Your NHS dentistry and oral health update

Wednesday 30 December 2020

An update from Eric Rooney, Deputy Chief Dental Officer England

Dear colleagues,

I hope you all had a restful Christmas break. 

In last week's bulletin, we announced that lateral flow antigen testing is being rolled out to all front-line patient facing NHS dental staff. This is an important step in empowering practices to stay open and see as many patients as possible. As stated last week, the deadline for orders to arrive in early January is today. Further detail, including what to do if you miss this deadline, is below.

As you will have seen on the news, the Government has today accepted the recommendation from the Medicines and Healthcare products Regulatory Agency (MHRA) to authorise Oxford University/AstraZeneca’s Covid-19 vaccine for use. Having studied evidence on both the Pfizer/BioNTech and Oxford University/AstraZeneca vaccines, the JCVI has advised the priority should be to give as many people in at-risk groups their first dose, rather than providing the required two doses in as short a time as possible. Everyone will still receive their second dose and this will be within 12 weeks of their first. The second dose completes the course and is important for longer term protection. The full advice of the JCVI is online. A statement from the four UK Chief Medical Officers on the prioritisation of first doses of COVID-19 vaccines can be found here. We will keep you updated of what these developments mean for patients and for dental professionals. 

The Health Secretary has also announced that a number of areas will change tier. NHS dental services in England should remain open to treat patients in line with the standard operating procedure and the national infection prevention control guidelines for dentistry, which remain unchanged. 

On EU Exit, we have included the key information you need to know as the UK exists the transition period this week.

Thank you again for your continued professionalism and very best wishes for the new year,

Eric 

Today: Lateral flow tests order deadline

Today we are sending a short reminder that Primary Care Support England (PCSE) has now sent direct invitations to all primary care contractors to place their orders for lateral flow tests onto the portal. If primary care contractors (medical, dental, optometry and community pharmacy) have not yet placed their order, they should log onto the portal and complete their order as soon as possible, and by today Wednesday 30 December to receive deliveries from early January.

Contractors who have not been able to place an order before the deadline will still be able to go onto the portal and order tests. However, deliveries of orders placed after the deadline may take place at a later date.

Each organisation should order one box for each patient-facing member of staff, for example if there are 10 patient-facing members of staff delivering NHS services within an organisation, the order should be for only 10 boxes of test kits.

Primary care contractors should already have access to the PCSE online portal, which is normally used to order secure stationery and supplies such as prescription pads, needles and syringes. However, if any primary care contractors do not have access, they should contact PCSE.

SOPs and FAQs on lateral flow testing in primary care are available for further information.

FFP2 masks: a reminder of the guidance 

At this time of increasing COVID -19 cases, it is particularly important to maintain high standards of Infection Prevention Control (IPC). As detailed in the UK IPC Guidance for dental settings FFP3 masks are recommended for AGP procedures.

FFP2 masks should only be used if FFP3s are unavailable and until staff are successfully fit tested and supplied with the appropriate FFP3.

The main IPC guidance on page 41 states,  “FFP3 and loose fitting powered hoods provide the highest level of protection and are recommended when caring for patients in areas where high risk aerosol generating procedures (AGPs) are being performed. Where the risk assessment shows an FFP2 respirator is suitable, they are recommended as a safe alternative”.

The NHS has published top 10 tips for IPC and testing and while this is primarily aimed at NHS Trust Boards, it includes some general helpful reminders that are applicable to dental providers.

EU Exit: a reminder of what you need to know

The UK exited the EU on 31 January 2020 and is now in a transition period until 31 December 2020. The UK government has reached an agreement with the EU as to the relationship beyond the end of the transition period. The House of Commons has now voted to approve this agreement which we expect will come into force on 1st January 2021.

Minister Ed Argar has written to the health and social care sector this afternoon, with what the UK–EU Trade and Co-operation Agreement means for the sector.

Personnel and Qualifications

The General Dental Council have updated their guidance about how the end of the EU Exit transition period will affect registration arrangements for dental professionals with non-UK qualifications. The rules for EEA-qualified dentists and dental care professionals will work differently from 1 January 2021. More information is on the GDC website.

Medicines

On EU Exit, as a reminder DHSC guidance is that it is not necessary for local providers, whether in hospitals or primary care, to stockpile medicines or for clinicians to write longer prescriptions for patients. Unnecessary stockpiling puts more pressure on the supply chain and can risk additional pressure on the availability of medicines in other parts of the country. Prescribers should explain to patients that they should continue to order their prescriptions as normal. Dr Keith Ridge Chief Pharmaceutical Officer for England wrote to NHS organisations with more detail which can be found online here.

Value Added Tax (VAT)

HM Revenue and Customs have published guidance on how to account for VAT on goods and services provided by registered health professionals, including dentists. You can find the guidance here.

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A reminder of the latest COVID-19 advice and guidance 

NHS updates to the profession 

During the course of the pandemic, we have regularly written to the NHS dental profession with important updates and information. This, and previous formal letters from the Chief Dental Officer and the NHS dentistry and oral health team are all 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.