‘Level of uncertainty’: fears of further lockdowns as practices in Wales fight impact of pandemic
At the start of the month, Wales was the first UK country to announce a reduction in fallow time.
If the necessary precautions are in place, CDO Colette Bridgman confirmed a minimum of 18 minutes is now appropriate for AGP treatments.
But access troubles and concerns over the possibility of further lockdowns continue to plague the profession, prompting calls for action.
Last week, the country introduced its first localised lockdown in Caerphilly country following a spike in coronavirus cases.
We heard from Owain Dimmick, of the Independent Dental Association Wales, who discusses the key concerns currently faced by mixed and private dental practices.
Are many practices reporting risk of closure?
The majority of mixed and private practices in Wales (probably across the UK too) are feeling very vulnerable at the moment. Thankfully, we are not currently facing the immediate threat of bankruptcy. We did, perhaps, in late March through to July.
The IDAW applied significant pressure on Welsh government by directly questioning their policies and the initially very restrictive SOP.
We have since worked with the CDO for Wales and managed to bring down fallow times. We are grateful that she has listened to our concerns. The current SOP is clearly an improvement over its predecessor – but there is still more work to be done.
Are there any backlog problems?
Currently, our members are reporting that private and mixed practices have mostly caught up and there aren’t significant backlogs at their practices. However, they are reporting high numbers of phone calls from patients who are struggling to access dental services.
What are the key issues currently faced by practices in Wales?
There is no denying that margins for private dentistry have got tighter. There is a level of uncertainty which we are not used to. The CDO for Wales has confirmed that we will not be subjected to ‘red alert’ restrictions again. If local lockdowns do occur then a temporary ‘ high amber’ alert (urgent/continuation of care only) would be imposed. But there is an element of clinical judgment.
The main worry would be if the government moved away from local lockdowns and instead tightened up restrictions across the whole country. The ‘high amber’ alert status is manageable for a short period. But anything longer than a couple of weeks would cause significant financial difficulties.
Other factors likely to cause problems would be the risk of staff having to self isolate due to unwell children. Or if childcare is needed for children sent home due to being part of a bubble with possible exposure to COVID-19. As all parents will already know, as soon as their kids go back to school, coughs and colds are commonplace.
In previous years this would have meant perhaps one or two days of sick leave to care for an unwell child. Now, however, it involves trying to get a COVID test potentially hundreds of miles away, or possibly two weeks of isolation. This is likely to lead to teams becoming short staffed and having to cancel appointments at short notice.
What do you think needs to be done?
The SOP, whilst much more workable, is still lacking the level of evidence we are used to as dentists. We would like further de-escalation to continue as the data emerges from countries with less restrictive SOPs than ours.
So far, we are yet to see any reports of dentistry being the cause of any local outbreaks.
We would also like all dental workforces, including private practice staff, to have access to testing as a priority to ensure adequate service provision. We also hope for all dentists to be offered the vaccine as soon as it becomes available.
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