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COVID-19 Update – 13th May 2020

We hope that you and your loved ones remain safe and well. With a traditional bank holiday weekend just passed it seems we remain a long way away from ‘normal’ at this time. We may of course need to prepare ourselves for the ‘new normal’ in due course.

We are today sharing our 23rd Scottish Dental Sector Covid-19 update with you.

GENERAL & POLITICAL UPDATE

The UK central and devolved governments have made various announcements about the plan for the country to return to normality over the last few days. The PM’s statement on Sunday evening, whilst only applying to England, set out the planned ‘road map’ of the next phase. I share the 60-page recovery strategy document published shortly after here;

UK Gov Strategy Paper

Using the watchword of ‘Be Alert’ it provided us with a flavour of the proposed management of the next stages. Unfortunately, like a lot of the announcements made throughout the crisis, it has led to a confused state of understanding. Some clarity has been sought on a number of areas over the last few days. It seems clear that the overview announcements at this stage are meant as general ‘positioning’ statements on which the detail will be worked through in the days and weeks ahead. It is unreasonable for us all to expect that a ‘one size fits all’ statement would emerge at any point, however the nation’s frustrations do emerge when accurate and clear guidance is not made available.

In the meantime, the Scottish guidance is that we can now take unlimited, safe outdoors exercise. I very much look forward to seeing everyone in good shape in due course!

The major additional political announcement today was the extension of the furlough scheme by a further 4 months. This makes the scheme available up to the end of October. The scheme which is presently underwriting around 7.5M employees wages is costing circa £14bn per month. This is clearly a hefty cost to the economy and will no doubt result in a period of recovery to repay the debt for the country, but remains a very valuable support scheme at this time. I will cover in more detail later in my digest.

In other news the government has issued guidance on how to make facemasks from old T-shirts! (homemade face masks) I sincerely hope that the availability of PPE is better served in the Scottish Dental Sector than this may indicate.

CLINICAL UPDATE

Over the last few days, we have continued to consider the return to practice journey ahead and like all our clients we are incredibly keen to have some form of timeline and clinical guidance to plan around. Without this our ability to provide support and advice around detailed financial planning is challenged significantly. With so many unknowns and variables the amount of alternative scenarios which would require modelling is extensive. It is hoped that some guidance will emerge soon.

Given the possible changes required to patient management and treatment every practice is likely to need a period of planning to train and orientate the dental teams. Some advance notice will be helpful before any return to practice takes place to facilitate that process. 

The Urgent Care Centres in place continue to attempt to deal with the most urgent cases, but we still talk daily with our clients who continue to feel helpless to support their patients with their care/pain management needs. Many would relish a relaxation at least to enable the possible treatment option of seeing emergency cases within their own practice settings (like other countries). It does seem more and more likely that this may emerge as part of a phased return process whist the continuing minimisation of AGP’s is attempted. 

Late last week two key papers were released which I digested over the weekend. Both focused on the return to practice. I share these in my digest now in case you have now seen them. They make for interesting reading.

The first I would like to share is the COVID-19 Dental Services Evidence Review (CoDER) Working Group findings. This document has sought to compile an international comparison on how best to return to practice and provides a very useful level of detail around some of the measures being adopted which may be necessary/relevant in Scotland in due course. I feel that it is of merit to apply some consideration in your own planning around the clinical and financial impact these measures would have and to mitigate the adverse impact where possible in your re-design of policies for re-opening.

Covid CoDER Report

The second is the Position Paper produced by the British Association of Private Dentistry.

BAPD Return to Practice Position Paper

I hope you find these two documents helpful in your own considerations about preliminary planning for your own return. My strong suggestion is that you attempt to create a ‘Plan A’ around your own situation and that this is then adapted where required once firm guidance emerges. A proactive approach is recommended, and time re-visiting your practice efficiency is never time wasted in my opinion. I will be happy to brainstorm this further with you at any point if I can add value to your considerations.

FUNDING UPDATE

BUSINESS SUPPORT GRANT PHASES 1 & 2

Following on from my previous updates on these valuable grants I am pleased to report that most of our clients have now received their funding where eligible and have had any additional property grants approved/paid too.

The ongoing ‘postcode lottery’ relating to the higher £25k grant for properties in excess of £18k rateable value continues. We were pleased to see three Edinburgh practices receive the funds on Friday after appeal but are aware that some areas, including Glasgow City Council, remain steadfast in their refusal to accept applications at that level. We advise anyone still in that position not to lose drive and to continue to raise the matter politically and issue further appeals. Hopefully a position of parity will follow and the funding will be released. 

