Your NHS dentistry and oral health update

Thursday 30 September 2021 (Issue 27)

An update from Sara Hurley and Ali Sparke

Dear colleague,

We have written to general dental service contractors to announce the next steps to support the recovery of NHS dentistry, with contractual arrangements from October to December.

This includes a safe increase in the activity thresholds, a continuation of clinical prioritisation, support for our NHS dental teams and an update on dental system reform.

On Monday, the UK Health Security Agency (UKHSA) announced amendments to infection prevention control measures for acute settings. As stated on UKHSA's website, "further changes looking at other services and environments, including dentistry and ambulance trusts, will be planned in future steps. We will be working with stakeholders to assess where access can be improved in these settings". In the meantime practices should continue to follow Public Health England's COVID-19: infection prevention and control dental appendix (last updated 2 September 2021).

We are happy to announce that for this flu season frontline NHS dental teams are entitled to a free flu vaccination - paid for by the NHS. 

We can also confirm that dental teams, including in private practice, are entitled to a COVID-19 booster jab, too. More detail on how to get this is included in today's bulletin. 

Finally, the UK's four Chief Medical Officers have stated their view in a joint statement that community water fluoridation is safe and beneficial for our oral health. A statement of support for this important public health initiative from the CDO is included below. 

Thank you for your continued hard work and dedication to NHS dentistry. 

Best wishes and thanks,

Sara and Ali

Next steps on supporting the recovery of NHS dentistry 

 In August 2021, mean performance was 70% and 63% of contractors are anticipated to achieve or exceed 60% of their contracted Units of Dental Activity (UDAs). Many contractors are safely exceeding the threshold.

But we recognise it isn't easy and that right now it's too difficult for patients to get an appointment. On behalf of patients, our shared mission now is to increase access and recover activity.

In our letter to dental contractors, we have given details of our next steps to support this:

1. Contractual arrangements that safely maximise access and activity
2. Support for our NHS dental contract holders and the wider dental team
3. Continuation of clinical prioritisation of patients such as those with urgent need and children
4. Proceeding with dental system reform.

What are the key contractual requirements?

• There will be ongoing contractual protection for practices unable to deliver their full contractual activity between October and December 2021. During this period claw-back will not be applied to practices delivering at least 65% of contracted UDAs and 85% of contracted Units of Orthodontic Activity (UOAs).

• The rate of claw-back will then reduce linearly down to a lower threshold of 52% of UDAs and 60% of UOAs. Below these levels normal claw-back will apply.

• In addition to the recently announced pay increase for dentistry by the Government, NHS England is reducing the adjustment made to payment for activity not delivered from 16.75% to 12.75% for general dental contract holders.

• Regional commissioners will also maintain arrangements for Urgent Dental Centres (UDCs).

• We have concluded we are only able to set contractual priorities for the next quarter as we need to retain the ability to respond to the revised IPC requirements later this year.

Free flu vaccination for frontline NHS dental teams

Let your colleagues know about the free NHS flu jab! Click on the picture below to spread the word on twitter

Who is eligible for a free flu vaccination?

We will provide a vaccination for staff employed by primary care contractors and involved in the frontline provision of primary care services. This includes non-clinical staff directly involved with the provision of NHS services on a day-to-day basis who have face-to-face contact with patients, for example reception and counter staff who play an integral part in patient care in primary care settings.

Any non-clinical staff not directly involved with the provision of NHS services on a day-to-day basis or do not have face-to-face contact with patients (for example cleaners, back office administrative staff, counter staff) are not eligible for vaccination under this scheme.

Primary care contractors and their frontline staff who provide private services only are not eligible for vaccination under this scheme. Staff who work in private practices can be offered flu vaccination paid for by their employer under their occupational health responsibilities. 

Where can I get an NHS flu vaccination?

Eligible primary care contractors and frontline staff may be vaccinated in any of the following places, which you should book an appointment for in advance:

• your own GP practice i.e. the practice you are registered with; or
• any community pharmacy that is offering NHS flu vaccinations, including if the community pharmacy is delivering vaccinations in your place of work, or.
• any other GP practice, including if a GP practice is delivering flu vaccinations in your place of work.

What proof is required to show that I work NHS primary care services?

When you attend for your flu vaccination you should take proof of employment as a health and social care worker. Acceptable documents are a workplace photo ID, a letter from your employer in the last 3 months (on headed paper) or a recent payslip from the last 3 months which includes your employer’s details. 

Receiving a COVID-19 booster jab

Eligible frontline health care workers (both NHS and private sector) are entitled to a COVID-19 booster jab. 

To be eligible, you should have direct contact with people at higher risk from coronavirus (COVID-19). For example you work in a clinical role (such as a dentist, dental nurse, dental hygienist or therapist) or you have contact with patients in a non-clinical role (such as a receptionist).  Please note that administrative staff who do not have any direct contact with patients are not eligible.

