NHS update – Exceptional circumstances, PPE and mandatory vaccinations

14 January 2022
5 min read

A new NHS dentistry and oral health update has been issued by Sara Hurley, chief dental officer England, and Ali Sparke, director for dentistry, community pharmacy, optometry and the NHS standard contract.

The update reads, “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 per cent, 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 per cent 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 per cent 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 per cent 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 per cent to 110 per cent 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 per cent 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.”

Exceptional circumstances arrangements from December 1, 2021, to March 31, 2022
“From December 1, 2021, to March 31, 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 five working days) of an absence. 

“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 a form along with all supporting evidence to NHS BSA via their generic email address:nhsbsa.dentalcases@nhs.netcopying 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 five-day period and submit supporting evidence within a period of no longer than 28 days.

“Retrospective claims from December 1, 2021, and early January 2022 will be considered if submitted no later than January 31, 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 until March 31, 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 March 31, 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 March 31, 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.”

Covid-19 vaccination as a condition of deployment
“From April 1, 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 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 April 1, 2022, individuals will need to receive their first vaccination by February 3 and second vaccination by March 31, 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.