COVID-19: The impact on the dental market – update 3

We are in unprecedented and challenging times at the moment and you are no doubt all anxious about the impact that COVID-19 will have on dental practices.

We at Hempsons are keeping a very close eye on developments as they unfold and we have set out in this newbrief some of the key issues for dental practices that have arisen since our first update on 27th March 2020 and our second update on 6th April 2020.  Advice and guidance from NHS England is slowing down now but we will continue to provide regular updates during these challenging times as new information arises.

This latest update is in relation to the most recent letter of preparedness which was issued by NHS England on 15th April 2020. This not only confirms the position for mixed practices being able to benefit, proportionately, from both government and NHS support (as mentioned in our last update), it also provides some more clarity in relation to the financial reconciliation proposed for NHS practices, and some key information relating to redeployment.

Mixed and private practices

As per our last update on 6th April, it has been confirmed that if you are a mixed practice, you can claim for additional government support in relation to the private proportion of your revenue.  Please be aware, however, that you may be expected to declare to your commissioner, in relation to the 20/21 reconciliation, that you have not applied for duplicative government funding.

The letter confirms that private practices can access government funding in the same way as any other private businesses.

Reconciliation and clawback

We stated in our previous update that for 2019/20, the intention was to use March 2019 figures instead of March 2020 figures to calculate annual performance. Some practices have expressed concern that this would worsen their figures (where their March 2020 performance was better than their March 2019 performance) NHS England had therefore announced two further alternatives that may be agreed with commissioners.  While the default will be to use March 2019 figures, practices can request that either March 2020 figures are used (so the year will be based on actuals from April 2019 to March 2020) OR for the 11 month actuals for April 2019 to February 2020 to be used together with a 12th month calculated by taking the average UDA delivery over an appropriate 3 month period in 2019/20 agreed with the commissioner.  It is not clear what an “appropriate” 3 month period is, or how flexible commissioners will be with agreeing these alternatives.  There is specific reference to practices that opened after 1st March 2019.

It seems that any clawback requirements for 2019/20 will still be payable over the financial year, and by 31 March 2021.

Telephone triage

Practices will not be able to make patient charges for triage by telephone but practices should keep a record of this activity as it may support the contract arrangements for 2020/21.

Redeployment

The position remains that practices should, where possible, be redeploying staff to assist the wider COVID-19 response, although it is recognised that this will not be possible for all staff,  for example if they are unwell or self-isolating.  Practices will, however, be expected to demonstrate that they have made every reasonable effort to re-deploy.  A possible area of redeployment for dental staff may be with NHS 111 as they look to increase their levels of dental activity.

Urgent Dental Care

It has been recognised in the latest letter of preparedness that some practices may have to undertake face to face dental assessment and care where in the best interests of patients.  This should not be for aerosol generating procedures and level 2 PPE should be used.  Once urgent dental care systems are operational, practices should not see patients face to face unless there is no UDC provision available.

As we have said, this is a very uncertain and unprecedented time and we want to support you as much as we can.  If you have any legal questions about the impact of COVID-19 on your practice, then please do get in touch.