COVID-19 Update – 29th May 2020
We are sharing our 26th Scottish Dental Sector Covid-19 update with and will continue to share any important news and advice for the Scottish Dental Sector on at least a weekly basis.
We hope you continue to find value and support in our digests, and as always if you need any bespoke and free advice at this time the whole team at Dental Accountants Scotland are here for you.
Please head over and ‘like’ our Facebook page to keep in touch with our news. Please do also scroll to the foot of tonight’s note for details of our ‘Bounce-Back Higher’ Webinar and Support program to book your place in these free of charge sessions. Places are limited so early booking is advisable.
POLITICAL UPDATES
Despite the distraction over the last week caused by Dominic Cummings decision to disregard the advice of both the government, and indeed his optician, we still move towards the phased return to normality.
After the First Minister’s briefing we have had the anticipated relaxations of the lock down measures confirmed and these will move in to play from today. We look forward to seeing a sensible liberation of the population whilst remaining safe.
We very much hope to get some further guidance from the CDO over the next few days in regard to the plans for ongoing financial support during phases 2a & 2b and for some update on the planned timetables. A widely heard rumour is circulating that the return to practice for urgent dental care may be accelerated if the PPE can be delivered in suitable quantities. It is therefore important to be ready for return at this stage. I will discuss this further in the clinical update below.
The expansion of treatments within the UDCCs has begun in earnest and I am tonight sharing a list of the treatment types within the Lanarkshire area for information.
There is a little unrest emerging from the fact that the ‘look back’ option does not automatically exist in these centres and that triage will be required again for referral purposes, but NHS are keen to avoid overloading the resource at this time.
Health improvement Scotland issued useful guidance on Friday to confirm that private dentistry providers are in a position to open and deliver their own urgent dental care. We anticipate a fuller, more detailed guidance note will come from them in the next few days. In the meantime, they have recommended that all fully private practices adhere to the CDO’s advice in regards to the delivery of services until the movement to next phase from tomorrow onwards.
CLINICAL UPDATES
Thoughts are turning towards the return to practice transition and as I have previously articulated there will be some careful planning required to mitigate the financial issues arising.
Some ambiguity does of course remain on the dates and whose guidance should be followed by Scottish Dental Practices. I previously shared some information on the jurisdiction of the CDO, and it is now a widely held belief that this is limited purely to NHS provision.
I was interested to note the two documents released in England from their own CDO, shared below.
As you will note from these documents the return to practice in England has been announced as Monday 8th June. As per my last digest the 19th of June was the earliest re-open date estimated from the guidance in Scotland. It now seems likely based on this news that Scotland may have an opportunity to return on an earlier date. This will be fully dependent on the ‘R’ factor and scientific guidelines. We expect the Scottish CDO to issue his guidance in the next few days.
It is important to note from the English notice that the return on the 8th of June is for routine care. This fully allows for AGP usage at this time (subject to risk assessment and professional judgement.) It will be very interesting to see how Scotland’s guidelines emerge in the days ahead, but I would recommend you get ready for a re-opening on that basis more quickly than originally planned.
That said the guidance issued by SDCEP this week, whilst very helpful for planning your SOP’s, does not provide guidance for the AGP phases to follow and will require a rapid update if we are to follow England’s lead. For ease of reference the SDCEP guidance is shared here.
I also have a number of additional documents of interest to share with you tonight which have been released over the last few days.
The first two are updates issued by the Chief of Dentistry in the Lothian and GGC areas.
These documents indicate and reinforce the anticipation that a supply of PPE is likely to be delivered to NHS practices in the days ahead and that no more that 10-12 patients per day in a single surgery setting is anticipated in the next stage of delivery. This may become redundant of course if we do end up following behind the English approach.
I have discussed with many over the last few days how to mitigate against costs arising from re-opening whilst the ability to generate additional revenue from treatment is minimal. Also foremost in the mind is the ‘un-furlough’ process and in the interests of clarity you should give careful consideration to how you take the team off furlough. I would set out some key points as follows;
– If practising in an NHS environment you will have some team members not presently on the furlough scheme. These would be the individuals you would turn to first in an effort to avoid adding wage costs
– You can, in essence, ask the full team to attend the practice for CPD on the new processes required. This would not require you to take them off furlough as training is permissible
– If in a private setting you should carefully schedule their removal from furlough. To avoid team unrest you might select the employees by asking for volunteers in the first instance rather than enforcement. However do bear in mind that furlough is not a choice for the employee. If you decide to remove anyone from furlough and they do not comply it technically becomes a disciplinary matter
– As you will only need one surgery typically you may wish to give some thought to how you resource the requirements and you have the ability to use the full dental team in a capacity that is deemed appropriate and safe. For example in some instances you may have multiple principals who could attend in a nursing and/or reception capacity. That way the costs arising from wages without furlough might be mitigated for a little while longer
– If you decide to remove an employee from furlough and then wish to place them back on furlough for any reason please bear in mind that they must serve a minimum of 3 weeks from the re-start date to be entitled to support grant funding.
