Further to our recent updates about the resumption of routine dental activity from 8 June 2020 (which can be viewed here and here), late yesterday afternoon the Chief Dental Officer for England and NHS England published the new Standard Operating Procedure (SOP) Transition to Recovery - a phased transition for dental practices towards the resumption of the full range of dental provision.

For those practices feeling under pressure to resume normality from Monday, it is immediately apparent from the SOP that the expectation of what practices should hope to deliver from Monday is low, with the CDO stating "the baseline expectation is for practice based urgent dental care provision" and that in turn only applies to those practices with appropriate personal protective equipment (PPE) and infection prevention and control (IPC) measures in place. 

Some key points which jump out on first reading of the SOP include: 

* Practices are advised to appoint a COVID-19 lead (and deputies if necessary) to take responsibility for tasks such as keeping up-to-date with all guidance, liaising with NHS England and monitoring PPE and IPC stock levels.

* Throughout the transition from initial operating capability to full operating capability, remote consultations should remain the first point of contact.  Remote consultations should also include the dental triage and COVID-19 risk assessment. 

* The applicable standards for PPE and IPC are those produced by Public Health England and must be followed.

* Where treatment is planned:

 - Care planning should focus on achieving stabilisation;

 - Intervention should be kept to a minimum, to reduce exposure risk;

 - AGPs (aerosol generating procedures) should be avoided where possible and only undertaken if the practice has the appropriate PPE for AGPs (i.e. disposable, fluid-repellent gown, gloves, eye/face protection and an FFP3 respirator for all those undertaking or assisting in the procedure);

 - All treatment should be completed in the minimum number of visits possible;

 - When an AGP has been undertaken, it is recommended that the treatment room be left vacant for one hour before cleaning is carried out.

* There is continued emphasis on supporting the dental team, both in terms of mental health and wellbeing and training and development on issues such as IPC. 

* No dates have been specified for routine resumption of moderate risk procedures.  Rather, the decisions on pace and patient priorities are left to the clinical leadership in each practice. However, considering the array of guidance produced this week alone, it seems very likely that  further guidance will be forthcoming during the weeks ahead. 

The full guidance can be accessed here

Please don't hesitate to contact Andrea James or Nicola Lomas of Brabners' Healthcare Team should you need assistance in relation to any COVID-19, return to work or other legal issues in dentistry.