Bernard's Blog: route to recovery

Hi All

Well, all I can say is...

“Watch out there’s a SOP about!”

We knew there was something coming, but we did not know when, where, and how until last Thursday when the latest documentation came out of the blue to surprise us all. Locally, we were engaged in looking at the “Road to Recovery” and how we were going to get there only to find all that work was superseded again by a Central release. Never mind; we will just have to get on with it as we normally do!

So, at grass roots level what is going to happen?

Let’s picture where we were up to - we had our UDC System in place, all was working well, and we had everything under control. We then had the instruction to open up again on or after 8th June to provide F2F appointments; once we had all necessary protocols and processes in place as per the SOP... This did rather accelerate the measured progress we were making to get back to normal working (whatever that would be like). Nevertheless this is where we are now and practices are preparing to move forward.

Because of the rapid transition from where we were to where we now need to go there are some underlying considerations to take into account.

So, what do we mean by that?

Under the previous arrangements we had our UDC System which included the Special Care Dentistry Services and GDPs set up to deliver services to the four cohorts of patients and this was working. The underlying considerations which now need to be taken into account are the fact that our Trust Based Services were the chosen sites for the Covid+ / Shielded / Vulnerable patients which compromised their capacity to provide the in-hours emergency care they were providing for patients without a dentist. The knock-on effect from this is that we ended up with a capacity gap across LASC. This gap was filled by our UDCCs who were supporting the delivery of care to these patients. As we all start to open our doors again we need to make sure, in the grand scheme of things, that we have capacity to provide urgent dental care (particularly AAA) for patients without a dentist.

So, what is the solution?

The problem-solving process is based on a capacity and demand exercise.

Firstly, our existing 60 UDCCs will continue to support the Urgent Dental Care System in their current form for the time being. 

There will still, however, need to be some extra capacity to fill the gap and to do this what is needed is a pledge from practices newly opening up to provide two appointments a day for AAA and potentially some follow up care for patients who do not have a dentist.

Below we have a statement from Nick Barkworth outlining the need for our GDP practices now coming on board:

“As you can imagine the announcement last week has caused us to rapidly put a transitional plan into place.

We are asking that UDCCs continue to support the urgent care pathway as they have been doing over recent weeks, until there is sufficient capacity from other practices to spread the load across all dental practices. We are presently trying to generate as much AAA capacity as we can to support the call handling service during the transition and would welcome your support with that initial part of the pathway.

The good news is that from yesterday there is no need to complete the online referral for your own patients (self-referrals), and the online referral system is just for moving patients between sites where there are services that need to be accessed elsewhere (shielded / vulnerable or AGP etc). We are also working to secure antibody testing for NHS Dental service providers and their staff, more details of that will follow soon.

I’m hoping that in the coming weeks the burden on existing UDCCs will drop and that the request for all practices will be to dedicate a couple of appointments per day for urgent patients from the call handling service. 

We receive about 180 calls per day and have approx. 220 practices so spreading the demand across all sites should free up space for everybody across the dental healthcare system.

This approach was agreed with the LDC and LDN and the group of UDCC coordinators who have been supporting practices and getting them up and running.

I would just like to add my heartfelt thanks for your support over recent weeks, it is very much appreciated, and if we can get through the next couple of weeks we should have some stability which will enable a coordinated road to recovery for everybody.”

So, what do we need to do?

• Make sure you have read and understand the latest SOP from the OCDO

• Pick up some CPD on Covid19 and guidelines along the way – scroll down to a UCLAN webinar this Wednesday.

• Ensure you have all necessary PPE and protocols in place as per the SOP

• Support your staff as they come back into work to provide any reassurances they may need; there are Wellbeing and Resilience Resources on our practitioner welfare pages which you may wish to share with your team

• Make sure you set up your appointments to ensure adequate social distancing be that temporal or physical

• Make sure your Indemnity Provider knows you are opening again

• Remember that you will have UDCCs in your area who have been providing services during Covid for some time and will be able to support you

• Linked to this Blog are some experiences of our UDCC co-ordinator practices outlining the issues they had and how they managed them - these hints and tips are really useful (quick 3 minute read – click here)

• Your LDC Exec is available 24/7/365 for advice and support (that’s a slight exaggeration; we do sleep… sometimes! - Stuart) just contact the Comms Team at admin@lasc-ldc.co.uk

Just one more thing...

These are challenging times we are enduring and what I have seen is the profession really working together and delivering a great service to our patients in the most difficult circumstances. The need to be flexible and also have the scope to revert back to where we were pre 8th June should we get a second spike or clustering is constantly in the background. However, let’s keep moving forward and get back to normality as soon as we can.

Just another thing...

I did explain in the last Blog that I had my appointment at Fleetwood tip last Sunday as arranged by Mrs A. I dutifully turned up on time and was greeted by a chap at the gate with, guess what, a clipboard! He checked my reg number and cross referenced that with his spreadsheet and then asked me what waste I had with me because you can only bring one type of waste at a time.

Having got through the interview I was instructed where to park and which skips in which to dump my recycling. When I parked up social distancing was easy as there was nobody else there! 

On the way out a second chap checked me out and I asked him when things would be back to normal (Road to Recovery Tip Style!) and he said he thought it would be a permanent arrangement that worked well and if the management did change it back then they did not know what they were doing. I thanked him and did not comment further as he had not done his capacity and demand exercise; on the way in I had seen numerous examples of fly tipping because people can’t get into the tip!

That’s all for now.

Stay Safe!

Onwards and upwards,

Bernard

Bernard Alston

Sec. LASC LDC Exec.