Your NHS dentistry and oral health update

Thursday 13 January 2022 (Issue 38)

An update from Sara Hurley and Ali Sparke

Dear colleague,

The NHS has stood shoulder to shoulder with dental practices throughout this pandemic. The NHS's generous income protection represented a substantial financial investment in the stability of NHS dentistry -  safeguarding provision for our patients, protecting valued dental practices and preserving livelihoods.

In addition to the recent pay increase announced by the Government, in our last letter we confirmed to you further financial support. Alongside ongoing income protection, this includes that the variable cost reduction is being retained at the lower level of 12.75%, applied to nondelivered activity, and that delivery over the performance threshold required for NHS income protection may be used to offset performance under the threshold in an earlier time period, offering contractors the greatest financial value. The government has also confirmed that free PPE provision will be extended beyond March 2022.

The 85% threshold for income protection during quarter 4 reflects our belief that, as practices have a proven ability to deliver more, it's only right this capacity is used to the maximum benefit of NHS patients. 

But we understand there may be circumstances where reaching 85% isn't possible, particularly as practices navigate the current workforce pressures relating to Omicron. We continue to stand by our hard working dental teams, today expanding on the exceptional circumstances guidance that has been in place throughout Covid-19.

We are also repeating our ask of those of you who are nearing (or already above) 100% UDA delivery that you go further where you can. In our last letter, we created an additional opportunity for practices in year by raising the upper tolerance threshold from 104% to 110% UDA delivery. We did this because we want NHS dentistry to see as many patients as possible. This opportunity is both for practices delivering over 100% UDAs in Q4 (after offsetting as necessary into earlier periods), or for the full year 2021/22.

Dentistry is an important part of the NHS. This year, by working with you and continuing to stand by you, we're determined to see NHS dental services recover and improve.

Best wishes,

Sara and Ali

Exceptional Circumstances Arrangements from 1st December 2021 to 31st March 2022

From 1st December 2021 to 31st March 2022 we have established specific temporary exceptional circumstance arrangements in response to the Omicron wave. These arrangements are in addition to the usual adverse events (force majeure) process and are designed to provide a further safety net for practices. The exceptional circumstances arrangements will specifically offer protection for individual members of practice staff who are advised to self-isolate or are unable to work as a direct result of Covid-19 illness, resulting in loss of patient care.

In these exceptional circumstances contractors are required under the terms of their contracts to promptly notify your commissioner (which for the purposes of these arrangements is to be within 5 working days) of an absence. For ease of reporting a template form has been produced, see annex 1 below.

We require clear evidence to be provided to support all claims. For the purposes of these specific arrangements we require:

1. Details of the staff advised to self-isolate;
2. The period patient care was affected;
3. Copies of the notification from test and trace or test results (lateral flow and/or PCR) where applicable;
4. Copies of the relevant appointment books will be required, relating to the sessions for which relief is claimed, demonstrating UDAs lost due to this absence and their indicative value.   

A condition of this arrangement is contractors will required to have submitted and adhere to:

1. Workforce returns are submitted and reflect the staff absences set out in the force majeure notice;
2. All other established conditions for income protection are being met; and
3. They are following NHS staff guidance on Covid related sickness absence.

To manage the volume of claims and ensure consistency of approach nationally contractors are asked to submit annex 1 along with all supporting evidence to  NHS BSA via their generic email address: nhsbsa.dentalcases@nhs.net, copying in your regional commissioner for information purposes. If all supporting evidence is not available at the time of the event contractors must notifying NHSBSA and their regional team within the 5-day period and submit supporting evidence within a period of no longer than 28 days.

Retrospective claims from 1st December 2021 and early January 2022 will be considered if submitted no later than 31st January 2022.

Without all supporting evidence and declarations referred to above, the contractor’s application will not be considered.

For the avoidance of doubt, no claims will be accepted under this process for:

1. Non-Covid related staff absence;
2. Loss of patient care due to vacancies;
3. Performers who are claiming Long Term Sickness payments (LTS) under the Statement of Financial Entitlement (SFE).

Post receipt of notification and support evidence is received contractors will receive confirmation of receipt of the notice.

Any “lost activity” will be manually credited to the contractor’s year end performance position, with the clear rationale for the calculation, based on the evidence provided by the contractor. This activity will then be included in any assessment against the relevant performance threshold(s) for income protection during 2021/22, as for any other delivered activity, and the contractor will not be expected to make up this “lost activity” or the adjustment applied as this will be considered delivered activity.

For the avoidance of doubt, if contractors experience Covid related sickness absence during the above period they are expected to apply under these arrangements and if applications are rejected, contractors are not able to be considered for dental relief.

NHS England regional teams retain decision making on applications and will work collaboratively to ensure consistency of approach nationally. The outcome of these decisions will be communicated to you.

