COVID-19, Practice Closure Information

COVID -19, Practice Closure Information

COVID - 19 WE’RE HERE TO HELP Henry Schein takes seriously its commitment to helping healthcare professionals manage the impact of the COVID-19 outbreak. We strive to be a valuable business partner that our customers can rely on to help operate efficiently and deliver quality patient care. We are always ready to stand by you during these challenging times.

Please contact us or visit henryschein.co.uk for more information

RELY ON US Plan your next steps with this checklist

Practice Owner’s Checklist

Practice Owner’s Checklist If you are completely closing your practice or reducing your workload to emergency treatments only, you might be looking for some information and resources to help you plan your next steps.

This checklist will provide some useful information and contact details to help you prepare for this difficult period. There are a number of experts and professional bodies who will be able to help you make the necessary arrangements. Top of the list will be your accountant, who will be able to advise you on those areas where you can make savings and manage your finances.

There’s also a proliferation of online webinars for dentists, technicians and DCPs which are mostly free to join and offer a great opportunity for you to ask specific questions you have about the current situation. Remember, you are not alone, there are many people in the same boat.

Contents Before you close 3 Who should I tell if I close my practice?

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Dealing with your staff

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Information on furloughed workers from the BDA

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NHS treatments: the Financial Impact

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Self Employed

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Protecting your premises

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Business interruption cover

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Other costs

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Lloyds Bank Cardnet

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Government support

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While you are closed

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Help in the community

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Information and links 12 2

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1. EQUIPMENT DECOMMISSIONING

It’s vital, should you need to temporarily close surgeries, that your equipment is correctly prepared for a period of sustained inactivity so that it is ready for use when you reopen and importantly, it is compliant with your practice insurance.

The Henry Schein technical service team can also ensure the correct protocols for your equipment are followed, which will help reduce possible issues when you return to work. Please contact our service desk on 0292 044 2806 or email equipment-servicedesk@henryschein.co.uk to book an appointment for an engineer to come and help you. This work can be completed one or two weeks after the practice has shut. All we need is access to the surgery for our engineer, so there will be very little risk of cross infection.

For further information on decommissioning decontamination equipment, treatment centres, ultrasonic baths, x-ray systems, compressors etc please checkout our youtube decommissioning playlist and visit our equipment website and refer to the user manuals and manufacturers’ guidelines.

help you with patient communication, remote access to your software, appointment rescheduling, and any other general queries you may have.

Practice Owner’s Checklist

Before you close

If you are an EXACT customer and you still need a remote licence for EXACT, please contact: 01634 266802 or email contactus@ soeuk.com.

Practices that will be offering emergency treatments should add text to their online booking service advising customers to refer to the latest information on coronavirus before their appointment. If you are an EXACT or Dentrix Ascend customer, you can visit softwareofexcellence.co.uk/covid19/ to view a tutorial about how to do this on your system.

Software of Excellence support lines remain open as usual (01634) 925049 (UK) or 014944001 (Ireland).

It’s important to be transparent with your patients, so that they understand how you’re handling the situation.

2. REMOTE ACCESS

Test your remote access to necessary systems before you shut the practice. Make sure all employee contact information is up-to-date, as well as contacts for all your key business partners and check you have access to this data and your patient contact details remotely.

3. PRACTICE MANAGEMENT SOFTWARE

Contact your software provider to see how they can help. Software of Excellence is maintaining a full support service and the team is available to Contact our service desk via email equipment-servicedesk@henryschein.co.uk

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Practice Owner’s Checklist

Who should I tell if I close my practice?

The BDA has issued specific guidelines as to which organisations need to be informed of a practice closure.

•• Inspecting body: You will need to notify the relevant inspectorate if you close the practice for more than 24 hours, this is the CQC in England and the HIW in Wales.

•• Relevant authority: In England, you must send a closure notification to the Local Area Team (LAT) to prevent breaching your NHS contract. We recommend agreeing arrangements now for emergency cover with other local practices in case they are needed and notify the LAT of these arrangements with your closure notification.

In Wales, the Health Board should be notified.

In Northern Ireland, the HSCB and RQIA should be told.

•• Inform your regional commissioner who will then inform the Directory of Services (DOS) lead so that 111 are up to date with the correct information.

•• Patients: We also advise that you contact patients if the practice has to be closed and don’t forget to put a message on your website to inform customers of their local urgent care centre.

