COVID-19: the impact on the dental market – update 4

Below is a summary and brief analysis of the latest guidance for NHS dental practices which was issued by NHS England on 13th July 2020. The full guidance can be found here.

Resumption of services

As dental practices are coming out of lockdown, the guidance emphasises the need for practices to put measures in place for the safe delivery of services. In terms of patient management, this includes continuing to provide remote risk assessments of patients prior to any face to face interaction.

Urgent dental care centres will continue to be maintained.

Financial arrangements

Some (albeit limited) clarity has now been provided in respect of the financial arrangements for NHS practices for the year 20/21.  There is an assumption in the guidance that all practices can now open and an expectation that they start to provide as comprehensive service as possible to patients.

First and foremost, practices that have not been operating as urgent dental care centres (UDCs), will have a 16.75% abatement applied to their contract value for the period from 1st April to 7 June. This will not apply to practices for any period where they were UDCs.

For the period from 8 June onwards, agreement is still to be reached with the BDA to determine measurement of activity.  In the meantime, there will be a 0% abatement for all contracts, taking into account the increased cost of providing services in the way currently required.  However, in respect of non-UDCs, this is subject to certain conditions. Practices are required to provide the following assurances:

• they are open for face-to face interventions;
• they are adhering to contractual hours with reasonable staffing levels for NHS services;
• they are performing the highest possible levels of activity (at least 20% of usual volumes of patient care activity); and
• there is no undue priority being given to private over NHS activity (i.e. they haven’t significantly increased private practice provision at a rate that exceeds that for NHS provision).

It has also been confirmed that if there was a second phase or regional lockdown, the NHS would seek to shift contracts back to the position for the 1 April 2020 to 7 June 2020 period.

The guidance again reiterates that the stability of funding was to ensure (amongst other things) that staff have continued to be paid at previous levels.  Practices will need to confirm that they haven’t gained any windfall profits from the funding made available.

As you can see, there are still many unknowns as to the financial arrangements going forward for 2020/21.  Although the guidance offers some reassurance for those practices that are open and achieving at least 20% of usual activity, it suggests that those that are not UDCs and do not meet the above conditions, would revert back to “pre-existing contract arrangements”.  This would, we assume, be based on UDA activity levels, and would therefore lead to large clawback payments for those practices.

If you have any legal questions about the impact of COVID-19 on your dental practice, then please do get in touch.