30th July GG&C LDC Update

30 July 2020

AGPs for Urgent Care; Face Fit Testing; Staff Health Risk Assessments

    • The CDO wrote to dental practices today to announce a move towards AGPs in practice.
    • From 17th August 2020 NHS AGPs may be provided in practice for Urgent Dental Care only.
    • Health Board notification/approval will be required before undertaking AGPs for NHS urgent care.
    • The CoD suggested in his update that the board will be contacting practices to establish whether they will be in a position to provide AGPs.
    • Practices are not required to start providing AGPs from this date. In fact it is more likely the case that the logistical limitations for providing AGPs in practice will prevent most practices from starting at that point (e.g. PPE, Fit testing, SOPs, Risk Assessments, Board Approvals)
    • The LDC recognise that taking part in Urgent Care AGPs is likely to increase overheads for those practices that take part. No commensurate increase in funding has been offered. We will therefore be asking SDPC to express our disappointment to the CDO.
    • Nonetheless, in the meantime, we would point out that this is about patient care and working collaboratively with our PDS and HDS colleagues (who have consistently supported GDPs throughout lockdown). We would therefore encourage those that are able to provide AGPs to do so as a gesture of goodwill towards our colleagues (while your representatives lobby for additional funding in the background).
    • As stated, NHS AGPs will be for Urgent Dental Care only
    • As we have mentioned in previous updates, the term ‘urgent’ is overused and therefore confusing. It is perhaps easier to use the term emergency dental care as described in the relevant SDCEP guidance, which details three categories of problem:
      • Emergency [red] dental problems to be seen within 1 hour (severe trauma, airway threatening swellings etc)
      • Urgent [amber] dental problems to be seen within 48 hours (irreversible pulpitis, abscesses etc)
      • Routine [green] dental problems to be seen within 7 days (loose crowns, uncomplicated broken teeth/fillings, denture trauma)
    • In terms of AGPs, the treatments that we will likely be able to provide will not be far from those that the UDCCs are currently able to provide (detailed in section XII(b) of SDR 145). The most common being:
      • Extirpations
      • Complex Extractions (sectioning roots, bone removal)
      • Recements (requiring AGP cement removal and debridement)
    • NonAGP care will continue for both urgent and routine dental care as described in previous CDO comms and available under sections I to XII(a) of SDR 145.
  3. PPE
    • AGPs in dental practices require additional PPE as described in the HPS guidance for primary care
    • GG&C have already fit tested FFP3 masks to UDCC nominees and some general dental practice nurses.
    • GG&C today started to take bookings for fit testing practice teams via a webform (circulated to practice generic inboxes).
    • Today’s CoD update indicated that the first week of appointments have already been fully booked (on a ‘first come first serve’ basis).
    • In the wake of the CDO announcement later in the day, GG&C have indicated that future bookings for fit testing will be limited to one dentist & one nurse per practice.
    • The relevant PPE will be provided to practices centrally and free of charge. The quantities have not been indicated (we don’t yet know how many AGP patients we will be limited to per day).
    • Some GDPs will soon be providing the full range of urgent dental  care (AGP and nonAGP) to their own patients in their own practices. Therefore it is likely it will soon become the case that GDPs in this category can wind down their commitment to UDCCs. Nonetheless, we would encourage GDPs to continue to support our colleagues for as long as they are able.
    • The CDO expressed the view that those practices who continue to rely on the UDCCs should continue to have a nominated dentist volunteering at the sites.
  6. PHASE 4
    • The CDO letter goes on to hint at what Phase 4 might look like.
    • A return to patient fees and a fee per item SDR are suggested until a new model of care is developed.
    • He suggests that Financial Support Measures will be adjusted accordingly.
    • The deadline for applying for these grants has now passed.
    • However, there appears to be significant variation between practices in different authorities as to whether these grants are being approved
    • The LDC are happy to try and help any practices that are struggling with ongoing application issues. Please email us at ggc.ldc@gmail.com if you need assistance.