Jason Wong, the new deputy CDO, discusses his return to practice and where he sees dentistry – and PPE requirements – heading in the near future.
When did you resume face-to-face treatments?
We happily resumed face to face at 10:30am on the 8 June 2020. We had a staff induction at 8:30am and recorded the session.
Did you offer AGPs straight away?
No we didn’t, but we fit tested the team on the first week, but held off till the 15 June before offering AGPs. This was so that the team had time to adapt to the implementation of our new standard operating procedure. I had worked on the national piece of work, so it was just the case of adapting it to the practice. Our team adapted to it brilliantly almost from the beginning.
So much of dentistry involves an AGP that we found little amount can be achieved without it. We worked a two-surgery system in order to take into account the fallow time.
How have you found it being back in practice?
We were so pleased to be back, but we were absolutely aware that there may be concerns from team members. We made sure that we had the most positive and adaptable members of the team back first.
The team returned to work more enthusiastic than they were before and I have found the patients were so grateful. Not just those who had issues but when we started on routine treatment, they were happy to be able to access care.
We were pleased that by the end of the week starting 15 June we were able to declare that no patient of our practice was still waiting for urgent care.
We phased it as follows:
- 8 June non-GP urgent treatments
- 15 June AGP urgent treatments and some discontinued treatments
- 22 June discontinued treatments and any urgent treatments
- 29 June discontinued treatment and routine treatments.
What have been the biggest challenges?
Adjusting to the enhanced PPE and arranging our work to fit in with the standard operating procedure. From a practice owner’s perspective, it was the constant decision making from how to apply operating procedures to our patients to how to work out the priorities. We ended up with several lists that had to be sorted through and that was a slow process.
What would your advice be for other practices?
Always act in the best interest of patients. Implement the operating procedure that works best for your particular setting and think through the implications for the whole team. Educate the team. Improve communication – we have a workplace software (Slack), which means we can communicate well with the team.
We have always had a daily team huddle in the morning so we conducted this over Zoom. The practice staggered start times, lunch times and finish times, which is helpful. We also implemented mask wearing throughout the practice even when there were no patients in the building.
We put a screen up, despite not having used the waiting room yet.
Do you think dentistry is sustainable in the current state?
This depends on the balance of the practices. I think the NHS payment for 1/12th has protected practices with a large NHS commitment. This is a novel virus, so evidence for anything to do with this is weak. But much work is ongoing about the evidence and that may mitigate some of the requirements.
We have always had a cautious approach as a country but opinion as to what the requirement should be is largely split in our profession. There were some associations and organisations that were calling for more stringent protection.
The good time will be when we return to incident threat level two. Here, we are likely to be able to return to PPE levels we had pre-COVID. In the meantime for me, we simply have to do what we can to continue to provide care.
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