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COVID-19 UPDATE #43 – 2nd DECEMBER 2020

As we ‘click’ in to December it is hard to believe that we are still in the grips of the pandemic some 9 months downstream. With the ongoing development of vaccine technology let’s hope we can see the end of this chapter in the short term future and return to some kind of normality. 
We are today sharing our 43rd Covid-19 digest in relation to the Scottish Dental Sector. We hope you find this digest of value.
As always – if you have any specific concerns or questions we will be delighted to hear from you.

POLITICAL UPDATE

The political focus since my last digest has been directed towards the Tiers for the home nations and the possible relaxation over the festive period. After the challenges of 2020 the government has created ‘festive bubbles’ in consistent agreement for the whole nation. With a potentially effective vaccine around the corner, time will tell if this relaxation was a cavalier approach and the threat of another possible lockdown in the dark month of January is certainly less than appealing.

CLINICAL UPDATE

We continue to see high demand for all dental services, but with ongoing fallow time and restrictions within SOP’s the capacity is not available to accommodate the demand. We have now seen a month of return to full NHS treatment options within the current transition period. Most practices appear to be capable of generating the 20% activity level that will become the minimum requirement from 1st March onwards to maintain the guaranteed 85% Covid top up once measurement commences. We are aware that the BDA are lobbying to see the 85% level increased to 100%. At this stage we have not received confirmation from PSD as to how the activity will be measured, but we remain of the assumption it will be based on SDR items of service levels in a financial sense. We understand that a tripartite meeting to discuss the measurement system was held between the BDA, Scottish Government and PSD on the 19th of November and I will share any updates on receipt.
Up until the additional lockdown measures emerged of late we have been witnessing a high demand for ‘large ticket’ private dentistry in areas of short term ortho, implantology, smile makeover etc. Anecdotally it appears, that the general population where their source of income has been maintained, is choosing to use some of their savings towards investing in their dental health. In the past this may well have been spent on holidays and social activities. The practices who have maintained their focus in these areas are currently benefitting from this new found disposal income. Those practices finding themselves in Tier 4 restriction areas have had to cease facial aesthetic delivery in the meantime however.
The BDA have estimated that circa 19M dental appointments have been missed as a result of the pandemic. Another worrying potential consequence of Covid-19 is the findings in the US which have identified that Long Covid and the primary infection may exacerbate dental difficulties. The report in the New York Times which can be read at this link identifies Perio issues and other complications worsening during infection.
PCD issued their PCA(D)(2020)14 yesterday setting out the possible involvement of NHS Dental Contractors in the forthcoming Covid Vaccination Programme. This indicates a commencement of the programme delivery from Early December 2020 onwards and will continue in to 2021. I have shared the PCA below for your information. 
PCA(D)(2020)14 – Covid Vaccination Programme – 2020/21

We have also see the Scottish Government announce in the last 24 hours a £500 ‘bonus’ payment to NHS staff. You can read their press release at this link.
Whilst not being extended to fully private dental practices it would appear that the payment will be applicable to all NHS committed practices in Scotland given that the release refers to “staff providing NHS services under independent contractor arrangements including: NHS Dental Surgery Staff”. At this stage, as has been the case so many times throughout the pandemic, we do not have the full detail and we will need to receive this to assess who specifically will be in receipt of the payment. The definition of ‘staff’ will be critical as we are unsure how the private/NHS split will be applied (if at all) and also whether admin staff, Dentists and Therapists will be included or not. There is a political drive to have this deemed a tax free receipt in time for Christmas but until the SNP vs Conservative ‘sabre rattling’ is completed, we proceed with cautious optimism that it will not create further division within Scottish Dentistry. In the meantime I share the recently received letter confirming the headlines from Jeane Freeman MSP below;
£500 NHS payment letter

FINANCIAL UPDATE

After the significant updates in the furlough and SEISS scheme shared in my last digests I am pleased to report that very little has changed further. I therefore share some key information/clarity in addition tonight.

