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COVID-19 UPDATE #38 – 24TH OCTOBER 2020

Today we are sharing our 38th Covid-19 digest in relation to the Scottish Dental Sector and hope that you find something of value within.
As always if there is anything of a specific nature we can support you with please do get in touch. The team are here to help.

CLINICAL & GENERAL UPDATE

We were treated to another poorly communicated update on NHS services with the news that ‘full’ NHS service is to resume from 1st of November onwards by the BBC rather than the CDO. Reporting on the Scottish Public Health Minister’s announcement in Holyrood the press informed us at the same time as the general public. It is really disappointing that the timing of announcements is not aligned with the workforce critical to delivery of these services. The morale of the profession is being tested significantly by this ongoing communication process. 
An additional challenge of this communication is the fact that the pent up demand in the public for dental treatment and the lack of clarity provided leads many patients to be under the impression this is ‘business as usual’ and we are aware that many practices were bombarded by incoming requests for appointments and faced with the repetition of the limitations on practice. Whilst it does provide an opportunity to stay in touch with patients, it would be more productive if this resource could be focussed on value added tasks rather than the mitigation of these announcements. 
We were pleased to see the efforts of the SDA to publicise some of the challenges gaining some coverage this week. Well done to Gillian and James for the press coverage here.
Following on from the SDCEP review paper I covered in my last digest we are now starting to see this turned in to guidance and the English CDO and Public Health England released their guidance paper this week. This confirmed the SDCEP fallow time recommendations of a minimum of 10 minutes (subject to mitigations in place) and we anticipate that the other nations will follow on in due course. For your information I have included this document below.
Public Health England – Infection prevention and control dental appendix

A free to use fallow time calculator has been launched and can be accessed at this link. It incorporates the SDCEP recommendations and may be useful to Scottish Dental teams.
For anyone who may not have accessed their NHS.NET email address recently they are recommended to login before the end of October to avoid losing this account. Any accounts not accessed for 90 days or more will be deleted from 1st November onwards.
Although not specifically Covid-19 related you may be interested to read the findings of the National Dental Inspection Programme’s report issued this week and their findings from the inspection of primary 1 & 7 aged children in Scotland. There are some positive findings and reduction in missing/filled teeth when compared against the 2002/03 inspections which is welcomed. However, some clear social inequalities remain an issue in the Nation. The pause for the Childsmile programme caused by Covid-19 is unlikely to help to maintain momentum in these positive findings. The report is shared below.
NDIP report – Primary School Inspection

POLITICAL UPDATE

As the whole of the UK moves towards regional and localised infection control measures we have seen some high profile cities ‘at war’ with the government. The scenes in Liverpool of wide spread public gatherings at the start of the week were trumped by the Mayoral battle in Manchester to seek additional financial support. Internationally we see another ‘Trump’ with the POA Presidential hustings continuing. The almost childlike approach taken by Donald Trump to congratulate himself on his achievements and continue to blame China for everything would be laughable were it not such a serious subject.
Setting any political persuasion aside remains important and a ‘joined up approach’ is desirable where possible. In Scotland over the last 24 hours we have received some key announcements about further financial support which I will cover later in this digest. In addition to this the First Minister has today announced the next phase of her Strategic Framework for recovery. The publication of this framework took place today and I share below for your information.
Scotland’s Strategic Framework – October 2020

I am almost certain that your energy for digestion of lengthy documents will be receding significantly by this stage and the thought of ploughing through a further 69 page document is probably less than appealing. In summary therefore, you should note the launch of a 5 tiered approach which includes the following tiers; 
– Baseline (level 0) – Levels 1, 2, 3 & 4 
The annex 1 in the document which runs from page 58 to 68 sets out in a useful table how each level will impact public services and restrictions. We will expect announcements to follow as to which level applies to each area when the tiered system is implemented.
Other than the single and general mention of increased provision of dental care on page 42 there is no specific guidance for the sector in the document. It is expected this may follow on from the CDO in due course.

FINANCIAL UPDATE

There is lots to cover in this area today, so please excuse the length of this digest.

Loans
Both the CBILs loan and Bounceback Loan (BBL) scheme have been granted short extensions. They can both now be accessed and applied for up to the 30th November. At that point they will be withdrawn. The government have announced they are likely to launch some additional loan funding in early 2021, however I recommend that if you have not yet applied for a BBL that it would be prudent to consider doing so without delay. With the uncertain trading conditions of the Winter ahead and the initial no cost flexible funding option involved it seems foolhardy for practices not to avail themselves of the £50k available and to set aside as contingency funding for the year ahead.
As a reminder the BBL is an interest and payment free (first year only) loan which can be repaid at any time without penalty. It is accessed via a short form application process and funds received within 2 days. It was originally required to repay at a very reasonable interest rate of 2.5% per annum and the full term of the loan to be 6 years inclusive of the first payment free year. The government have relaxed the rules on this loan to allow a ‘Pay as you Grow’ option. This will allow you to spread the loan over 10 years and also to pay interest only at any point (twice) for 6 months. This is some of the cheapest debt you will ever access and is worth considering at this time. Please note the looming deadline of 30th November and don’t miss out if you wish to borrow via the scheme.

