Covid-19 Policy Patient Journey
This policy is based on multiple resources from within the dental professions, the government and our regulating bodies. It is likely to change depending on new scientific evidence that has been carefully evaluated and the recommendations provided by the Office of the Chief Dental Officer for England.
It outlines alterations to our normal procedures that we intend to employ once the practice can be reopened. It is not known at this time whether these procedures are temporary or whether they will become a permanent feature of the way dental practices must be run to ensure patient and staff safety in the future.
We would like to thank all of our patients for their patience during the period of temporary practice closure and for their continued understanding and cooperation whilst we implement new measures at the practice.
Our aim is to provide the safest possible environment for our team to provide dental care to our patients.
Our proposed timetable for a return to routine dentistry (which is subject to change)
Phase 1: The practice is open for patients who require emergency or urgent dental treatment. Our dentists will be triaging patients requiring urgent assessment and treatment by telephone consultation and where appropriate face to face appointments will be made. This will include those patients requiring follow ups from emergency triaging and referrals to Urgent Dental Centres (UDCs). It will then be extended to include other patient groups as the Tier restrictions and Covid risk levels allows and we proceed to the next phase. The dental team is prepared and has been practising our updated procedures in anticipation of an increased level of service.
Phase 2: When the Covid-19 Alert Level has been further reduced and restrictions are further lifted we will be able to see patients for routine dentistry from prior to lockdown and patients who were due for routine examinations and hygienist visits during the period of restricted access. Following on from this point, those patients have been in contact with us during the lockdown period will be contacted in due course.
We will be contacting patients by telephone and confirming appointments ahead of their scheduled time. We will request that all patients who are attending Thames Dental Surgery update their standard medical and dental history forms beforehand. These forms are available on our website in electronic format and during the next few months we will no longer be using paper forms. To assist us to communicate with you please update your contact Email address and telephone number. We have currently suspended our patient routine appointment reminder service so you will not be sent a letter or text message asking you to book an appointment. Reminders for booked appointments will still be sent via text message.
The assessment forms include a new section which will allow us to assess your level of risk for coronavirus infection before you attend the surgery, these questions will also be asked when the practice is making contact prior to your appointment.
You may find that appointment availabilities are limited as we will be seeing restricted numbers of patients. As time goes on we will expand the service until all three of our surgeries are operational but that is dependent on the guidance issued by the DoH, PHE and NHS England and the Covid-19 Alert Level.
We will ask that you please use your bathroom at home as we would not be able to provide restroom facilities during the initial phase of our return. Please remember to brush your teeth and use a mouthwash at home before your appointment and try not to eat or drink anything until after your appointment.
Over the last months we have been busy trying to actively ensure we have sufficient PPE supplies, prepare new protocols and undergo training for us to remain compliant and safe for your visit. The fallow time of between 30mins-60mins we have to observe between patients currently will inevitably affect our ability to offer appointments to patients to previous levels of service. Aerosol generating procedures carry higher risks and require enhanced protection equipment to enable the team to safely provide you with treatment.
Our pre-Covid-19 cross-infection control protocols are implemented into all clinical activity carried out at the practice were already to the highest standard. In comparison to public areas, dental practices are already very clean environments.
We have updated our cross-infection protocols based on guidance and measures that have been put in place in place by OCDO, NHSE and PHE. This will minimise risk of Covid-19 transmission within the practice.
When you see us next you will notice some changes affecting your visit. We have implemented these changes to help protect both patients and staff. Refusal to comply with them will unfortunately mean we cannot treat you.
In order to minimise the risk of Covid-19 transmission the changes you will see include:
Prior to attending the practice
All contact with the dental practice must be made by phone. We will not be accepting walk-in requests as the entrance will remain locked.
We will carry out a pre-attendance assessment including taking your completed Medical History and an assessment to determine your coronavirus infection risk before your appointment.
If you have any difficulties with completing the forms a member of staff can help you with this over the phone.
If the risk assessment indicates that you are at risk of having possibly been infected, even if you are asymptomatic, we will request for you to observe the government guideline on self-isolation and we will be unable to see you for a minimum of 7 days depending on your symptoms. If we are unable to contact you, we may need to cancel your appointment.
We will accommodate patients in the high-risk groups of developing complications from coronavirus in allocated slots at the beginning of the day. We recommend patients in these groups delay non-essential dental treatment for as long as possible until the government rescinds their shielded status.
