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New Year Blog: Oh what a lovely pandemic

Well what a year and certainly one to forget! As we take a look back at 2020 it is difficult to see any good points with the exception of the way the profession stood up to the plate and supported the delivery of dental care against all odds. Problems such as lack of information, lack of PPE, confusion around fallow periods, concerns for patient and staff safety not to mention the series of SOPs coming down from the centre to implement changes with the shortest of notice. Financial concerns were to say the least extremely worrying to the profession and the stress and anxiety levels of our practitioners across LASC was immense.


As the LASC LDC Executive we quickly organised ourselves to support the profession as much as we could. The Comms Team processed all information we could get hold of and were able to condense this into regular updates. We liaised extremely closely with the LASC Area Team and worked to ensure our practitioners were supported to deliver care as needed. Naturally in the early days dental care was limited to emergency care only and hence the UDC System was developed in line with the request from the CDO. LASC led the way with more UDCs than most Area Teams.


As the profession across LASC we need to give ourselves the credit for a job well done and look to build on our resilience to ensure we manage the forthcoming situation in 2021.



So what were the memories of 2020?

  • Boris announcing the first Lockdown in March was a complete shock because I think most of us thought it would never happen. We had no idea of the consequences of this decision until we found we were unable to get supplies of anything least of all PPE.

  • Immediately we were in this position the LASC LDC Cobra Committee was established and we set up weekly meetings with our Area Team to ensure communication was maintained. The LDC Exec support to the process throughout last year was exceptional; examples being Andy Harvey who scoured the internet to purchase PPE for distribution and also a number of Exec members training as early Fit Testers, and those who ran a PPE delivery service across our region to ensure that support was there for practices.

  • Establishing the UDC System was a challenge in terms of how do we go about it but out of the blue the troops rallied and a huge number of practices put themselves forward as UDCs – well done all those who joined the party.

  • Guidance on what PPE to wear for which procedure was debated at length and the advice changed regularly. What is an AGP? What was the effect of ACH in the surgery on fallow periods? These were all regular discussion topics as nobody seemed to agree.

  • We had all the structure and location stuff around categories of patients in the early days, where they could be seen and by whom. We continued to tweak this structure regularly to ensure we had patients in the right place and clinicians were protected.

  • Add to this the continual changing of Covid Restrictions, Test and Trace, self- isolation guidance, staff to staff transmission advice etc - what a challenge it was!

  • Punctuating the progress through the management of dentistry in the Pandemic, just to keep it real, was the appearance of the “SOP of the week” on a regular basis from the CDO. Keeping track of these was a task in itself and thanks to the efforts of the Comms Team in getting the information out along with some supporting advice we managed it.

  • Who can forget when the SOP of the week said “Business as usual” from Monday 8th June. Getting the change in service implemented in such a short period of time was tight to say the least but no surprise - the profession delivered.

  • Our Area Team were extremely grateful for the support given by the Profession, and the support given by the LDC Exec. Although we have always worked closely with the Area Team this relationship developed even further during the Pandemic. This close working relationship has always been to our mutual advantage and will continue to stand us in good stead going forward.


So, what was the fall - out from all of this?

  • The stress experienced by the whole profession across LASC was extremely concerning. A number of practitioners were struggling to keep pace with the changing environment which is completely understandable under the circumstances.

  • As the level of anxiety rose the state of health and wellbeing of our Dental Teams was of great concern to us at the LDC Exec. We handled numerous enquiries around many varying issues and endeavoured to support our colleagues to the best of our ability.

  • Financial considerations were at the forefront of dentists’ minds through these dark times. Financial stability was debatable because the position depended on decisions from the centre which are out of local control.

  • Managing the general public was a massive challenge and every credit to our call handling services for doing this and for referring patients in the right direction.

  • Political pressure and lack of knowledge was unbelievable. We had MPs and Councillors contacting the Area Team and Practices asking as to why we were only providing remote consultations with AAA and limiting F2F care - where the heck had these people been when at the end of the day the profession are simply carrying out their duties as directed by their government!

The LASC LDC Exec response to the situation


I have outlined some of the support we provided from the Exec. but behind the scenes we were engaged with deeper problems.


