Your NHS dentistry and oral health update

Wednesday 27 January 2021

Farewell from Eric Rooney, Deputy Chief Dental Officer England 

At times its hard to visualise getting through to the other side, but each jab we give is another step forward and the vaccine roll out is progressing at pace with many of our colleagues vaccinated, too.

It hardly seems a year since I was working on minimising the disruption to the supply of our normal and routine dental face masks. All due to a new novel virus affecting China.

As the year goes by, so come birthdays and anniversaries, and this week it’s my birthday. That’s the same, but it’s different. Not just because of social distancing and the impact of Coronavirus, but because I have reached the normal NHS retirement age!

Just like last year, I can hardly believe how time has flown, from being a fresh faced 17 year-old entering Dundee Dental School, to this last tumultuous year. Throughout that time, the dental profession, it’s institutions, and the wider NHS have been a massive part of my work life.

That daily work rhythm has been nurtured, sustained and developed by so many colleagues and friends over the years. Each one, and every conversation, feeding into my clinical practice and contributing to my ideas and thoughts, in talks, documents, diagrams and policies I have been fortunate to be involved with.

For the support and camaraderie of colleagues across dentistry, health and beyond, I will always be grateful, as I will for the longstanding support of my wife and family throughout my career.

There is still much to be done to improve our NHS services, for the good of patients, the profession and the taxpayer and there will continue to be difficult times ahead, but I have every confidence in our profession and in the wider health system that together they can build a better future.  

Whilst dentistry has consumed my working life, I have a number of other interests including traditional music and I share my birthday week with one of Scotland’s most well known poets, Robert Burns who’s poems were often set to the rhythm of traditional tunes. With that in mind, and as I retire,

To all my friends and colleagues, best wishes for the future and one day

“ We’ll tak a cup o’ kindness yet, For auld lang syne!”

Eric

A personal tribute to Eric Rooney from the Chief Dental Officer

Following Eric’s announcement of his intention to retire at the end of January 2021 we were inundated with warm words and acknowledgment of the amazing contributions that Eric Rooney has made over an extraordinary career committed to improving dental care and oral health.  Eric has been involved in dental care since 1983, from clinical practice to public health, designing and delivering regional and national initiatives, shaping contract and commissioning policy in conjunction with the British Dental Association, Department of Health and latterly NHS England.  His leadership, collegiate approach and commitment are admired and respected nationally and internationally.  Whilst he neither seeks nor enjoys the limelight Eric is undoubtedly one of the most respected role models of his generation and for the next generation of dental professionals. 

It has been an incredible honour and a real pleasure to work alongside Eric Rooney as Deputy Chief Dental Officer for England. His wry, dry, humour and his humility and humanity have shaped not just the office of CDO but in the genuine warmth of his sharing of knowledge he inspires all those that have the good fortune to work alongside him. He truly cares and his quiet deliberate passion to do the right thing sets a benchmark that many aspire to, but few can claim to have achieved. Eric’s impressive CV, including an MBE for services to Dentistry in the 2015 New Year’s Honours and the plethora of national and regional achievements underline his clarity in advocacy for oral health and ensuring that patients receive the most effective dental care.  His contribution as co-author of the 2009 review of NHS Dentistry, known as “the Steele Report” and his clear thinking and evaluation of the Government’s Dental Contract Reform programme have shaped the intent for future service provision with an improved offer for patients and professionals alike.

We frequently talk about “standing on the shoulders of giants” – Eric is one of those giants who has lifted our sights, allowed us to see more and to see further.  With his commitment to challenging orthodoxy and as a powerful advocate for the patient as well as the professional he steps out of the dental arena leaving a legacy of excellence that will endure.

I know that I am not the only one who will miss him very much.

Sara Hurley

Chief Dental Officer England 

Rapid Review of the Mitigation of Aerosol Generating Procedures in Dentistry

The Scottish Dental Clinical Effectiveness Programme (SDCEP) have issued an update to their ‘Rapid Review of the Mitigation of Aerosol Generating Procedures in Dentistry’ within a new appendix and as a standalone document. 

The four nation Working Group considered the implications of the substantial increase in prevalence of COVID-19 infections in recent months, the emergence of more transmissible variants of SARS-CoV-2, no reports of transmission associated with dental care, the greater availability of testing and the vaccination programme that has recently commenced. The Working Group agreed that at present, despite these developments, the agreed positions and other conclusions within the Rapid Review remain unchanged.

As such, the Chief Dental Officer England is clear that the current standard operating procedures (links are at the base of this bulletin) are unchanged and are still applicable in England and the dental IPC guidance remains the benchmark for safe practice and quality care.