JOB RETENTION SCHEME (FURLOUGH)

The scheme extension announced by the Chancellor earlier today will now take the support package all the way through to the end of October. Today’s statement should be seen as advisory at this stage as it seems that the scheme beyond the end of June is set to be amended to deliver a more flexible and collaborative package. The full detail is set to be released before the end of May which will help with planning, but at this stage it sounds very much like the ability to return full time employees to part time input whilst still receiving furlough support may be possible. This would be beneficial if the return to practice phase necessitates a reduced workforce and may help to keep the dental teams together despite a fall in income levels which may emerge from the clinical restrictions. Some suggestion that employers may need to contribute towards the furlough payment was made but clarity will be required. We will keep our eye on the full guidance and interpret on your behalf to assess where it may be helpful. As no further guidance has emerged from the CDO in the last month on how this scheme interacts with the NHS support we continue to move forward under the last interpretation of the use of furlough in mixed practice. I do not anticipate that the position is likely to change in that regard.

Now that the furlough portal has ‘bedded in’ and is being updated with some more functionality we suggest that the furlough grant funding requests be submitted timeously around 14 days before the payroll payment dates. Our payroll team have scheduled to work the coming weekend to work through our submissions for the end of month payrolls. Given the fact that HMRC continue to pay within 6 working days this should allow you to be in funds in time to pay the teams involved.

BOUNCE BACK LOANS FOR SMALL BUSINESS

The Bounce Back Loans launched last week have been accessed by many of our clients (and indeed our self) successfully. The funding scheme is almost unbelievably simple/rapid and the banks should be applauded for the speed at which they have delivered this critical support. 

There have been one or two who have struggled e.g. Barclays but the majority of banks have paid the funds within 48 hours of application and in some cases same day. The short form application process was easily completed and I have never seen anything like it in my career before. 

Given the uncertainty of the period ahead it remains my advice that the funding may provide a useful contingency and could be repaid flexibility if found not to be fully required downstream. Do remember however that this is clearly not grant funding and it should be borne in mind that it will be fully repayable within 6 years.

PIVOTAL ENTERPRISE RESILIENCE FUND

I made mention of this funding support scheme in my last digest. I feel that the possible eligibility for Scottish Dental Practices is theoretically possible but in reality is more likely to be remote. We monitor on your behalf with interest.

The scheme remains closed tonight to new applicants and if we hear that the small number of applicants we have support do receive any feedback on their claims we will feedback and signpost further applications if appropriate. In the meantime you can continue to monitor the scheme status at this link: Pivotal Resilience Fund.

SELF-EMPLOYED INCOME SUPPORT SCHEME

Applications for this support open tomorrow (13th May) and where you are eligible you should already have received some form of notification from HMRC. The portal for you to apply will open in the morning and may experience a large initial volume of applicants causing some connections issues. You can access the application link here SEISS scheme home page. Our understanding is that the process will provide you with a calculation of the amount payable to you and the basis of the calculation. The funds should be paid to you from the 25th of May onwards and will be paid in to your nominated bank account in one lump sum.

We have assisted a number of eligible self-employed Associates this week on the subject of whether the SEISS funding is payable in addition to any NHS support which may be in place for them at this time. We are aware that PSD have issued informal advice that these schemes are not to be claimed together in relation to NHS activity. We advise that the SEISS is not proportionate to % of trading profits generated from any source, and is a ‘binary’ entitlement under the current rules and guidance. As such as long as your treatment delivery is not 100% NHS and you have encountered any adverse impact from Covid-19 in the private side of your income that you would be entitled to claim your allowance via SEISS as it cannot be linked to NHS in anyway. To apply is of course optional, but do bear in mind that even if your position is insulated to a degree at present that the landscape may change in future should the costs of PPE and reduced throughput impair earning potential and as such this support package may be helpful to mitigate present and future losses.

We have taken the opportunity tonight to update our guide of support packages and I have pleasure in sharing this version 5.0 below.

Summary of Support Available Vs 5.0

Once again love and best wishes to you at this time from myself and the full Dental Accountants Scotland team. I hope you manage to stay safe and well.

As a recurring reminder – our full team are now working remotely but ready and willing to continue to do all we can to support you in any way possible. Please accept my ongoing apology for any delayed reply to your emails while we work harder than ever to support you during this crisis. The level of correspondence required has severely tested my words per minute typing skills! For any urgent queries you may have please continue to call my mobile 07375 700468 (day or night) or book a zoom online consultation here and I will be glad to support you in anyway. Our no fee advice is available to you at this time and we will do all we can as part of your team.

I invite you to keep up to date with information our blog and to like our Facebook page to stay in touch.

Stay safe and look after yourself and all around you at this difficult time.

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