Letter to Primary Care Dental Teams in Wales

The Chief and Deputy Chief Dental Officers inWales have shared a letter addressed to all Primary Care Dental Teams in Wales. The letter can be read below.

Dear Colleagues

By now you will have heard and be aware of the announcement made by the First Minister introducing national firebreak restrictions from 6:00pm on Friday 23 October until 00:01 on Monday 9 November. https://gov.wales/coronavirus-firebreak-frequentlyasked-questions

We want to update you on what this means for dentistry and the actions you need to continue to take to keep your teams, your families, your patients and the wider community safe over the coming weeks. Maintaining wider NHS healthcare activities is a broader aim in this period. Dentistry is an essential part of healthcare delivery and remains a valid reason to travel. However as emphasised in the last CDO letter https://awfdcp.ac.uk/content/files/2020-08-27-Covid-19-Progress-through-AmberPhase-of-Recovery-in-Dentistry.pdf it is important that dental teams offering NHS dental care provision, focus on provision of urgent care and addressing delayed and postponed treatment; for everyone not just previous routine attenders. If there is capacity in a practice to offer routine assessment, please use clinical judgement to offer any such availability to those patients who you know tend to be at risk of oral health deterioration. It is important that we in the dental community of Wales contribute to First Minister’s ‘short and deep’ firebreak principles by not encouraging unnecessary travel for routine check-up appointments that can, and should be, delayed. We cannot write ‘rules’ for every clinical scenario; it is a time for professional leadership and judgement.

This continues to be an uncertain and challenging time for everyone. We are making progress in restoring dental services in Wales and that must continue as we head in to this necessary two-week ‘firebreak’. We need to slow the transmission of CV19 virus, to manage the winter months ahead and ensure that everyone in Wales, with dental pain, problems and risk, can access timely advice and treatment.

This period of lockdown measures will feel especially hard for some, and many patients may and will decide to cancel appointments to remain at home as advised. That is why Welsh Government are continuing to provide financial support to NHS Dental Care Providers and private dental providers can continue to provide necessary dental treatment to their patients.

Dental healthcare is part of essential healthcare provision and we want to make sure everyone has the support needed to continue to offer a reasonable throughput of patients and offer essential dental services. We are aware this needs to balance the unprecedented demands on the workforce, to maintain social distancing in staff rooms, use enhanced PPE and implement appropriate fallow time requirements for AGPs etc. We have therefore suspended the UDA activity targets. However, Welsh Government and Health Boards will be benchmarking the numbers of unique patients seen, to give assurance that the investment made, is supporting recovery of dental delivery as intended in line with necessary SOP requirements and our vision for more preventive, needs-led dentistry. These data will be shared and reviewed with Health Boards and practices, together with the ACORN findings, over the next couple of months and will be used to support decision making in quarter 4 so please ensure that you complete and submit FP17Ws promptly.

The news of the national firebreak will be concerning for everyone, in particular where you or members of your teams are juggling childcare and caring responsibilities with work responsibilities, wider family pressures can all impact on mental health and some may have health conditions which bring their own level of challenge. Please continue to support those colleagues who need to make changes in response to these lockdown measures and seek advice from professional representative bodies, regulators and health board colleagues who can offer advice.

You will be aware that guidance, to ensure a consistent and resilient UK wide IPC approach for dentistry, has been published this week. It is issued jointly by the Department of Health and Social Care (DHSC), Public Health Wales (PHW), Public Health Agency (PHA) Northern Ireland, Health Protection Scotland (HPS), Public Health Scotland, Public Health England and NHS England.


Given the current rising community transmission we plan to continue with the delivery of dental care services in Wales during the forthcoming period of lockdown using the current SOP. All the relevant mitigating factors mentioned in the new guidance are included.

Given the release of the new dental IPC appendix the SOP will be reviewed, once we return to lower community transmission. In addition, please be aware that as infection rates rise, there will be added pressures on PPE supplies and practices are reminded, that they can use FFP2 and reusable FFP masks in accordance with the SOP.

Finally, we appreciate that currently there may be some difficulty in obtaining face to face Basic Life Support (BLS) training which may result in a certificate being out of date. The GDC expect dental professionals to follow the advice of the Resus Council. However, if it is not possible to obtain the normal face to face BLS training then it will be acceptable in the interim to obtain online training combined with practical training delivered within the dental practice by one of the dentists. This practical element should be recorded appropriately including information such as who delivered the training and an “attendance record”. In addition dental team members should have either booked or have evidence that they are on a waiting list to receive BLS training from their normal BLS training providers.

HEIW will be offering online training which complies with the Resus Council guidelines and this will be supplemented by the regional Resus Officers attending practices to undertake the competency element on a socially distanced basis.

We will continue to keep you updated on arrangements, how we are responding to the latest ministerial and public health advice and what this means for dentistry.

Thank you again for all you are doing and please take care of yourself and your teams during the weeks ahead.

Yours sincerely,

Colette Bridgman - Chief Dental Officer

Warren Tolley - Deputy Chief Dental Officer

Paul Brocklehurst - Deputy Chief Dental Officer

The official letter can be found here.