We had anticipated that the Chancellor might announce the new furlough rules from 1st July onwards tonight. However the PM deemed it more appropriate to appear and ‘bat off’ any further questions on Dominic Cummings. I would recommend keeping an eye on the conference over the next few days to assess if the furlough scheme announcements are made as this may have a bearing on your strategic plan to resource the return to practice.
I would like to share an opinion piece written by Dr Victoria Holden.
Dr Holding is a GDP and a senior dental advisor to Taylor Defence Services, who you will recall were the first indemnity provider to ‘stick their head above the parapet’ and suggest that private dentistry could be delivered within the setting of Scotland. This opinion piece is an interesting read.
Part of the considerations at present is whether adequate indemnity cover is in place should you re-open., I would like to share a document from BAPD which sets out (as of the 26th of May), the position for all the major indemnity provider in regard to face-to-face care within each practice.
Indemnity Providers Position 25-05-20
I would advise that you would be sensible to receive confirmation that you will be indemnified for any services which you intend to deliver in your practice by your own individual provider(s). You should also consider contacting your employer liability insurer and any provider in connection with your other underwritten risks to protect your best interests.
Another document I’d like to share with you is an opinion piece by professor Ross Hobson entitled ‘To prove a negative’ and this document aims to expand upon pseudo-science and the AGP risks within a dental practice at this time which I found to be a very interesting read and hope it is of interest to you also.
FUNDING UPDATES
Covid-19 Statutory Sick Pay (SSP)
The government gateway for the reclaim of the first 14 days of SSP for anyone on sick leave due to Covid-19 has now been launched and can be accessed via this link. The government have also announced today that SSP payments will be extended to anyone who is required to self isolate during the ‘track and trace’ phase of containment.
NHS Support Package
Practitioner services have this week issued a FAQ update in regard to the Covid-19 financial support payments. This is update number 4.0, and now includes some helpful guidance around maternity and VDP trainers/practitioners. I share this document below and would highlight for your ease of identifying the updates as the bullet points asterisked within.
OTHER MATTERS
‘Bounce-back Higher’ Webinar Program
I hope that our ongoing support has been helpful during this difficult time. We have continued to try and proactively support everyone as much as we possibly can. As an effort to support further we have decided to trial a live online support option via webinars and ’round table’ support forums and I am delighted to announce the initial sessions for your booking.
This is split in to two streams as follows;
(1) – Exclusive to Dental Accountants Scotland Principal/Practice Owners only
For our practice principal clients only we will host an online ‘check in’ round table format meeting each Friday afternoon at 2.30pm for 1 hour (plus an optional Q&A thereafter).
Recognising that there are some common shared issues which may benefit from advice and peer to peer discussion we will host these relatively informal sessions which will follow this format
– Initial ‘hot topic’ short presentation from one of our team or guest speaker
– Panel Q&A
– Breakout session on three key issues regarding the phased return to practice in the following areas – Clinical, Business & Team
– Wrap up followed by optional Panel Q&A
The first session will run on Friday 5th June at 2.30 – please book at this link
The following week I am delighted to announce that we will be joined by Paul Graham, Head of Dental – Christie & Co. Paul will participate in the panel discussions as well as giving his insight in to practice valuations during and post Covid-19. This session will run on Friday 12th June at 2.30pm – please book at this link
The following two weeks sessions for this client only support session can be booked at the links below.
(2) – Bounce-back Higher Webinars – For all Scottish Dental Professionals
We will also deliver, along with our guest speakers a series of webinars aimed at supporting the phased return to practice considerations. These webinars will be free of charge and open to all but limited to 100 delegates so please do book your place early if you feel the format is of interest. The webinars and their booking links are as follows.
– Business planning for the phased return – Tuesday 9th June 7PM – Book here
– How are practice valuations impacted by Covid-19 with Paul Christie, Head of Dental – Christie & Co – Tuesday 23rd June 7PM – Book here
– Business planning for the ‘new normal’ – Tuesday 7th July 7PM – Book here
We hope this additional free support will be of interest to you and look forward to seeing you there!
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.
