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COVID-19 Update – 6th July 2020

We are happy to share with you today our 32nd Covid-19 digest in relation to the Scottish Dental Sector and we hope you find it of interest.
We will continue to digest and communicate on arising news as and when we have something to share. As matters become clarified the frequency of my digests may continue to reduce. At present a weekly digest timetable feels about right, but we may see this spread out further in the weeks ahead. 

POLITICAL UPDATE

Last Wednesday the First Minister announced a definition of the anticipated timetabling of movement out of the current Phase 2 stage to Phase 3. This was closely followed up by a Tweet from the CDO confirming the position. The relatively informal nature of Twitter as a means of communication from the CDO may well be taken as an implication that the FM announcements are highly independent of the CDO and that he may not have a great deal of control over the key announcement timings. It seems likely that we will continue to see the First Minister and/or BBC may be the foremost source of information for the foreseeable future.
In the revised timetable issued by the Scottish Government (shared below) it was confirmed that the Phase 2 stage will end on the 13th July and move to Phase 3. For NHS practices this of course still restricts to non AGP treatment types but allows the re-introduction of ‘routine dentistry’. 
Phase 2 & 3 update

Page 3 of the document sets out the various trigger dates for other sectors too including the re-opening of hairdressers on the 15th which I am sure will be good news to many looking to have their ‘lock-down styles’ shorn. At this stage there is no guarantee of any NHS support beyond the 13th, but we would anticipate some further announcement in the days ahead in relation to the support package and the temporary SDR in place at this point. As the phase 3 resourcing is likely to require additional costs alongside the ongoing requirement to provide input at the UDCC’s it would seem just and equitable to expect at the very least a maintenance of the current support package, but we will await an update this week to allow for robust planning.

BOUNCEBACK HIGHER WEBINAR PROGRAM

The final event in our webinar program is scheduled for 7pm on Tuesday the 7th July and is titled ‘Business Planning for the New Normal’ – This webinar will be presented by Guy Meyers (Director – Customer Success) from SOE/EXact. It will cover best practice management tips and learning for the Scottish Dental sector drawing upon their international learning from their other territories who have returned to more advanced practice already. Places are almost full but you can still book your free place at this link – we look forward to seeing you there. 

CLINICAL UPDATE

As most practices have returned in the last two weeks the ongoing adjustment to the revised SOP’s continues. As we all know the last few months and the quest for consistency has been extremely challenging and the fact that no single voice of authority for the profession has existed has compounded that problem. I know that ‘ploughing through’ the guidance has been exhausting and I have been craving an executive summary throughout. I was pleased to see the SDCEP comparison of SOP document released highlighting the consistencies and deviations in the SOPs therefore and am happy to share this tonight;
SDCEP Comparison of SOPs

We are all craving the scientific evidence in relation to fallow time and the use of AGP’s too and I am happy to share a number of documents you may well find of general interest in that regard in this digest.
Firstly I share Dominic O’Hooley’s article entitled “The Aerosol Generating Procedure: How a Phrase Lost Its Way Within the Maze of COVID-19 and Dentistry”
Dominic O’Hooley – AGP Article

On the same topic you may also find the comparison of Fit Testing and Fallow Times Internationally of interest in the document below;
INTERNATIONAL FIT TEST/ FALLOW TIME COMPARISON

And to further expand on the matter I have pleasure in sharing a pre-print research paper entitled “Exposure assessment for airborne transmission of SARS-CoV-2 via breathing, speaking, coughing and sneezing.”
Aerosols Preprint Findings Paper

I hope you find these of interest. 
In addition to these clinical considerations NHS Lothian issued two letters in quick succession last week to explore the phase 3 matters of relevance. The first on the 29th of June was effectively a confirmation of the Phase 3 re-opening and a request to report how many dentists would be working to allow a PPE deployment mission to take place. This letter was received with a great deal of unrest as it was felt to be almost dismissive of the fact that no financial support or SDR has been confirmed as yet for Phase 3 and that planning was nigh on impossible as a result. The instant feedback and responses of questions motivated a further expansive letter to be issued on the 30th in an effort to enhance the communication. I am sharing both these letters tonight for your information. 

DoD NHS Lothian 29th June

DoD NHS Lothian 30th June

FUNDING UPDATE

NHS Support Package
We await some update this coming week about the Phase 3 funding package for NHS/MIxed practice. In the meantime PSD have issued their 5th update to their FAQ paper around the existing Covid-19 support measures and I am able to share this below.
PSD FAQ’s Vs 5.0

As you will note from the document the changes made are highlighted with an asterix for ease of reference. We continue to help many to appeal their support but are aware that PSD are still stretched with their response times and the process can be somewhat slow. 

Business Support Grant
The ‘postcode lottery’ of the £25k grant eligibility still rumbles on, but we do encourage you to continue to appeal directly and via your MP/MSP as we are still achieving success in some areas. I can report another Lothian based practice we helped to appeal have been granted their payment this week and persistence is recommended.

Bank Finance – **** Urgent Action Required if Relevant****
Most practices have successfully applied for the Bounceback loans of £50k (BBLs) and some have managed to release the CBIL’s Loans which are considered the ‘big brother’ to the BBL’s. In the early releases of the CBIL’s funding we were aware that most of the lending banks were only willing to see these ‘cheap loans’ as additional finance and could not be used to re-finance existing and potentially more expensive borrowing. However we have become aware of one of the ‘challenger banks’ in the last week who are now willing to re-finance existing debt as long as Goodwill and/or property values cover the borrowing.
We have seen a number of practices apply for re-financing, and as this technically gives a full year of interest paid by the government can save a substantial amount of funds. The lending rate in years 2-6 has been set at a low level too and the savings can be significant. The bank involved will pay the valuation and legal fees and with no arrangement fee the switch is inexpensive as the only charge levied is via the brokerage involved.
This funding stream is very time limited and is likely to disappear in the next week or so as the CBIL’s funding is rationed to each bank. It would be very well suited to practices with less than 6 years left on their existing debt, but in theory to all. If you would like to explore this further do let me know and I will be happy to pass you on to the right people.
Flexible Furlough Scheme (FFS)

As of the 1st July all practices are entitled to make use of FFS funding. As I have previously illustrated the implementation and administration is complex and fraught with possible pitfalls if dealt with incorrectly. We have had many workshops with our clients over the last few weeks in an effort to help you navigate the rules for your own circumstances. If you would like to discuss your own considerations please do get in touch at any point and we will be delighted to help.
It seems likely that you may have a myriad of HR issues to contend with over the next period and I have had a number of discussions with our clients this week on potentially challenging HR points. As a reminder, all of our clients have free of charge access to our HR Advisory service, and the advisors on the helpline will be delighted to help you with your issues if it is beyond my own generalist knowledge. If you need a reminder of the phone number and policy number please do get in touch with us.

Once again love and best wishes to you at this time from all the team at 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 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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