guidance ‘Emergency Dental Care’ whilst paying mind to the AAA detailed in the Covid guidance on prescribing.
      • NB The 2013 SDCEP guidance ‘Managing Acute Dental Problems’ leans heavily on the EDC guidance but is designed for non-dental healthcare colleagues, it does not replace the EDC guidance.
    • When referring and prioritising treatment, it might be easier to think of the categorisation in similar language to the guidance as demonstrated  below:
      • EMERGENCY (RED) ‘Acute Dental Problems or Emergency Dental Care’ (To be seen within the hour – avulsions, severe swellings etc)
      • URGENT (AMBER) ‘Acute Dental Problems or Emergency Dental Care’ (To be seen within 48 hours – toothaches, moderate swellings etc)
      • ROUTINE (GREEN) ‘Acute Dental Problems or Emergency Dental Care’ (To be seen within 7 days  – patch fillings, recements, denture adjustments etc)
      • AAA-Only ‘Acute Dental Problems or Emergency Dental Care’ (patients who don’t fall into the above or are unable/unwilling to take the risk to travel to practices/UDCCs).
    • All of the above is included in the ‘Urgent Dental Care’ we can provide in Phase 2 either at practice (nonAGP) or hubs (AGP) and mirror the items in the interim SDR.
    • A guidance document to the interim SDR was circulated last week and provides a useful guide to the triage codes.
    • The CDO has advised these codes are to monitor activity only.
    • The expectation is that all triage activity will be resumed ‘in-practice’ (rather than remotely) and that the outcomes of triage will be ‘claimed’ as SDR no-fee items.
    • Some examples (as we have interpreted it) are below:
      • If triage outcome was an antimicrobial prescription you would claim:
        • 80[a] (triage phonecall)
        • 80[c] (AAA only)
      • If triage outcome was Extraction in practice you would claim (after treatment complete):
        • 80[a] (triage phonecall)
        • 80[e] (appointed at practice)
        • 80(g) (nonAGP procedure)
        • 21[1] (extraction permanent tooth)
      • If triage outcome was referral for extirpation (without the need be seen in practice first) you would claim:
        • 80[a] (triage phonecall)
        • 80[f] (AGP referral)
    • We are still awaiting formal advice on what to do with ‘open courses’ of treatment but we are of the understanding that ‘Covid courses’ can be opened separately and sent as complete while these other plans sit in limbo.
    • Practice Management Software suppliers have been given all the necessary information to update systems with the new SDR Codes
    • The CoD update links to a website with live updates as to the PMS progress in implementing the changes.
    • Most have already provided updates or made them available
    • The remainder appear to be on track to have something available by the end of this week.
    • The CDO announced yesterday that we will be moving to PHASE 3 on Monday 13th July.
    • Phase 3 allows more routine dental procedures to be carried out in practice (exams, denture stages etc) but only nonAGP. 
    • We expect announcements as to the practicalities of this (e.g. how many patients we can see, how PPE is to be provided, how this will be funded etc) to be made in the coming weeks.
    • 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.