We had an increase in the need for us to be able to give sound advice and recommendations to practitioners who are struggling in the present climate. To support this the Exec. have been undergoing Health and Wellbeing Training facilitated by HEE to ensure we are able to identify potential problems practitioners may have, get them the appropriate advice and counselling that may be needed


We have come across some challenging situations and have supported practitioners with their individual problems. We do have good connections with NHSE Performance Management and also GDC and CQC.


In the case of any Practitioner Support problems we have all the necessary knowledge and contacts to support our practitioners. Much of the worry and concern is precipitated by a lack of understanding of how processes work. If you are in this position do not hesitate to get in touch and we will help you.


Please remember if you have any worries or concerns about anything please contact us through the Comms Team on admin@lasc-ldc.co.uk , the LASC LDC website contact form or email me directly on bernardalston@nhs.net (please note there is no full stop between my names)


However you choose to contact us, be assured your enquiry will be processed with the utmost sympathy and discretion, and all information will be confidential.



So what will happen in 2021?

  • We will work with our Area Team to support our Practitioners in moving forward.

  • New contractual developments are very much going to influence how we run our practices and how we engage with the developing NHS; in terms of the Primary Care Networks and the integration of Oral Health support to this process. We have made some ground with this and have achieved national recognition with our involvement in Fleetwood PCN.

  • Similarly, we are engaging with PCNs over in East Lancs as part of our Oral Health Support for Care Homes pilot, which fits with the medics Enhanced Health in Care Homes Directed Enhanced Service.

  • Please remember that we will work with all our practices to support them to achieve stability and financial security in the developing landscape.

  • Be reassured whatever is thrown at the GDPs across LASC we will embrace it and succeed.

  • If any practice is struggling for whatever reason please do contact us ASAP and we will help you.


BAs top tips for 2021

  • Engage with us as your LDC Exec - if you know someone that is not registered on the website/e-group then get them to do so without delay.

  • Make sure you read the information we distribute.

  • Be wary of information seen on social media such as Whats App – often the information is wrong – only take notice of information coming from the Exec Comms Team, NHSE, CDO, BDA.

  • When new information comes out don’t panic – wait until the dust settles and the real messages are clear.

  • Contact us if you have any worries or concerns of any kind and we will support you.

  • Stay in close touch with your neighbouring practices and share information and experiences - we will be looking to set up some Peer Review opportunities in 2021.

  • Finally, but most importantly - look after each other, but don’t forget to look after yourself.


DON’T FORGET YOU CAN GET HOLD OF YOUR LDC EXECUTIVE BY EMAIL 365 DAYS OF THE YEAR admin@lancashirecoastalldc.co.uk or bernardalston@nhs.net


HAPPY NEW TIER!!!


What is all this Tier stuff Boris and Matt (otherwise known as B&M Bargains) keep going on about and how do they come to their conclusions? They had London in Tier 2 for quite a while because it suited them and as a result cases in the whole South East of the country went out of orbit and they are now paying the consequences. Lancashire has been hammered and now despite our cases coming down we find ourselves in Tier 4.


So rumour is the way it works is as follows...


Boris and Matt get together in the Cabinet room which apparently now has an ACH figure of 100 thanks to an ultra-covert system developed by British Aerospace. The Fallow period is 30 seconds and the room temperature is minus 70 degrees centigrade.


They both wear appropriate PPE which consists of:

  • Cabinet issue Gowns

  • Gloves (special dice rolling gloves developed by Oxford University)

  • House of Commons FFP3 masks

  • Brexit visors


Matt then dons a sparkly bingo jacket, picks up the microphone and calls out the area, e.g. Lancashire


Boris after a few warm up piffs and pfaffles rolls his dice and whatever number comes up is allocated to the area – simples. What is concerning is that we have only got as far as Tier 4... but rumour has it that they may even be starting to consider 5 and 6!


Further malicious rumours suggest Boris is trying to source a second dice which would then give B&M the option of a Tier 12 allocation. I dread to think what would be the restrictions applied in Tier 12, but I have heard that we will only be allowed to eat once a day, showers will be limited to one a week, looking out of the window will be banned, we will be only allowed to take one breath a minute, and we must exhale into a high volume suction unit. Thankfully this is being delayed because Boris’s second dice is part of the Brexit Deal and is stuck in a lorry queue to cross the channel!


Looking forward to next year – hopefully the 2022 New Year’s Blog will be Covid free - bring on the vaccine!


That’s all for now so take care and stay safe,


Bernard,


Bernard Alston

Sec LASC LDC Executive

Practitioner Support Lead

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