Free PPE provision extended to 31 March 2023

In response to COVID-19, the Department of Health and Social Care (DHSC) has provided free access to centrally procured personal protective equipment (PPE) to NHS trusts, adult social care providers, as well as primary care and some other healthcare providers. DHSC has previously committed to providing this central, free provision of COVID-19 PPE until 31 March 2022. 

In response to the recent consultation, and in order to help protect health and care staff while COVID-19 case levels are still high and high PPE usage is still required by infection prevention and control (IPC) guidance, the government has decided to extend the provision of free PPE to the health and care sector to 31 March 2023 or until such time as the UK IPC guidance is withdrawn or significantly amended, whichever is sooner.

We will share further information as and when this becomes available.

Action for all NHS dental practices: update your directory of service (DoS)

Practices are contractually required to update their dental profiles within NHS UK and work with their regional commissioner to ensure that the Directory of Services is up to date during Q4. This is needed to make it easier for people seeking care to find a dentist.

If you require a manual update to the Directory of Services (DoS) that informs NHS 111, including your capacity status, you should contact your local dental commissioning team or your DoS Lead so the change can be agreed prior to the system being updated.

If you do not know your DoS lead you can contact the DoS Provider and Commissioner Helpline on 0300 0200 363.

In addition NHS Digital has also provided guidance to help you ensure that your NHS website profiles are kept up to date.  

COVID-19 vaccination as a condition of deployment

From 1 April 2022 amendments to the Health and Social Care Act regulations will mean that those working in dental practices aged 18 and over, who have direct, face to face contact with service users will be required to evidence that that they have received a complete course of a Medicines and Healthcare products Regulatory Agency (MHRA) approved COVID-19 vaccine, subject to limited exceptions.

This will include front-line workers, as well as non-clinical workers not directly involved in patient care but who nevertheless may have direct, face to-face contact with patients, such as receptionists and cleaners.

To be fully vaccinated (first and second dose) by 1 April 2022, individuals will need to receive their first vaccination by 3 February and second vaccination by 31 March 2022.

NHS England strongly encourages members of the dental team who have not had both doses of the COVID-19 vaccine to book their vaccine without delay.

Further information can be found on the NHS website.

Further information can be found in the Vaccination as a Condition of Deployment (VCOD) for Healthcare Workers document which was published on 6 December 2021 (Version 1).

Healthcare evidence and knowledge now a simple search away

The new NHS Knowledge and Library Hub is a ‘one-stop’ gateway which, for the first time nationally, connects NHS staff and learners seamlessly to a significant range of free, high-quality knowledge and evidence resources, services, tools and databases, all in one place.

Funded by Health Education England (HEE), content of the easy-to-use platform includes over 7,000 journals, e-books - including OUP handbooks, clinical decision support tools - such as BMJ Best Practice, NICE pathways and guidelines and clinical and medical databases.

Accessed via OpenAthens, users will be able to tap into the same system wherever their career takes them.  Start your search or learn more through our short user guides. Updates will be posted on the new Twitter channel – follow @NHSKFH

Getting It Right First Time in restorative dentistry: improving data quality 

On Wednesday, 19th January 2022, GIRFT and the Faculty of Dental Surgery (FDS) at the Royal College of Surgeons will be co-hosting a lunchtime webinar to share the findings and recommendations of the GIRFT national report for Hospital Dentistry. The webinar will discuss how GIRFT’s recommendations can lead to better quality data in Restorative Dentistry, including a wider coding review, to help measure clinical outcomes, assure quality and support workforce planning and service improvement.

The webinar discussion will address the report’s recommendations and implementation, to help improve patient pathways by establishing managed clinical networks to ensure equitable access across the regions.

Please register in advance.

NHS Safeguarding learning together week 17 - 21st January 2021

The NHS safeguarding team is holding a number of webinars during NHS safeguarding learning together week to promote understanding and best practice. Dental team members are welcome to register for any of the webinars and further detail is below.

Day one: 17th January 2022 

• Best practice: health and social care working with people experiencing homelessness
• Adopting a compassionate leadership approach to homelessness and the wider inclusion health agenda 

Register Here  

Day two: 18th January 2022

• An update: Honour-based Abuse, Child Marriage and Virginity Testing

• An update: FGM Reporting

Register Here 

Day three: 19th January 2022

• Supporting 14-19 year olds transition safely into adulthood with confidence

Register Here  

Day four: 20th January 2022

• Raising Awareness of Sexual Assault and Abuse: Interventional services for all ages

Register Here  

Day five: 21st January 2022

• NHS Case study: Online Abuse
• Implementation of the Disclosure and Barring Service

Register Here  

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Previous dentistry and oral health bulletins 

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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.

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