Coronavirus Job Retention Scheme (CJRS)
CJRS (furlough) , as extended until 31st March 2021, will remain at the 80% recovery level until it is reviewed in January 2021 and assessed economically.
For any practices continuing to utilise flexible furlough options I draw your attention to the tighter timeline limits for claims. All claims for November must be submitted before the 14th of December at latest. Thereafter every subsequent month must be submitted by the 14th of the month following. Late claims are likely to be automatically rejected and missing these deadlines could be a costly error. All practice payrolls overseen by Dental Accountants Scotland will be submitted within these short timelines, but any practice undertaking their own payroll submissions should take careful note of these deadlines.
NB; With the forthcoming traditional holiday season approaching I draw your attention once more to the rules around furlough and holidays. The new guidance is clear and states that employees should not be put on to furlough purely for holidays, but where they are already flexibly furloughed and take holidays you can consider the holiday as ‘not worked’ and claim 80% grant funding. As previously you need to top up their wage to 100% for those days, but where this applies to the practice workforce you should ensure you claim this valuable support. 

Self Employed Income Support Scheme (SEISS)
The window for application for the 3rd SEISS grant is now open. Like the prior 2 grants any Scottish Dental Professional who is eligible should have received an invite to apply directly from HMRC. Please take care as we are aware that fairly convincing ‘phishing scams’ are being seen at present. We are also seeing some rogue debt letters from HMRC so please be vigilant.
The eligibility for the 3rd grant is almost identical to grants 1 and 2. If you continue to be impacted by Covid and were previously eligible you should make your application once more. The key difference this time around is the need to provide a declaration that you “have had a new or continuing impact from coronavirus between 1 November 2020 and 29 January 2021, which you reasonably believe will have a significant reduction in your profits.” It is also a requirement for you to keep records proving you have been impacted, which given the ongoing financial challenges should be easily demonstrated by comparing the same period in the prior year. It has been confirmed that even if you are in receipt of maternity allowance you remain eligible, which is a query raised previously on a number of occasions. 
You can read the full current guidance on eligibility at this link.

NHS Covid Top Up
We are aware that there continues to be significant ongoing confusion around the NHS Covid Support where a practice sees a change of performers due to maternity, retiral, locum, resignation etc. The FAQ’s from PSD remain at version 11 and I continue to share these in the archive of documents in my footer. However if your particular circumstances are not covered you are advised to submit the ‘Changing Practice Form’ for the incoming performer to assess what ongoing support will be received. Each circumstance is being assessed individually, and where the incoming performer is coming from another NHS Scotland Practice, Covid support should continue in some capacity. The form for your information is shared below.
Changing Practice Form

And Finally…. Have yourself a Zoomy Christmas?

2020 has been a challenging year for the whole Scottish Dental Profession. 
This time of year would normally be the time to get your funky Christmas jumpers on, kick back and relax as a team. The pandemic makes the traditional Christmas party impossible. However HMRC have now confirmed that ‘virtual parties’ will be covered by the £150 per head tax deduction allowance so there is nothing to prevent you (budget permitting) coming up with some creative ideas to thank your teams this year.
The technical requirements to consider are that, as long as you invite everyone (whether they attend or not), you can pay anything up to £150 per head on a food and drink hamper for them to enjoy! If held over Zoom at least you can assume that everyone gets home safely from this years Christmas party!…. 
In addition you also have the opportunity to utilise the rules around ‘trivial benefits’ to gift a small thank you to team members. Under these rules you can gift something as long as you ensure
– The benefit is not cash or a cash voucher – The cost to provide does not exceed £50 – The benefit is not provided as a contractual entitlement – The benefit is not provided in return for a normal service (or services) expected by the employee – eg hitting a pre-set performance target
Common examples might include a gift of flowers, a turkey, etc. More than one trivial benefit can be provided during the year; however, where the employer is a small company and the trivial benefits are given to a director, office holder or members of their families or households, an annual limit of £300 exists. 
Hope this gives you some inspiration of how you might substitute the Christmas party this year. Here at Dental Accountants Scotland the team have decided to defer the celebrations until the New Year and head away for a few days R & R to recharge the batteries after an exceptionally busy year. Perhaps you might canvas your own teams for what they might like to do too?
Please do let us know what you get up to, and whatever you do we hope it brings you and your team some festive cheer.

Once again love and best wishes to you at this time from 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 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.

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