4th June GG&C LDC Update

04 June 2020

Reopening Practices; PPE Packages; Emergency Care Summaries; Furlough and SISS

Today’s update from the GG&C Chief of Dentistry is available here.

The LDC summary of the most relevant news affecting GG&C GDPs today is:

    • No further update from the Chief Dental Officer has arrived since ‘Remobilisation of NHS Dental Services in Scotland’ on May 20th, however a PCA is expected very soon.
    • It is now widely reported that we are to expect an announcement that practices will be asked to start reopening in mid-to-late June.
    • Practices are expected to be well underway with the process of preparing facilities, procedures and staff in line with the standards described in the SDCEP Toolkit.
    • It has come to our attention that a leaked draft version of an Emergency SDR has been doing the rounds. GG&C LDC does not endorse the sharing of draft documents as it undermines the consultation and negotiation process. This document is not to be relied upon as it is not final. The prolific sharing of such documents may have the unintended consequence of future draft documents being withheld from the profession, entirely removing our ability to consult and negotiate!
    • We have reached the end of the first week of ‘Phase 1’ in GG&C (the expanded range of urgent treatment offered at hubs).
    • As the start date of 28th May was extremely short notice for both the GDS and the Hubs, there were some teething problems getting the service off the ground which meant some of the treatments were not available in the first few days creating a backlog from the start.
    • We are assured that the service is now starting to adapt well to the changes and that the 7 day turnaround for ‘Green’ patients should be achievable if GDPs send appropriate and adequately detailed referrals.
    • We are told that the patient contact numbers  are frequently incorrect as supplied by GDPs on referral forms. Please reconfirm the details with patients before referral and please let them know that the hubs use an 0800 number to contact them for appointments (some patients may have such numbers spam-blocked or ignore them altogether).
    • NHS practices will have packages of PPE (for nonAGP treatment) provided to them by NHS NSS at no cost.
    • This is intended to be maintained at a level to allow practices to run one surgery seeing 10 urgent nonAGP patients per day in phase 2a. (Some practices may apply to have two surgeries running). AGPs should still be referred to UDCCs in Phases 2a and 2b.
    • A mass delivery of PPE has arrived in Glasgow today and the OHD are currently splitting this into bundles (the contents of which are detailed in the CoD update).
    • Packages are to be collected by practices as early as next week (we are reassured they will fit in one car). The specifics of the process are detailed in the update.
    • The intention is to move to a delivery service for further top-up packages once the practices’ doors are open and able to take delivery.
    • Practices will soon receive an email link to a ‘Webropol’ online   survey IN THEIR GENERIC INBOX requiring the lead dentist, practice owner or director to certify that they have adequate and robust arrangements in place before reopening.
    • This will largely be based on the principles set out in the SDCEP Toolkit, however there is now also FGDP and BDA guidance available that might assist in the development of protocols.
    • This ‘Webropol’ will also ask for a nominated dentist to provide AGPs at an Urgent Dental Care site (see below).
    • As indicated previously and in today’s update, GG&C are requesting that every practice (or buddy grouping of smaller practices) nominate one GDP to be face-fit tested and deployed for one day a week in an Urgent Dental Care Centre providing AGPs.
    • It would make sense for those that are already in these sites to continue, although this is not a must. It may well be that the current crop of GDPs have a few face-fit failures, requiring some to be subbed out for a different GDP.  The LDC are consulting on the practicalities of this with the CoD. If you have any concerns you wish us to raise, these can be emailed directly to us.
    • The CoD has provided the standard risk assessment form for deployment in frontline NHS services so that each practice can ensure their nominee is suitable.
    • The risk assessment is also useful for returning to practice in the coming weeks. The LDC are currently lobbying the OHD for direct access to Occupational Health Services for assistance in the risk assessment of GDPs who are expected to return to practice.
    • On a practical note – FFP3 masks don’t fit everyone… you may wish to research the obstacles to passing a face fit test and consider this when making your nomination. The  current GG&C process is outlined here but this is not dental-specific.
    • All NHS GDPs should be receiving log in details to the Emergency Care Summary system soon. This system was originally intended for ambulance services to be able to gain quick access to essential medical information such as allergies and medications, but has obvious benefits for GDPs.
    • GDPs can soon gain consent to access this information on behalf of the patient in order to clarify a vague or incomplete medical history. This will significantly improve patient safety going forwards.
    • The system must be accessed from a SWAN networked computer and there are significant and robust audit trails and alerts built in to prevent misuse.
    • This is a great example of the sort of thing we achieve for our constituents in normal times! GG&C LDC lobbied for this at conference, successfully, and so this became SDPC policy. They in turn successfully negotiated the roll out of access for GDPs after piloting with some GG&C LDC dentists.
    • Rishi Sunak announced that the Self-Employment Income Support Scheme will be extended – with those eligible able to claim a second and final grant capped at £6,570. However, disappointingly, the 50K earnings cap remains. Those who qualify must speak to their accountants and give consideration to how best to make use of the scheme.
    • He also outlined further details of the extension of the Coronavirus Job Retention Scheme (Furlough), including improved flexibility to bring furloughed employees back part time in July, and a new taper requiring employers to contribute to furloughed salaries from August
    • For practices who have been able to take advantage of this scheme (for the private/nhs ratio of employed staff) this may be useful in phases 2a and 2b, where only small numbers of the team will be working at any one time. As always, speak to your accountant about how best to make use of these packages.
    • The CoD update dedicates a full page to a CLO (Central Legal Office) opinion on treating private patients during Covid-19. Best read the whole thing but the highlights are:
      • NHS boards don’t have jurisdiction over the opening of whollyprivate practices.
      • Mixed practices can see wholly private patients for urgent dental care only if they notify the board. In Phase 2a this can include AGPs if following accepted protocols and patients are given the clear choice to attend an NHS UDCC instead.
      • IT IS NOT CLEAR WHETHER YOU CAN PROVIDE PRIVATE TREATMENT ON AN NHS REGISTERED PATIENT. The inclusion of the caveats at item 4b of the opinion would imply the answer is yes, the frequent use of the phrase ‘wholly private’ would imply the answer is no. We are seeking clarity on this.
      • The board can carry out unannounced inspections of NHS/mixed practices where there are concerns.
      • Breaches may merit referrals to the GDC or police.
    • After significant and forceful condemnation by the LDCs, SDPC and others… the Scottish Government have reversed their decision to stop paying CPD Allowance.
    • 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.

4th June GG&C Chief of Dentistry Update
Personal Health Risk Assessment Form
CDO Letter: Remobilisation of NHS Dental Services in Scotland