Make sure you are registered to receive CAS alerts directly from the MHRA

Dealing with your staff Your staff will be one of your biggest concerns and it is likely you will have to make some difficult choices: Practice owners are faced with the following options:

•• Lay-off employees on guaranteed pay •• Agree reduced hours for proportionately-reduced pay •• Consider making staff redundant.

The government is keen to avoid redundancies if at all possible. That is why it has introduced payments for furloughed workers. However, practices may be able to make staff redundant, but there is a procedure to follow.

•• Utilise the government’s furlough scheme to keep staff employed on 80% pay Click here for more information from the BDA. 4

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The government is very concerned that many workers are going to be made redundant or laid off without pay. This will have a devastating impact on them as individuals, and on the wider economy. The government is therefore prepared to pay up to 80% of the wage costs of workers who are not needed at this time.

You may, with their agreement, designate employees as furloughed workers. This includes employees who are currently self-isolating. You can then submit information to HMRC about the employees that have been furloughed and their earnings, through a new online portal that HMRC will set up.

HMRC will reimburse employers 80% of furloughed workers' wage costs, up to a cap of £2,500 per month.

HMRC has not yet provided details.

Employers will not have to top up the remaining 20% of the furloughed workers’ pay but you may choose to pay more if you wish. A draft letter can be found here.

For information on managing your staff and the process contact Petaurum Solutions.

They will help you answer questions such as: •• How do I select which staff to furlough?

•• Can staff do any work for me while they are furloughed?

•• Are they allowed to work on CPD? •• Do I have to offer them employment at the end of the period?

•• How do I pay my staff whilst they are furloughed?

•• How do I claim a furlough rebate?

•• How do I treat someone coming back from maternity leave?

•• Can I operate a rota between staff if I offer private and NHS treatments?

•• The minimum number of days staff can be furloughed is 3 weeks. So you can bring them back from furlough and refurlough as your needs require. They should be paid in full while they are working.

Practice Owner’s Checklist

Information on furloughed workers from the BDA

MIXED PRACTICES:

The BDA understands that NHS England confirms that the application of the principles outlined in the preparedness letter of 25 March 2020 for practices benefitting from continued NHS funding are intended to apply to NHS income only. Contract holders wishing to claim against additional Government support schemes should ensure that this is in relation to the proportion of private revenue only.

In line with the methodology of determining private and NHS income used for business rates reimbursements contractors are advised to use the proportion of gross income that relates to GDS/PDS contract value as NHS revenue, the balance being private share.

Those contractors who claim business rates reimbursements will have this data readily available.

NHS England expects that as part of the 2020/2021 reconciliation process practices will be expected to declare that they have not applied for any duplicative Government funding and provide evidence of the portion of NHS/private income used in any applications for additional support.

Click here for the 3 April 2020 update Scotland

Northern Ireland

Contact our service desk via email equipment-servicedesk@henryschein.co.uk

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Practice Owner’s Checklist

NHS treatments: the financial impact Please click here to visit the BDA site which is constantly updated.

Because of the disruption caused to the current month, for the purposes of calculating year end contract delivery, NHS England will now consider the current year to be March 2019 to February 2020, and will apply March 2019 data instead of March 2020 to contractual performance.

For the financial year 2020-21, NHS England will continue to make monthly payments that are equal to 1/12th of current annual contract values.

The BDA will then work with NHS England to consider contract value and reconciliation in 2020-21 to take into account the difficulties of delivery for the period of the COVID-19 pandemic.

Contract delivery and year end payment will be assumed to have been maintained at a level that allows continued employment of staff (despite reduced actual activity).

From NHS England

• For contracts delivering above 96% over this period we will then operate normal year end reconciliation with the ability to carry forward activity to 2020; and • For contracts delivering below 96% over this period we will enter into normal clawback position up to 100% of total contract value (TCV).

Ongoing updates from NHS England can be found here

As your contract completion will be affected

by COVID-19, we suggest that you monitor and record cancellations that arise as a result of the virus. This information will be useful when your NHS contract is complete.

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EXACT customers can visit softwareofexcellence.co.uk/covid19/ to find out how to record a new reason for cancellation.

You can also sign up for SOE’s weekly newsletter and request your guide on how to suspend patient communications.

Software of Excellence support lines remain open as usual (01634) 925049 (UK) or 014944001 (Ireland).

