Included in this bulletin:

1. COVID-19 Clinical Waste Management

2. New LDN Chairs Appointed

3. Outbreak SOP: Management of COVID-19 in Primary Care

4. Patients Without a Regular Dentist

5. Update on expectations from NHSE/I

6. Orthodontic Services Opportunity

To minimise the number of emails sent to practices, NHS England and NHS Improvement is using this regular Dental Bulletin as its main method of communication. The Dental Bulletins contain important information, which on occasion might include requests for information and deadlines, as well as updates on issues relating to dental contracts, policy and process.

Please share the Dental Bulletins with ALL the staff within your practice and save for future reference.

1. COVID-19 Clinical Waste Management

Please see latest COVID-19 Waste Management Standard Operating Procedure.

2. New Appointments to the LDN Dental Chairs Across the Midlands Region

It is our great pleasure to announce that following a recent recruitment process for the three additional Local Dental Network (LDN) Chair roles, NHS England and NHS Improvement Midlands Region has successfully appointed to the following posts:

Leicester, Leicestershire & Rutland (LLR), Lincolnshire and Northamptonshire – Deborah Manger

Herefordshire & Worcestershire and Coventry & Warwickshire – Steve Claydon Birmingham & Solihull and The Black Country – Peter Thornley

News and Updates for Midlands East

Dental Bulletin 19 October 2020 - Issue 21

All three appointees bring a wealth of knowledge and experience, which will be of significant benefit to delivering in their new roles across the respective LDN areas. We will be completing internal processes to confirm HR arrangements in the next few weeks but felt it important to share these appointments at the earliest time to give the candidates an opportunity to engage with various teams and networks.

All three posts above are currently interim roles but as a Region we are committed to developing these roles into long term posts. The three new LDN Chairs will join the current incumbent LDN chairs for:

Staffordshire and Shropshire – Tony Ahmed Derbyshire and Nottinghamshire – Christine Utting

Our new complement of five LDN Chairs ensures full representation for all our Midlands Region STP areas. This fills a sorely felt gap as these are critical roles; particularly at this challenging time which has been defined by the Covid-19 pandemic.

Our LDN Chairs will provide local clinical leadership; something that is vital to ensure resilience and in supporting recovery and restoration of dental services. Looking forward, they will also have a key role in establishing wider links with emerging Integrated Care Systems and Primary Care Networks and ensuring that dental services are considered and recognised as part of the wider healthcare system.

Our LDN Chairs will also provide ongoing clinical advice to constituent organisations (commissioners and providers alike) and help to co-ordinate the activities of local Managed Clinical Networks in their work to improve quality and outcomes. They will also support a two-way communication between these commissioners and the local clinical networks allowing the dissemination of national policy and giving a voice for local networks to feed ideas and input back to NHS England and NHS Improvement.

Each LDN Chair will work with their local dental community to implement solutions that benefit local populations and develop specific initiatives in support of this. We have noticed accelerated progress in joined up system working throughout the pandemic and would hope that our LDN Chairs will champion and foster such an approach going forward. We would like to encourage the dental community and various stakeholders to welcome and support our LDN Chairs as they step into their roles across the Midlands Region.

3. Outbreak SOP: Management of COVID-19 in Primary Care

A consistent approach has been adopted for the management of case/outbreaks of COVID-19 across primary care pharmacy, optometry and dental settings across the Midlands Region. This will ensure that the relevant bodies are also notified of any cases/outbreaks. An outbreak is defined as, where there are two or more cases linked in time, place and person.

In circumstances where there is a staff absence due to COVID-19 within a pharmacy, optometry or dental setting and this is likely to impact on service delivery, providers must notify NHE England & NHS Improvement via a Notification of COVID-19 Service Disruption and/or Outbreak in Primary Care form. The form can be accessed via this link.

There is no requirement to complete the form for single cases where it is not likely to impact on service delivery. The form must however be completed if the practice/pharmacy becomes aware of two or more positive cases in staff or members of the public who have attended their premises.

Upon receipt of the above form, NHSE&I will ensure that a clinical adviser contacts the provider where additional information, support or advice is required. Providers may need to complete a separate reporting form and advice and guidance will be offered to the provider during this call.

For the avoidance of doubt, Public Health England must be informed of all positive cases in a healthcare setting. Public Health England contact details for reporting positive cases for the East and West of the Region are included within the attached SOP.

To assist you, please find attached a Standard Operating Procedure (SOP) for the management of COVID-19 cases in pharmacy, optometry and dentistry in primary care settings. The SOP includes a web link to the NHSE&I reporting template.

A separate FAQ relating to NHS Test and Trace is also attached to support the information contained within the SOP.

4. AAA Triage for Patients Without a Regular Dentist

As dental services are continuing to resume, there is still a need to manage patients who have an urgent dental need without a regular dentist.

During this time, 111 will sign post patients with an urgent need, without a regular dentist to a local general dental practice for tier 1 telephone triage.

All general dental providers are required to continue providing remote AAA telephone tier 1 triage e.g. advice, analgesia and antibiotics for patients with an urgent need without a regular dentist.

Many of the existing contractual provisions rules continue to apply. Patients requiring an urgent appointment should be offered the next available slot, whether or not they have been treated on the NHS previously at the practice. Contractors have been advised by the NHS to prioritise patients with urgent care needs. NHS England advice is that the

sequencing and scheduling of patients should take into account the urgency of needs; the particular unmet needs of vulnerable groups and practices' available capacity to undertake activity. We appreciate your continued support with providing urgent dental services to patients without a regular dentist whilst face to face dental services are being restored.

5. Update on Expectations from NHS England and NHS Improvement

From the preparedness returns from practices in the Midlands it appears that the overwhelming majority of practices are up and running as well as providing Aerosol Generating Procedures (AGP).

All general dental providers are required to achieve 20% volume of care to receive full contractual payment; this is not a minimum but is a threshold. Practices must continue to spend the same amount of time seeing NHS patients as prior to the pandemic. Priority should not be given to private patients where NHS capacity still exists.

6. Orthodontic Services Opportunity

We would like to invite expressions of interest (EIO) for an opportunity to provide orthodontic services to an existing caseload, in Lincolnshire. There will be no more than 577 cases in Active Treatment and no fewer than 210 cases in Supervised Retention. There will be a payment of £662 for a patient in Active Treatment and a payment of £25 for a patient in Supervised Retention, in line with the National Tariff.

The service will commence on 1 January 2021 and will be delivered under an NHS England Personal Dental Service Agreement for Orthodontic Patients in Active Treatment.

Please see the full details on Contracts Finder and OJEU