Your NHS dentistry and oral health update

Friday 11 February 2022 (Issue 42)

An update from Sara Hurley and Ali Sparke

Dear colleague,

Many of you have got in touch with your commissioner about our £50m investment into dental services between now and the end of the financial year. We've noticed a few common myths around the offer which we hope we have cleared up with our myth buster below. We have a backlog, patients need our important service and this is one opportunity to begin to address that. So please do contact your commissioner if you think you can take on any sessions, however many or few between now and the end of March.

The NHS has published its elective recovery plan, setting out a blueprint to address backlogs built up during the COVID pandemic and tackle long waits for care with an expansion in capacity for tests, checks and treatments. The ‘Delivery plan for tackling the COVID-19 backlog of elective care’ will also give patients greater control over their own health and offer greater choice of where to get care if they are waiting too long for treatment. The plan aims to boost capacity and improve patient outcomes and has been developed to take into account the challenges that primary care continues to face. The plan is good news for those of you working in secondary care dentistry as the NHS works to tackle the backlog in oral surgery.

This week is Sexual Abuse and Sexual Violence Awareness Week and the NHS has launched a new campaign to raise awareness of the services available, which we wrote to practices about earlier this week. More detail is below.

Further updates on vaccination as a condition of deployment and reforming the GDC's international registration legislation are included in today's update too.

With best wishes,

Sara and Ali

Vaccination as a condition of deployment: updated information

A letter and updated FAQs on vaccination as a condition of deployment for healthcare workers have been published today. These include detail on recruitment and recommendations for any formal processes which may have already begun.

Tackling the dental backlog: myth busting the £50m investment offer

NHS England will be making available an additional £50m of non-recurrent funding for NHS Dental care provision for the remainder of 2021/22. This funding is available within this contractual year only and cannot be accrued into 2022/2023 contract year. This is being commissioned on a sessional basis with a national tariff payment of £654 per 3.5 hour session. This figure reflects the requirements for a rapid response on the part of contractors to mobilise additional sessions.

We're very grateful to the practices who have already come forward to offer their services. Many of you have sent in questions around eligibility for this funding. We've put together this myth buster, which we hope clears up any confusion for the dental profession and encourages anybody eligible to take this important opportunity on behalf of patients. 

Myth 1: "Contractors who have not already expressed an interest are now unable to access this funding"

In fact: Whilst NHS England sought initial expressions of interest from regions by 31^st January 2022, this was not a final deadline. The offer will remain open until the end of March 2022, so contractors who are interested are strongly urged to continue to come forward so long as any additional sessions can be delivered before the 31^st March 2022.

Myth 2: "All additional sessions must take place out of hours"

In fact: Sessions must be delivered outside of contracted hours, not opening hours. Whilst it is likely that most of these additional sessions will be delivered out of hours, delivering in hours care may be funded under these arrangements where a contractor can demonstrate the sessions are delivering additional NHS care over and above their contracted hours. If you think this may apply to you, please speak to your commissioning team.

Myth 3: "All additional sessions must be delivered in one 3 ½ hour block"

In fact: Contractors are able to split sessions, subject to patient demand and by mutual agreement with their local commissioner.  This means a 3 ½ hour session could take place over multiple days. This will need to be clearly documented within the national contract variation notice.

Myth 4: "I have to commit to new sessions every week until the end of March"

In fact: There is no commitment needed to do ongoing sessions through to the end of the year. If you can deliver even one or two weekend or evening sessions this will go a long way. Please speak to your commissioning team to discuss options which may work for you.

Myth 5: "Once a patient is out of pain they cannot come back during one of the newly funded sessions"

In fact: The initial appointment will be classed as an examination of urgent need and treatment requirements, with an average of 4 to 6 patients per session, this gives sufficient appointment time for more than advice and/or dressings.

Clinical restoration/stabilisation will follow this assessment, this can be provided within this or another session funded under the same arrangements, and as a sole course of treatment or in line with The Avoidance of Doubt- Phased Courses of Treatment, published (here) on 8^th July 2021.

Where a patient requires care to continue beyond 31^st March contractors can then claim UDAs in the usual way in the new financial year.

Myth 6: "I have to already be delivering 85% to be eligible for this funding"

In fact: It is important that this activity is able to be delivered in addition to your existing NHS funded activity, and so commissioners may discuss with you how the delivery of additional sessions will impact on your ability to achieve 85% by the end of the quarter. 

