COVID-19 Update

Shielded Patients

On May 28th, after nearly 12 weeks of being closed for direct patient contact, we were advised that we would be able to resume face-to-face visits with our patients as of the 8th of June 2020

As you can imagine, this return to work has been subject to a change in our working conditions

The Standard Operating Procedure (SOP) recognises that in particular, clinically extremely vulnerable patients would benefit from a domiciliary visit to protect them from the possibility of contracting COVID-19 outside their home environment.  As such, we have extended the eligibility of domiciliary care to cover Clinically extremely vulnerable (formerly shielded) patients in addition to our traditional patient groups.  The SOP recommends that patients who are clinically extremely vulnerable and require urgent care would benefit form a domiciliary visit if a telephone consultation is not appropriate.  See here for details regarding shielding

For more information, see the simplified algorithm at the bottom of this page

Staff Precautions

In addition to undertaking daily testing for temperature and COVID-19 symptoms, our staff have access to COVID-19 swab tests.  It is our policy that any members of staff who exhibit symptoms should remain in isolation as per recommended guidelines or until a swab test returns negative.  This allows us to remain confident that our staff are low-risk health care workers at all times.  As of January 2021, all our members of staff will be undertaking daily rapid-result COVID tests to ensure all our contacts remain safe.  All our staff are double-vaccinated against COVID-19

Screening Our Patients

We understand that most of our patients are at ‘increased risk’ for harm from COVID-19 (see here for details), and we are trying to minimise the risk of community transmission of COVID-19.  When making appointments, we will therefore be trying to ascertain the COVID-19 risk of each patient and their household.  If a patient – or any member of their household:

  • has shown symptoms of COVID-19, (see here for details) or,
  • has received a positive test for COVID-19 or has been told to isolate (and is within that isolation period),

we would be unable to make a home visit.  We will instead attempt to deal with problems over the telephone or via a video-call and give advice and prescribe medication as appropriate.  For urgent dental issues, we will be able to refer patients to a ‘hot’ UDC, where patients with confirmed or suspected COVID-19 infection are seen

We will avoid any high-risk procedures such as aerosol-generating procedures (AGP – e.g. the use of the scaler and the ‘drill’) whenever possible, at this time.  Examination, denture work and the repair of teeth by manual instrumentation is considered low-risk

Prioritising Patients

As we start working again, we will need to prioritise some of our patients.  We will be identifying shielded patients and those ‘at increased risk’ for domiciliary visits.  We will also attempt to provide definitive treatment for those patients who had a remote consultation and a prescription issued during the time that we were unable to provide direct patient contact

We would like to reassure our patients that we will follow up-to-date guidelines on the prevention of cross-infection and the use of Personal Protective Equipment (PPE) for our mutual benefit at this time

Whilst we endeavour to minimize the risk of transmission of COVID-19 and take active steps in this regard, it is important to stress that direct contact is never risk-free, and it remains ultimately our patients’ choice as to whether to be seen by us at this time

Care Homes

In order to keep our staff and patients safe, we will amend our method of delivery in care homes.  In cases where care homes have suspected COVID-19 cases, but the patient in question is not suspected to be affected, we will make an individual risk assessment on the matter, depending on the means of isolation being employed

Where it has been deemed safe to do so, we will be happy to visit patients in care homes, with a few changes to the way we work:

  • We will endeavour to complete all relevant documentation in advance (ideally electronically) to minimise cross-contamination of surfaces
  • Patients should be awaiting our arrival in a treatment room or other private area as appropriate (ideally not a bedroom).  We will give prior notice of our visit
  • Patients are not to be accompanied by chaperones and other staff wherever possible
  • We will need a separate area to don & take off our PPE and practice hand hygiene before and after our visit
  • Social distancing is to be practiced where possible (e.g. hallways, doorways etc)
  • Patients will be asked to rub an alcohol gel on their hands and rinse their mouths with a disinfectant solution wherever possible

COVID-19 Risk and Domiciliary Care