COVID-19: Monday Update – Row erupts over Minister’s claim
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- Published: Monday, 30 March 2020 06:49
- Written by News Editor
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At yesterday’s No 10 briefing, Minister Robert Jenrick claimed that ‘every single … dental surgery has had a PPE delivery’. This was robustly denied on Twitter by dentists, including BDA Chair Mick Armstrong: “We can do without Cabinet Ministers talking about non-existent deliveries of PPE. Weeks have been lost on setting up a properly equipped emergency dental service.”
The GDC updates guidance on COVID-19
Stefan Czerniawski, Executive Director Strategy GDC, has updated and clarified GDC guidance in responding to COVID-19.[i] It concentrates on three areas:
- Dental professionals working in non-dental settings.
- Remote advice and prescribing.
- Treatment in dental primary care settings.
Dental professionals working in non-dental settings
When a dental professional is providing support to the wider NHS, the same basic principles apply as in any other situation: the test is whether they are trained, competent and indemnified for the tasks they undertake. Registrants should satisfy themselves that they are competent to perform the tasks being asked of them, or are given the training necessary to equip them to do so. The note adds “Indemnity should not be an issue where support of this kind is being provided to the NHS, since the Coronavirus Act provides cover for any liabilities beyond the scope of existing cover.”
Remote advice and prescribing
Where patients cannot come to a dental surgery, dental professionals may be asked to provide advice remotely and to work with patients to defer the need for active treatment through the use of pain control and antimicrobial treatment. The basic principles of our guidance on remote consultation and prescribing continue to apply, but in the specific circumstances of COVID-19, the key requirement is to make an appropriate risk assessment.
Treatment in dental primary care settings
For the duration of the COVID-19 epidemic, infection control is of paramount importance and even greater than normal care will need to be taken to minimise the risk of infection to, from, or between patients and between members of the dental team. In many cases, the right approach will be to stop providing treatment altogether.
Orthodontic Emergencies Protocol
The British Orthodontic Society has reminded dentists of its Orthodontic Emergencies Protocol.[ii] They say most orthodontic appliances can be left in situ for some months without causing harm to the patient if the patient continues with the usual after care instructions. In many instances, appliances will continue to work for many weeks without needing any adjustment.
The protocol states all patients should undertake these steps to protect their teeth and appliances:
- Carry out exemplary oral hygiene – brushing 3 times a day with their standard toothbrush, followed by interproximal brush use. As an adjunct, use of a fluoride mouthrinse e.g. Fluoriguard (225ppm), once a day.
- Consume a low sugar diet - Where possible avoid all snacking on sugars and drinks with ADDED SUGAR. Fizzy drinks should be avoided in particular.
- Avoid hard, sticky and hard foodstuffs that could break the brace wire or fracture brackets (debond) off a tooth.
The BOS continues: “In the coming weeks, it is likely that orthodontic patients will ring with pain, problems and loose wires. Current advice is to avoid all but the most essential mouth procedures to limit spread of COVID19 to the wider population.”
Plight of dentists raised in the House of Commons
In a written answer,[iii] Jesse Norman, Financial Secretary to the Treasury, said dentists holding a contract to provide NHS dental services are remunerated through an annual contract value dependent on delivery of an agreed amount of treatment (activity). There is no separate reimbursement of practice costs apart from rates reimbursement. He added: “On 20 March 2020, the Chancellor announced the Coronavirus Job Retention Scheme to help firms continue to keep people in employment. The scheme will apply to dental practices.”
He was replying to a question from Labour MP for Bedford, Mohammad Yasin, who asked whether the Government had plans to reimburse the fixed practice overheads of dentists to allow them to close their dental practices to non-essential services to prevent the transmission of covid-19.
[i] http://xl80w.mjt.lu/nl2/xl80w/5q818.html
[ii] https://www.bos.org.uk/News-and-Events/COVID19-BOS-Advice/BOS-COVID-19-Orthodontic-Emergencies-Protocol
[iii] https://www.theyworkforyou.com/wrans/?id=2020-03-19.32237.h&s=Dental
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