Update to dental infection prevention control guidance 

There has been a minor change to the COVID-19: infection prevention and control (PIC) dental appendix. The change relates to the risk pathway table (page 7) and clarifies the definitions within the medium and low risk pathways.  The change has been made to the dental guidance to align with changes in the main guidance. There have been no changes to the PPE requirement for dental teams.

A single result from a lateral flow device (LFD) antigen (Ag) test, whilst useful in some circumstances, is inadequate when considering on which pathway patients should be placed. A negative LFD Ag test result in an asymptomatic person should only influence pathway choice if the test was conducted as part of one of the variety of formal NHS testing programmes, and the meaning of the individual’s test result within the context of the specific testing programme is fully understood.

There has been no change to the IPC guidance since the emergence of the new variant of the virus. The IPC guidance continues to be reviewed regularly as evidence becomes available.

COVID-19 vaccination programme update

In our last update, we confirmed that dental teams, along with other healthcare staff, are being prioritised for COVID-19 vaccinations. We are very pleased that the vaccine roll out continues at pace and many dental team members have received their first dose.

If you have not received an invite yet, don't worry, sit tight and the NHS will come to you. Until you hear from the NHS, do not contact the NHS, such as your local GP surgery. Dental teams are on the lists and local systems are working their way towards you. 

COVID-19 vaccination for dental teams: Call out to non-NHS dental practices to update your CQC contact details

As we said earlier this month, the NHS requests that independent providers without a NHS contract update their practice contact details with the Care Quality Commission (CQC) as a matter of urgency. This is because if you work in private sector dentistry and the practice you work in or you personally do not have a NHS contract, then the NHS does not hold any contact details for you. This means we need to get hold of your contact details, or that of your practice, from the regulator the CQC. It is therefore essential that private practice owners ensure the contact details for their practice with the CQC are up to date, especially with an up to date email address. The NHS can then begin the process of vaccinating staff.

If you are a private practice and your details are not up to date, let the CQC know by submitting a notification form.

*Please forward this notice on to colleagues in non-NHS dentistry*

Guidance on claiming reimbursement for COVID-19 PPE-related costs in dental practice

Dental practices will be able to claim for personal protective equipment (PPE) between 18 January and 20 February 2021, which means no claims will be accepted after 20 February 2021. Claims can only be made for PPE purchased between 27 February and 31 December 2020 for use in the delivery of NHS dental services as a result of COVID-19 infection control guidance.

Please remember to put in your claims before the deadline.

Further information is available on the Department of Health and Social Care website.

Supplementary advice for GDC decision makers on factors specific to COVID-19

The General Dental Council (GDC) has issued supplementary advice that has been developed to support decision makers in considering factors relating to the impact of COVID-19 on a professional’s ability to deliver care, and to provide a lasting point of reference.

Under legislation, context is usually considered at the Case Examiner stage. Case examiners are appointed GDC staff members with a statutory duty to make decisions on cases that have been referred to them for more detailed consideration. It is at this stage that a concern or complaint in the context of COVID-19 would be examined in more depth.

There have been multiple challenges during the pandemic for dental professionals.. The GDC has published a non exhaustive list of some factors brought about by COVID-19 for consideration when deciding whether there is a real prospect that a registrant’s fitness to practice is currently impaired. More information is available online.

Dental students in tenant and landlord guidance

In its guidance for landlords and tenants, the Government has made clear they are prioritising the return to face-to-face teaching for courses which are most important to be delivered in-person in order to support the pipeline of future key workers. Only students doing medical, clinical and healthcare related subjects, including dentistry should return to face-to-face learning as planned. 

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Previous NHS dentistry and oral health updates 

Previous bulletins can be accessed by clicking on the links below:

• Issue 1: 27 October
• Issue 2: 2 November
• Issue 3: 27 November 
• Issue 4: 10 December 
• Issue 5: 22 December 
• Issue 6: 30 December 
• Issue 7: 4 January
• Issue 8: 7 January

NHS primary care bulletin

The NHS primary care bulletin provides resources on health policy and practice and we encourage you to sign up for this, too. It is aimed at teams across general practice, dentistry, community pharmacy and optometry. 

A reminder of the latest COVID-19 advice and guidance 

Letters of preparedness to the profession 

During the course of the pandemic, we have regularly written formal letters to the NHS dental profession with important updates and information. They are online here. 

Transition to Recovery: Dentistry's standard operating procedure

This document is the essential guidance for all dental teams in England. In it, we detail all the key things dental teams need to know about how to run their services safely, for patients and themselves. The latest version was published on Tuesday 27 October. Changes to the previous SOP are in yellow. You can read the SOP online here. 

Urgent Dental Centres: Standard Operating Procedure 

If you work in an urgent dental centre or are responsible for one as a provider, or as a commissioner, then the Urgent Dental Centre SOP should be your guide. Changes to the previous SOP are in yellow. It was updated on Tuesday 27 October and is online here.