The mortgage or rent on your property is one of the major overheads for any business. If you think you will be unable to meet your rent or mortgage obligations, you should contact your landlord or mortgage company immediately and request a three-month payment holiday or deferment. The government has offered some support in this area and it was announced last week that commercial tenants unable to pay rent because of coronavirus will be protected from eviction for a three-month period. For practices that have financial support measures in place, the General Dental Practice Allowance, rent reimbursement and individual commitment payments will be protected.

Practice Owner’s Checklist

Protecting your premises

Business interruption cover Business interruption insurance covers a business for loss of income during periods when they cannot carry out business as usual due to an unexpected event. It aims to replace certain losses sustained by the business during the period of the disruption. However, the Association of British Insurers has warned that only a small number of companies in the UK will have cover which allows them to claim on their insurance for the impact of the Coronavirus pandemic. Most practices will not be covered for closures due to COVID-19. The BDA continues to lobby insurers and government, on behalf of the dentists all over the country.

Contact our service desk via email equipment-servicedesk@henryschein.co.uk

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Practice Owner’s Checklist

Other costs In these uncertain times, cost containment is vital. There are a number of other overheads that may be able to be cancelled, temporarily suspended or payment deferred for a period of time.

•• Cleaning services •• Finance contracts - you may be able take out a contract to cover your existing payments or reduce your current contract payments.

•• IT solutions’ provider •• Contact companies with whom you have any •• Dental protection. If you are not practising, loans or finance contracts to check whether you may be able to suspend these payments, deferment is possible. and this can be quite a significant saving if •• Rates – you can apply for empty property you normally perform ‘high risk’ procedures relief (up to 3 months rates free). Contact your such as implants. Further information can be local billing office. found here •• Buildings and/or contents insurance •• Phone and Wi-Fi For Henry Schein, please visit our useful information page for the relevant contacts.

Lloyds Bank Cardnet If you are a Lloyds Bank Cardnet customer they will be helping support your business during this time. From 1 April to 30 June 2020, Lloyds Bank Cardnet will be waiving some fees and charges. Lloyds Bank Cardnet won’t charge the following fees: Payment Card Industry Data Security Standard (PCI DSS) Fees and Charges Minimum Monthly Charge (MMC) Refund Fees – Lloyds Bank Cardnet will not charge these starting from 1 March 2020 but in some instances may charge you initially and then refund you.

All usual transaction fees will still apply and from 1 July 2020, your fees will go back to the same as they were before Lloyds Bank Cardnet made these changes.

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Safeguarding your business and customers: please continue to comply with industry security standards to safeguard your customers and your business against theft and fraud. You can find more information here If you are concerned about the impact of coronavirus on your business, Lloyds Bank Cardnet have put in place some support and information to help at lloydsbank.com/ business If you would like to talk to Lloyds Bank Cardnet about how they can help you and your business at this time, please call on 01268 567100.

Chancellor Rishi Sunak has pledged additional support for business, on top of measures set out in the budget. These include: •• Coronavirus job retention scheme covering 80% of workers’ salaries •• Government-backed loans of £330 billion which have been made open to all businesses •• Business interruption loans, with no interest for 6 months, will be available

Grants

Self employment income support scheme (SEISS)

Grant of 80% of your trading profits up to a maximum of £2500 per month Only available if sole trader or member of partnership

Must have been trading in 2018/19, 2019/20, and intend to continue trading in 2020/2021

Corona Job Retention Scheme (CJRS)

Grant of 80% of your basic wage (no fees, bonuses, commissions) up to a maximum of £2500 a month

•• £10,000 extra cash grant for the smallest businesses.

•• Support for the self-employed currently excludes anyone earning over £50,000. This has an impact on dentists and those in private practice with no access to ongoing NHS earnings. The BDA is lobbying the Chancellor and the Health Minister to extend this financial support.

More details click here.

Loans and deferrals

Coronavirus business interruption loan scheme (CBILS)

Loans between £1000 and £5 million

First 12 months’ interest and charges paid by the government

Practice Owner’s Checklist

Government support

Additional state benefits Statutory sick pay (SSP) Ability to recover cost of SSP from government Not available to sole traders

Need to make business proposal that would otherwise be viable ignoring COVID-19

Self-assessment tax deferral July PO deadline automatically deferred to January 2021

Furlough requirement

Relevant if employed by your PSC

VAT payment deferral Option to defer any VAT payment due between 20 March and 30 June 2020 Must be paid by 31 March 2021

Universal credit Might be available if on low income or out of work Household savings and partner’s income must also be taken into account

Employment and support allowance Available to sole traders

Must be unable to work due to having COVID-19 or be following government self isolation guidelines Can claim universal credit at the same time

Mortgage payment holidays Not ‘interest’ holidays

Typical period of 3 to 4 months

Council tax reductions and holidays Varies between councils

Time to pay arrangements Accessed via dedicated HMRC helpline Case-by-case basis; must be suffering financial distress

Contact our service desk via email equipment-servicedesk@henryschein.co.uk

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Practice Owner’s Checklist

While you are closed TELEMEDICINE AND REMOTE PRESCRIBING

You can continue to offer advice and appointments to your patients via video conferencing or phone calls for urgent or emergency appointments. There are many applications that offer free conference facilities, so take advantage of Microsoft Teams or Zoom.