From Friday 24th September, eligible staff are able to book their appointment online through the National Booking Service here or by ringing 119. You may also have been contacted by the NHS directly.

As part of the booking process, you will need to self-declare you are a frontline health worker. When booking, you will be advised on the evidence you will need to provide at the vaccination site as of proof of employment. Staff will only be vaccinated if official proof is presented. Whilst this guidance is aimed at NBS bookings, the ID requirements also apply to individuals who are vaccinated via local booking services or walk-in clinics.

Staff employed by an NHS Trust should follow their Trust’s guidance on booking a booster vaccination in the first instance.

Chief Medical Officers back community water fluoridation and statement of support from Chief Dental Officer England

The UK's four Chief Medical Officers have issued a joint statement stating that there is unquestionably an issue with tooth decay in the UK and an entrenched inequality which needs to be addressed. The CMOs have agreed that fluoridation of water can reduce this common problem and that there is strong scientific evidence that water fluoridation is an effective public health intervention for reducing the prevalence of tooth decay and improving dental health equality across the UK. 

Statement of Support for Water Fluoridation by the Chief Dental Officer England 

"The statement by the UK's four Chief Medical Officers is a welcome endorsement of water fluoridation’s health benefits and safety from the most senior doctors in each nation of the United Kingdom.
 
Rotting teeth are not an inevitability and in children they are a tragedy. 
 
Every day dental care professionals see tooth decay which could have been prevented.
 
There is strong evidence that fluoridation of water can could help reduce this common problem and tackle dental disease.
 
The Chief Medical Officers are right to point out that fluoridation is not a replacement for good oral hygiene. Nor will it spell "the end of dentistry” - the need for dental care across a whole range of oral and dental conditions will continue.
 
As the robust international evidence shows, water fluoridation is another public health tool that can reduce the incidence of tooth decay amongst adults and children – saving potentially thousands of teeth and improving oral health inequality in the process.
 
As the Chief Dental Officer, I strongly believe that water fluoridation can benefit the nation's oral health”.
 
Sara Hurley
Chief Dental Officer England

Support for NHS dental teams with Long Covid 

For some people, coronavirus (COVID-19) can cause symptoms that last weeks or months after the infection has gone. This is sometimes called post-COVID-19 syndrome or "long COVID". The term ‘Long COVID’ includes both ongoing symptomatic COVID-19 (5-12 weeks after onset) and Post-COVID-19 Syndrome (symptoms continuing 12 weeks or more after onset). 

The NHS has a range support and services for our staff which include the following: 

• Staff with Long Covid can access support via online rehab services at Your COVID Recovery | Supporting your recovery after COVID-19
• The comprehensive health and wellbeing offer, including mental health and wellbeing hubs, apps and helplines for all NHS staff can be accessed via england.nhs.uk/people
• The 38 system-wide staff mental health and wellbeing hubs in place provide proactive outreach and assessment services ensuring staff receive rapid clinical assessment and supported onward referral to mental health services and psychological support where needed. More information available here.
• Staff can be referred to one of the 89 Post-COVID Assessment Clinics by their GP. The clinics offer holistic assessment and help people access the right specialist services.

If you have Long COVID and your symptoms are having a big impact on your life, please let your manager know. You may need to be referred to a Post-COVID Assessment Clinics to help you manage your symptoms and recover.

Signing up to this bulletin

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This bulletin is a round up of all the latest news and important resources for anyone working in NHS dental services. We'll send it out as and when important news needs to come your way. If you've already signed up but didn't receive the update, then check your junk folder for the confirmation email and make sure you've followed the instructions to complete sign up.

Previous NHS dentistry and oral health bulletins 

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

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. 

COVID-19 advice, guidance and resources

Communications resources for NHS dental practices

Click on the links below to view and download useful communication resources:

• Click here for social media image cards and patient leaflets
• Click here for social media assets and posters explaining IPC requirements
• Click here to download website/social media copy and scripts for answer machine message, text message and emails.

NHS updates to the profession 

Key letters from the Chief Dental Officer and the NHS dentistry and oral health team are online here. 

Transition to Recovery: Dentistry's standard operating procedure

The latest version was published on Friday 16 July 2021. Changes to the previous SOP are in yellow. You can read the SOP online here. 

COVID-19: infection prevention and control dental guidance

The guidance is an appendix to and should be read in conjunction with the national guidance on infection prevention and control for COVID-19 . You can read the general guidance and the specialist dental appendix online here.

Avoidance of doubt note: provision of phased treatments

This document is to support dental professionals, and to clarify where it might be appropriate to provide phased treatment spanning over several courses of treatment (CoT). You can read it online here.

Health and wellbeing support