Update from the chief dental officer on national restrictions in England

02 November 2020
3 min read
Published:

Sara Hurley, CDO for England, has released an NHS dentistry and oral health update in light of the new lockdown restrictions coming into effect on November 5. The statement reads:

I am writing to update you in light of the prime minister’s announcement that from Thursday, England will enter a period of further national restrictions until December 2.

The government's guidance states that “a number of public services will also stay open and you will be able to leave home to visit them. These include [...] the NHS and medical services like GPs”.

I can confirm that this includes NHS dental services. Therefore, during the period of tighter restrictions practices should remain open to treat patients in line with the standard operating procedure and with regard to the recently updated national infection prevention control dental appendix. Detail on both of these were shared in last week’s update and are repeated below.

As a reminder, I am also hosting a webinar this Thursday November 5 at 16:30 on the recent infection prevention control guidelines. Public Health England will be on the call, too. You can find details on how to sign up below. I hope you can join us.

Additionally, I want to draw your attention to Friday’s decision by the secretary of state to temporarily suspend the need for patients to sign prescription, dental and ophthalmic forms for a period of five months to March 31, 2021. Further detail is below, and I encourage practice managers to read the detail carefully.

I really do appreciate how hard everyone is working to provide dental care right now. Please look after yourselves and I will update you again soon.

Kind wishes - and thanks,

Sara

Temporary approval to suspend the need for signatures on prescriptions, dental and ophthalmic forms

The secretary of state for health and social care has approved a temporary measure in England to help limit the transmission of coronavirus (Covid-19) by suspending the need for patients to sign prescription, dental and ophthalmic forms for a period of five months to March 31, 2021. This is to avoid cross contamination and help minimise the handling of paperwork when collecting medicines or receiving dental and eye care.

This must be carried out in line with the criteria set out by the department online here.

Patients will still be required to either pay the relevant charge or prove their eligibility for an exemption from charges. Where patients are exempt from charges, the dispensing contractor, dental or ophthalmic contractor will mark the form on the patient’s behalf to confirm the patient’s entitlement to exemption and, where applicable, to confirm that the patient’s evidence of eligibility has not been seen. Additionally, where patients would otherwise be required to sign the dental and ophthalmic forms, contractors will annotate the form with ‘Covid-19’ instead.

Further detail from the DHSC is online.

New infection prevention control guidance and our NHS dentistry webinar

The recently published dental appendix to the UK infection prevention control guidance – issued jointly by the DHSC, PHE and the devolved nations' public health authorities contains the necessary detail to keep your patients, your teams and yourself safe. You should read the guidance in full online here.

The guidance addresses one of the key challenges facing dental practices; the duration of the post aerosol generating procedure (AGP) downtime. The guidance details the variable duration of the post-AGP downtime, with detail of the required mitigating measures and ventilation parameters. In summary, where a surgery’s ventilation system can achieve six to nine air changes per hour (ACH), a baseline post-AGP downtime of 20 minutes is recommended. Where there are 10 or more ACH, a baseline post-AGP downtime of 15 minutes is recommended.

As detailed in the UK IPC Guidance for dental settings, FFP3 masks are recommended for AGP procedures. As recommended in the main IPC guidance on page 41, “FFP3 and loose-fitting powered hoods provide the highest level of protection and are recommended when caring for patients in areas where high risk aerosol generating procedures (AGPs) are being performed. Where the risk assessment shows an FFP2 respirator is suitable, they are recommended as a safe alternative.”

This means that as there are existing stocks of FFP2 masks, it is understood that it may be necessary for practices to continue to use these until staff are successfully fit tested and supplied with the appropriate FFP3.

Sara Hurley is holding a webinar on Thursday November 5 at 16:30 on Microsoft Teams on how infection prevention control and the new fallow time requirements are due to work in dental settings. She will be joined by representatives from Public Health England and deputy chief dental officers Eric Rooney and Jason Wong. The webinar will last approximately an hour.

Click this link to register. Once you have registered for the webinar you will be sent a link to join.

For more information on joining the briefing via Microsoft Teams please refer to this guide: Guidance for external parties joining a meeting