The FGDP website is invaluable and offers nation-by-nation clear information and updates on urgent care arrangements. It also covers: • Telephone triage and assessment • Remote prescribing and advice

• Reducing the risk to dental professionals and patients

• Definitions of routine, urgent and emergency care • Aerosol generating procedures • Record keeping

The list of emergency hubs for England is here The range of conditions provided for by local Urgent Dental Care Centres can be found here

You may be able to make up analgesic and antibiotic kits which you can post out to patients.

Alternatively, dentists can offer remote prescriptions by contacting local pharmacists.

The pharmacist can supply a medicine provided the dentist undertakes to provide a physical prescription within 72 hours of making the request (Human Medicines Regulations) For excellent triage advice from the British Endodontic Society, click here For GDC information please click here.

For General Medical Council information please click here To sign up for the AQA COVID-19 dental bulletin service here

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SOCIAL MEDIA

If you’re on social media already, think about how you can continue to communicate with your patients. Can you offer them any advice, either online or over the phone? Could you set up a conference call dealing with any questions at a set time each day? Think about whether you could offer your staff private prescriptions by email?

Remember, if you are only doing emergency treatments you cannot promote your opening hours.

Whatever you decide, social media is a great platform for you to keep talking to patients. It’s free and more people than ever are now using it.

If you haven’t already got an account on each of the major platforms: LinkedIn, Facebook, Instagram, Twitter, this is a great time to do it and connect with all your patients.

CPD AND ONLINE LEARNING

This is a great opportunity for you and your team to catch up on CPD. Visit hsdeducation.co.uk and click on the online learning tab for details of all the useful webinars we can find that might support you in this time of need.

Software of Excellence are running a series of on-demand webinars on Navigating the COVID-19 pandemic and how to ensure your practice bounces back.

Dentinal Tubules are offering a month’s free membership as well as free online conferences Monday to Friday #TubulesLiveAid – Coronavirus special edition. 5-6 webinars daily to provide help, support and facts beyond clinical dentistry to help overcome the challenges of these uncertain times. Visit dentinaltubules.com for more information.

3Shape have launched an online learning hub with webinars, virtual classrooms and 121 training sessions on making the best use of your 3Shape digital equipment.

WEBSITE You should keep your website up-to-date whilst you are closed, with information for patients about how they can contact you, how to access an emergency appointment, what’s happening at the practice and when you are likely to re-open. Remember communication is KEY. RECRUITMENT If you’re making any staff redundant at this time, please refer them to MediCruit, The UK’s largest dental jobs agency.

WELLNESS It’s important to stay mentally as well as physically fit during this period of lockdown.

Petaurum Solutions can offer you advice on wellness and BDA members suffering from stress can receive counselling and emotional support through the BDA’s Health Assured service. To protect your mental health and that of your staff please stay in regular contact with your team.

Practice Owner’s Checklist

While you are closed

FINANCIAL SUPPORT Dentists in financial hardship can apply to the BDA Benevolent Fund for financial assistance.

Contact our service desk via email equipment-servicedesk@henryschein.co.uk

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Help in the community Mark Topley – The CSR Coach can offer some ideas about helping your business through COVID-19 especially around about how you can help support your community.

More information can be found here or you can schedule a complimentary call with Mark to discuss – bookable online

Information and links There is lots more information on the Henry Schein website. www.henryschein.co.uk and a new Coronavirus resource centre with links, webinars, checklists, and useful contacts.

t 0800 023 2558 e info@henryschein.co.uk w henryschein.co.uk HenryScheinUK

Please visit http://www.henryschein.co.uk/gb-en/Dental-GB/LegalTerms.aspx for full terms and conditions. E & OE.

HSD156-03-20

Henry Schein Dental, Medcare House, Centurion Close, Gillingham, Kent, ME8 0SB.