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Guidance for providing remote prescriptions which has been agreed with Sheffield Local Pharmacy Committee (LPC):

In order to make providing urgent prescriptions easier, minimise the need for patient travel and face-to-face contact and in line with the COVID-19 Advise-Analgesics-Antimicrobials guidance Jim has very kindly put together some guidance which we hope you find helpful:

Where you need to issue an emergency prescription please use the following process in order to avoid the patient needing to come to the practice in person to collect the written prescription:
1. Ask the patient which pharmacy they want to collect the prescription from.
2. Write the prescription as normal
3. Telephone the pharmacy (if in doubt, google the number) informing them you have an urgent prescription needed, the patient’s name, the prescription details & confirm the pharmacy’s NHS email address to email them a photo of the prescription
4. Photo the completed prescription and email it to the pharmacy’s NHSmail with the subject:
URGENT DENTAL PRESCRIPTION - “patient name”
4. Put the paper copies in the post to the pharmacy or hand deliver these at the end of the day if it does not mean unnecessary travel (Legislation sets out that the paper copy should be received within 48 hours).

If possible please send via an NHSmail email account, but this is not essential.

Remember you can add NHSmail to many smartphones - works well on iPhones, though you may need to change your password a bit more often!

Thank you for this Jim!

SY LDC’s interpretation of the CDO’s letter dated Mar 18th 2020

As you are probably aware, the Chief Dental Officer has recently responded to concerns from the BDA about a lack of guidance.

https://bda.org/advice/Coronavirus/Documents/CDO%20England%20Response%20to%20BDA%20COVID19.pdf

The CDO is clear to emphasise that the has great confidence in the profession’s clinical judgement and has included a live link to the NHS England COVID-19 guidance “standard operating procedures” which has a number of further links to related documents. This document will be updated as the disease and our knowledge of it develops and so it is important to check it regularly for updates. Unfortunately we are not aware of any updates on the guidance for asthmatic or pregnant professionals.

We are all aware there has been a lot of and frustration and confusion during what is already a stressful time of the year for many and unfortunately the standard operating procedures are themselves open to interpretation and so we, as the four South Yorkshire LDC’s reps, wanted to share our opinions and general interpretation of the current document and some of the other precautions we have put in place in our practices. We hope that you find them useful.

Please bare in mind we are not saying this is what you must do and please continue to use your own professional judgement to your own circumstances but here is out interpretation. As new guidance is issued we will try and keep this up to date and if you disagree with, have further information available or wish to add clarification to statements on this list please do email us.

Again, please keep checking the “standard operating procedure” in case of changes and for the latest guidance.

https://www.england.nhs.uk/wp-content/uploads/2020/02/20200305-COVID-19-PRIMARY-CARE-SOP-DENTAL-PUBLICATION-V1.1.pdf

  1. Update patient reminder texts/e-mails etc to advise patients with COVID-19 symptoms not to attend
  2. Encourage staff and patients to ensure excellent hand hygiene, to avoid touching their faces (harder than it sounds), avoid touching handles/handrails/surfaces where possible (consider propping open waiting room doors if suitable), etc
  3. Advise patients not to attend with other people unless absolutely necessary
  4. Cancel all routine appointments for at risk groups (over 70’s, COPD, heart conditions, immunocompromised, etc)
  5. Give others the option to cancel if they wish
  6. These gaps can then be offered to other patients to help finish open COT, reduce future load, etc
  7. DO NOT treat patients who have potential COVID-19 symptoms or who are in isolation due to COVID-19 in their household, etc. Direct these to 111
  8. Everyone who arrives at the practice should be asked at reception whether they have symptoms which have started within the last 14 days of a cough, high temperature or shortness of breath, have been in contact with someone with confirmed coronavirus or have been advised to self isolate – if so immediately politely ask them to leave, self isolate and call 111. If they are unable to leave under their own steam then isolate them, preferably with a phone available, and phone 111 for advice.
  9. Consider adding a “COVID-19” option for “reason for cancellation” on your software to distinguish this from a normal DNA or SNC and as this will help provide evidence of “Force Majeure” in the seemingly inevitable underperformance of UDAs/UOAs next year
  10. If an “at risk group” patient tries to book an emergency appointment, consider is it a true emergency (pain, infection, etc) or could it be left as is currently (asymptomatic lost filling, Maryland debonded, etc) which may be better left until a later date
  11. Consider “if this problem was left for the next 6 months does it risk the patient having to attend A&E or ringing 111 and place more burden on the system” particularly if they are currently showing no signs of COVID-19
  12. Continue to see exams, extractions, denture stages (under 70) and other non-aerosol creating procedures as normal
  13. Handscale rather than using ultrasonics. If unable to provide the treatment with handscalers alone then consider whether it is strictly necessary at this time.
  14. RCT or restorations done under rubber dam should theoretically be fine as although there will aerosol it should not contain saliva so should not be infected.
  15. For fillings that NEED to be done, only use slow hand piece where possible, stabilise if unable to remove all caries. If air rota is required use rubber dam.
  16. Either wipe down pens or Ipad pens between patients or use verbal consent and record this in the notes as advised by the Scottish CDO. 
  17. When using 3 in 1 avoid air and water together wherever possible. When using air have high volume suction on the area and use other isolation methods (cotton wool rolls, parotid pads, etc) to reduce the need for drying. 

We hope that you have found that helpful and welcome any feedback or further questions you may have. These are challenging and uncertain times but are here to offer help if we can and will do our best to update this if further guidance is released and we think it would be useful.

Sheffield Local Dental Committee

Salvation Army Sheffield Citadel Corps,
10-12 Psalter Lane,
Sheffield,
S11 8YN

Meetings held at 7pm on the third Wednesday of every month

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