Self Employed Income Support Scheme (SEISS)
I appreciate that this scheme had limited eligibility for Dentists in Scotland due to the fact that it was only offered to self employed where their average earnings fell below £50k. With most dentists working full time earning more than this threshold it has left many without support but has been helpful to the part time and therapy team colleagues.
The chancellor has announced that the scheme will now be extended for two further 3 month periods. The first to run from November 2020 to January 2021. He announced that he is now enhancing this scheme and has doubled the benefit to be paid to those eligible. Those who qualify will now be given a grant of 40% of their average monthly profits paid in a single instalment. Although nothing has been issued to clarify the application process our anticipation is that this will be via invite once more and involve an online application. 
The second grant period from February to April will be set at a level yet to be agreed and will be based on the affordability of the support and the current economic conditions.
To be eligible for these two additional grants each applicant must be have been previously eligible for the Self-Employment Income Support Scheme first and second grant (although they do not have to have claimed the previous grants). They must also declare that they intend to continue to trade and either: – are currently actively trading but are impacted by reduced demand due to coronavirus; or- were previously trading but are temporarily unable to do so due to coronavirus

Grants & Business Hardship Funds
The chancellor announced support grants for businesses impacted/closed by Covid-19 restrictions. The First Minister mirrored those grants in Scotland in her announcement today. On first read it looks very much like this will be restricted to the hospitality and leisure sectors and the supply chain feeding them. Once the full release is made we will let you know if there is any scope for benefit in the Scottish Dental Sector, but that looks remote at this stage regrettably.

Job Retention Scheme (JRS)
As you are aware the JRS comes to an end at the end of this month. Please be aware that all claims for the scheme must be made no later than 30th November to avoid missing any support.
If you have some of the team still on flexible furlough you should also ensure that you issue a ‘return to work’ letter and keep copies on your files in case inspected by HMRC downstream. I refer you to the possible template for that purpose I shared in an earlier digest which is still in the footer of documents below entitled ‘1-Notice of return to work from furlough’.
As a reminder also, if you are to retain the services of any furloughed worked from November to January and pay them in excess of £520 per month you will be entitled to a retention bonus of £1k per employee paid in February. This will not be automatic and is likely to involve a claim via the furlough portal in February. 

Job Support Scheme
The replacement to the JRS furlough scheme was announced just over a week ago and received some less than favourable feedback. The majority of employers stating that to effectively pay an employee overtime for not working is not sustainable in these hard times. To their credit the government have taken that feedback on board and significantly improved the scheme. It is complex, but flexible, and the key points of this are now as follows;
– Any employee can participate (whether furloughed or not previously) – The employee must be written to and told that they will be employed on a ‘short time’ basis working less than their contractual hours. This must be agreed to by both parties. The government will advise what to include in this agreement by the end of October. – They must work a minimum of 20% of their normal hours i.e. 1 day per week for a full time employee- For the hours that they work the employer is 100% responsible for their payment of wages at their normal rate- For the hours not worked they will be paid 2/3 of their normal rate. The employer will pay only 5% of this payment with the rest paid by HMRC- No contribution is granted by HMRC for NIC, PAYE or Pension – The grants will be claimed in arrears, after the employees have been paid – Claims will open from 8th December 
You should bear in mind that the requirement to pay a minimum of £520 per month to get the £1k retention bonus remains so any reduction in income for the dental team should be carefully managed to avoid invalidating that grant.
The full policy paper on this new and improved version of the scheme has been launched and is available to read at the following link. It includes two variants of the new scheme ‘JSS Open’ and ‘JSS Closed’ to cover the levels of support for businesses who can remain open and those forced to close due to restrictions enforced on them. We would anticipate JSS Open being the most relevant scheme for Scottish Dental Practices. This policy paper confirms that practices can elect to ‘top up’ their employees pay beyond the minimum and still claim support. In line with furlough, an employee can undertake training during un-worked hours.
As the claims are not able to be filed until December there is very little you can do at this stage. The key things to consider are ensuring you end the furlough period correctly and formally and that once the government release their guidance on the elements required in a written agreement that you issue the formal agreements for anyone you wish to enrol in this support scheme.
I hope you find this content of value and interest. Enjoy your weekend!

And Finally
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. Have a restful and enjoyable weekend whatever you have planned.
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 feel free to 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 on 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 and have lovely weekend.

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