Thames Dental Surgery will be operating contactless payment system. If at the time of your appointment you do not have a means of making contactless payment, we will request that payment is made online or over the phone for your appointment prior to you attending. We have introduced this to minimise unnecessary contact or use of pin entries on the card terminal at reception. If you are unable to make a card or online payment, then we ask you to place the exact cash amount in a sealed plastic sandwich-type bag.
In order to maintain social distancing and prevent overcrowding one adult will be able to attend with a child; please do not bring additional family members with you unless they
are happy to wait in the car or outside the building. There will be no facility for them to wait within the dental practice.
Arriving at the practice
When you arrive at the surgery please ring the doorbell located at the entrance. In order to ensure access to treatment face coverings must be worn unless exemption evidence can be provided. In order to protect our workforce and other patients we reserve the right to refuse access to patients refusing to wear a face mask. A member of staff will welcome you. If there is a delay you will be asked to wait outside or in your car and we will telephone you when the dentist is ready to see you. We ask that where possible, please bring only essential items please do not bring bags or coats. You will be asked to remove any outerwear at the entrance to the practice. The front door will remain locked, however we cannot accept liability for personal items brought into the dental practice building.
We will take your temperature with a no-touch thermometer. If your temperature is above 37.8°C, you will be unable to enter the practice and will be asked to return home and self-isolate as per current government guidelines. To eliminate waiting inside the practice and at reception all appointments will be staggered. This will minimise patients arriving or leaving at the same time as other patients where practicable. If you are well, we will direct you to the hand sanitiser station located in the waiting room and we will provide you with an alcohol based hand rub to use for 20 seconds and tissues for you to use should you need to cough or sneeze at any point. From there the nurse will take you straight to the surgery and may request that you do the following before, during and after your appointment:
Use the hand sanitiser or thoroughly wash your hands for 30 seconds with the antiseptic hand wash provided in the surgery. We may ask you to use a Hydrogen Peroxide mouthwash before some dental treatments are provided. There will be greater use of rubber dam or other barrier mechanisms for certain procedures.
The dental team have removed all non-essential items that can potentially be a source of infection transmission. As a result, you may find that the practice may appear to be quite bare when you attend this in the interests of reducing all opportunities for cross infection to a minimum.
All clinical and common areas will be subject to rigorous surface cleaning protocols between patients. We will be allowing for fallow time between patients to provide additional time for inhanced decontamination procedures. There will be a time allowance for any treatment overruns and preparation time for the next patient so that they do not need to wait in the reception area but occasionally delays are beyond our control. Any follow-up appointments will be made and confirmed by telephone once you are home to limit your time spent at reception.
All of our dental team will be using PPE in line with current infection control guidelines. The use of greater levels of PPE will result in a reduction in social interaction for which we apologise in advance.
Initially we will be unable to provide any treatments involving aerosol generation procedures (AGPs). When it is safe for us to perform AGPs the level of PPE we will need to use will be potentially unnerving for some patients. The majority of dental treatments are AGPs so in the initial phase we will be severely limited in the treatment options available since we will be providing only non-AGPs.
The aim is to minimise the amount of aerosol suspended in the air which could be a possible source of infection. We are confident that our normal dental procedures can be carried out with minimal risk. During non-AGPs we will minimise aerosols by utilising our normal high-volume suction (over 90% reduction in aerosol production), the use of dental rubber dam (a further 30 to 90% reduction in aerosol production), our regular surgical type IIR facemasks (filter up to 60% of remaining airborne particles) or FFP2 masks. In addition to these measures, during AGPs we will use FFP3 masks (which filter 99% of airborne particles).
We are confident that we are able to provide dental care to our patients without coronavirus Covid-19 infection whilst maintaining our responsibilities to our patients and staff in the mitigation if infection transmission risk. Initially, given the issue of PPE, we will be severely limited and restricted in the treatments we are able to provide however, once the correct PPE becomes available, we will be able to provide a far wider range of dental care. We would greatly appreciate your patience during this period as we work towards a return to the pre-Covid-19 levels of provision as soon as is practicable.
If you have any questions regarding this policy or about your dental care at Thames Dental Surgery, please do not hesitate to contact us.
2nd December 2020