In a letter to general dental practitioners, acting Chief Dental Officer Michael Donaldson said that it will be a three-phase process to help address the growing number of people with pressing oral health needs.
When lockdown began, five regional urgent dental care centres (UDCs) were set up for patients with high needs.
These clinics are seeing only those with urgent dental needs and patients have to be referred by their local dentist and treated any identified COVID-19 (coronavirus) patients as well as any other patients who required emergency dental treatment
Phase 1a: The current phase
Phase 1b: This phase will be introduced on 8 June 2020. No change to restrictions but all practices to offer face-to-face urgent dental care in an attempt to maximise the number of patients with urgent needs being treated. To ensure appropriateness of referrals, all patients referred to UDCs to have initially been seen face to face by the referring practice unless this would not be in the patient's interests.
It is accepted that a proportion of practices will not, due to extenuating circumstances, be able to provide face-to-face dental care. However, it is believed that this figure is significantly less than the 27% of practices that did not see patients face to face during the last full week for which information is available. It is also acknowledged that some practices are in ‘buddying arrangements’, which may make it appear that they are not seeing patients face-to-face dental care. Such arrangements will continue to be acceptable during phase 1b.
Phase 2: in addition to the current restrictions, practices will be able to offer nonurgent dental care, However, treatments will be limited to those that are non-aerosol generating.
Practitioners will need to prioritise those patients with the greatest oral health need and consider what treatments can be provided through non-AGPs. Urgent dental care centres will continue to operate for the foreseeable future and to provide AGPs. However, their remit will remain limited to patients with an urgent care need. At the moment, the capacity of the UDCs is around 250 patients per week. They are investigating the prospects of increasing this number but even if this is possible it is not likely to result in a dramatic change in the number of patients who can receive AGPs through these facilities.
To assist practitioners during phase 2, guidance will also be issued in the near future advising which clinical conditions practitioners may want to prioritise and which nonAGP options may be offered.
Phase 3: Routine dental care may be offered and AGPs provided in general dental practice. Practices will have to comply with the extant guidance in relation to aerosol settling periods between patients, surgery cleaning and PPE.
The announcement letter, dated 2 June, adds: ‘There are also two other groups which have been established, one looking at the immediate oral health needs of the population and also the longer term needs and a group developing solutions for the large numbers of children on Trust waiting lists for extractions under general anaesthetic.
‘The Department is aware that dental supply houses may not be able to fully meet the demands for PPE if there were to be a sudden increase in dental activity. The Department is closely monitoring the availability of PPE and considering a range of options.
Acting CDO Michael Donaldson adds: ‘You will be aware that the Financial Support Scheme has been in operation through the course of the COVID-19 pandemic to date as a temporary measure in order to reduce the risk to the financial viability of the General Dental Service as Item of Service payments have fallen. The support arrangements will need to be amended on a phased basis as part of the resumption of routine dental activity.’
Dentists will be contacted when timings for phases 2 and 3 are set so they have ‘as much notice as possible to make the necessary arrangements’.