If you are unsure if you will reach 85% and are still interested in this opportunity, please speak to your commissioner who would be happy to discuss this with you.

Myth 7: "These sessions are being funded through clawback from poorly performing practices"

In fact: No. These sessions are being funded through NHS England making a non-recurrent investment of an additional £50m in NHS dentistry.

Myth 8: "Foundation Dentists may not undertake additional sessions associated with the £50m investment."

In fact: Both NHS England and Health Education England are supportive of Foundation Dentists (FD) involvement in this initiative but certain criteria will apply in order to prioritise training and ensure wellbeing of trainees:

1. The FD voluntarily agrees to provide additional sessions.
2. The sessions (1 session is 3.5 hours) should be limited in number, 4-6 sessions a month ensuring at least 1 weekend free a fortnight.
3. There should be appropriate named support available on site to the FD during the clinical sessions, ideally the Educational Supervisor (ES)but may be an experienced dentists who has agreed to support the FD.
4. The trainee must have received an outcome 1 at Interim RCP (outcomes available by the end of February 2022).
5. The trainee must have support of their ES and TPD to undertake sessions.
6. The request needs approval of the local HEE Dental Dean or nominated deputy.
7. Clinical activity undertaken in the additional session(s) can be recorded on the FD portfolio. The activity will however, be outside of the expected 1875 UDA activity of an FD.
8. The FD should inform their indemnifier prior to undertaking additional sessions to ensure their indemnifier is aware of ‘out of training ‘clinical activity and may be required to pay an additional fee.
9. Remuneration - FD are to receive a fee per session, to be agreed between the FD and the NHS contract holder.
10. HEE will be developing a national template for trainees to complete to ensure appropriate agreement to the additional sessions as per the contract and educational agreement.

Please get in touch with your commissioner if you think you could deliver this extra activity.

Changes to the General Dental Council's international registration legislation

The Department of Health and Social Care, on behalf of the UK government and the devolved administrations, is seeking views on proposed changes to the General Dental Council's (GDC) international registration legislation.

The aim is to provide these regulators with greater flexibility to amend their international registration processes by removing prescriptive detail about how such processes should operate from legislation.

The consultation also amends the GDC's legislation to protect candidates whose opportunity to sit Part 2 of the Overseas Registration Exam (ORE) within 5 years of first attempting Part 1 (as required by GDC regulations) was lost as a result of restrictions on the operation of the exam resulting from the coronavirus (COVID-19) pandemic.

More detail on the consultation can be found online here.

Respond by clicking here. This consultation closes at 11:45pm on 6 May 2022

Guidance and advice for dental teams on patient welfare and safeguarding

If you are concerned about a patient's welfare, please refer to dentistry's official safeguarding guide for detailed advice. More information can also be found in our special focus bulletins on domestic abuse and paediatric dentistry and children's oral health. 

NHS campaign to raise awareness of Sexual Assault Referral Centres (SARCs)

Victims and survivors of sexual and domestic abuse are being encouraged to come forward for NHS help and care, as part of a major campaign backed by a £20 million boost to specialist services.

The new campaign – which has backing from the Duchess of Cornwall and former Prime Minister Theresa May – will highlight the specialist support offered at dozens of sexual assault referral centres (SARCs) in England.

While the majority of victims of sexual assault and domestic abuse are women and girls, health service leaders are encouraging anyone who needs support to turn to the NHS at one of the country’s 24-hour centres. SARCs offer confidential specialist, practical, medical and emotional support to anyone who has been raped, sexually assaulted, or abused – regardless of when the incident happened.

If you have been raped, sexually assaulted or abused and don’t know where to turn, search “sexual assault referral centres” to find out more or visit www.nhs.uk/SARCs to find your nearest service.

You can find your nearest SARC via the directory.

More information on how to recognise the signs of domestic violence and abuse, and where to get help, can be found on the NHS.UK website.

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Previous 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

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 Thursday 25 November. 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.

Dental recall priorities for children: implementation tool

Children are a clinical and contractual priority group for all NHS dental teams. Practices are encouraged to use the NHS implementation tool which assists dental professionals in the recall of children for a dental appointment, in line with NICE guidelines. You can view the tool online.

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