Safety, not activity targets, must be the priority
The Faculty of General Dental Practice UK (FGDP), College of General Dentistry (CGDent) and the Faculty of Dental Surgery of the Royal College of Surgeons of England have issued a joint message that safety must take clear priority over dental activity levels during the latest national coronavirus lockdown.
The leading dental organisations have also highlighted the continued applicability of their guidance, and reiterated the need to consider the prevalence of COVID-19, and local rates of infection, when carrying out risk assessments.
Ian Mills, Dean of the FGDP, said:
Many patients have been unable to access dental care for over a year, with their dental problems getting steadily worse, and oral health inequalities exacerbated by coronavirus restrictions. The dental profession is acutely aware of the present backlog of unmet dental need, which requires treatment as soon as possible. However, the recent imposition of UDA (Units of Dental Activity)-based targets in England to remedy this, just as the pandemic becomes worse than it has ever been, is at odds with the Government's message to 'stay at home to protect the NHS and save lives'. The dental profession has worked assiduously to create a safe environment for dental treatment to be delivered, but there are justifiable concerns that significant increases in patient throughput, in order to meet UDA targets, could potentially compromise staff and patient safety. The UDA was an ineffective measure of activity before the COVID pandemic, and we consider it even less appropriate now. Circumstances will vary by practice and by patient, but the priority should be on safety, the treatment of those with acute needs, and essential maintenance of oral health.
Matthew Garrett, Dean of the Faculty of Dental Surgery of RCS England, added:
Positive tests for COVID-19 and COVID-related deaths are at record levels, emergency departments and intensive care units are under severe pressure, and hospital staff are stretched like never before. Dental teams have robust infection prevention and control protocols in place, which can reduce the risk of transmission if rigorously applied, but we cannot eliminate it altogether, not least given the risks inherent in patients travelling to appointments. Encouraging greater throughput at the present time may not be in the best interests of patients with routine oral health needs, nor does it support the NHS and the national coronavirus response. However, the public should be reassured that dental practices are safe places to visit if they need to access urgent care.
Mick Horton, Trustee of the CGDent, was the college's lead representative on the group which developed the FGDP-CGDent guidance, Implications of COVID-19 for the safe management of general dental practice. He commented:
The risk-based approach we set out in our guidance is adaptable to each national alert level, aiding the revision of practice protocols to ensure they remain appropriate over time. Though dental practices remain open in the latest national lockdown and patients are permitted to attend, the high prevalence and transmission rates of coronavirus at present, which underpin the rule to avoid non-essential travel, are important factors to consider in risk assessment. Practices which conclude that the responsible course of action at present is to postpone certain appointments should not be penalised for serving the greater good.