The Scottish Government

Updated – Remobilisation of NHS Dental Services in Scotland

In a letter published today Tom Ferris, Scotland’s Chief Dental Officer updates the process to ‘Remobilisation of NHS Dental Services in Scotland’.

Preparations to step up to Phase 2

Cabinet Secretary for Health and Sport, Jeanne Freeman announced in Parliament on 2 June, as part of the Scottish Government preparations for the remobilisation of NHS services, that we are intending to reintroduce dental services on a phased basis over the course of this month.

This means dental practices will be able to see NHS patients for face-to-face consultation who are in need of urgent care, using non-aerosol generating procedures. The precise date will be confirmed following the next 3-weekly review of lockdown regulations on 18 June. I am aware that not all dental practices will be able to open at the same time as some practices may take longer to prepare. The start date is not to be considered a target – practices must be certain they can safely open before they do.

I am also taking the opportunity to update the naming of the dental phases, as per my letter of 20 May, to align with wider route map framework. This will ensure clarity going forward and is attached in the annex to this letter.

Preparations and Next Steps

Dental practices should prepare a single surgery in anticipation of opening to patients. SDCEP has developed a ‘practice recovery toolkit’, available at the following link:

Practices are encouraged to work with their NHS Board and Dental Practice Adviser throughout the preparation process; practices will be required to certify to their NHS Board that they are fully compliant with current guidance during the COVID-19 pandemic. In some circumstances the NHS Board may wish to visit the practice before opening.

NHS Services Scotland have ensured adequate stocks of appropriate PPE through a central distribution system of PPE that dental practices may access via their NHS Board. Practices should contact the NHS Boards to discuss the local arrangements for the supply of PPE. Directors of Dentistry in each NHS Board have been advised to ensure a person from the dental team is available to provide a contact point and on-going support to practices.

In the meantime practices should continue to telephone triage patients according to the revised guidance included in my letter of 20 May. On opening, dental practices should refer all patients who require an urgent AGP to their local urgent dental care centre.

The intention is to publish a revised Statement of Dental Remuneration (SDR) shortly. This will include the list of treatments that dental contractors providing NHS dental services can provide under Phase 2 of the remobilisation plan. The purpose of this interim SDR is to record activity against the appropriate items of treatment. The NHS financial support measures that were provided to NHS dental contractors and NHS committed practices, as described in Memorandum to NHS: PCA(D)(2020)7, will remain in place during Phase 2 and that these measures are not dependent on the date of opening.

Finally, I need to impress on dentists and dental teams, not only the absolute necessity to ensure patient and staff safety as we move forward but also public health more generally. Transition to later recovery phases will be determined by taking a graduated risk-based approach to the type of care and treatment to be made available, the risk and level of transmission within the community as determined by the reproduction number “R” and other factors including the number of cases and wider control measures in place.

Previous letter, 20th May

In the letter he outlines 3 key phases of remobilisation which are summaries below. No precise time line is provided but it is anticipated that by the 31st July all practices wil have reached phase 2(a).

Phase 1: Increasing Capacity of Urgent Dental Care Centres (UDCCs) .

The capacity of UDCCs will expand as soon as possible towards dealing with red, amber and green care set down in the SDCEP guidance on urgent dental care. During this phase dental practice should work with their Health Boards to prepare their practices to receive patients.

Phase 2: Restarting Dental Practices

During this phases NHS dental services are expected to re-start. During Phase 2(a): All dental practices to open for face-to-face consultation for patients in need of urgent care that can be provided using non-aerosol generating procedures;

Phase 2(b): Face-to-face consultation to be expanded for patients that can be seen for routine care, including examination,and treatment that can also be provided using non- aerosol generating procedures.

During phase 2 UDCCs will continue to see patients on referral for treatments involving aerosol generating procedures (AGPs) .

Phase 3: Introducing AGPs to Dental Practices

During this phase there will be a limited introduction of AGPs to dental practices, this will be dependent onevidenceofriskandpossiblemitigation.

At present the main focus will is on a staged recovery and phases 2(a) and 2(b).

Further details are available in the letter which can be downloaded here.

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