Over the last week we have seen further updates from NHS England for the dental profession. We have considered these and whether they provide any clarification for mixed NHS and private practices in terms of redeployment of staff and the practicalities of making use of the Government’s Job Retention Scheme (the “Scheme”).
On 15 April 2020 NHS England published its fourth letter of preparedness (the “Letter”) which brings some further clarification. In terms of contracts and financial arrangements, it makes specific reference to practices providing private and NHS services. The Letter confirms that, whilst continuing to receive NHS funding, support can be sought from the Government in relation to the proportion of a practice’s private income. It advises practices to use the methodology of determining private and NHS income when it comes to business rates reimbursement, and to use the proportion of gross income that relates to GDS/PDS contract value as NHS revenue. The balance is then the private share, which alternative support can be sought in relation to.
In the 2020/21 reconciliation process, practices will need to declare that they have not applied for duplicative Government funding and provide evidence of the proportion of NHS/private income which they use in applications for any additional support, e.g. through the Scheme.
In terms of the redeployment of staff, the Letter confirms the expectation that, in return for the continued income, practices will be able to provide continuity of employment for staff. Practices will be expected to demonstrate that they have made every reasonable effort to offer staff appropriate opportunities to support the wider COVID-19 response. The British Dental Association states that in the case of dentistry, that starts with the ongoing provision of remote advice and the provision of care in the urgent care system. What still isn’t clear is how this relates in practice to mixed practices, where staff aren’t necessarily allocated to NHS or private work.
The guidance note which we referred to in our last update, ‘Redeploying the clinical workforce to support the NHS clinical delivery plan for COVID-19’ (the “Guidance”) was updated on 20 April 2020, but unfortunately not in relation to the remuneration of staff who are redeployed from mixed practices. This continues to state that further guidance will be provided separately to recognise the nature of various funding streams that underpin most NHS dental practices. We have not seen anything of this nature yet.
In light of this, dental practices can only interpret the guidance as best they can. This will translate into many forms in practice, whether that be supporting the full redeployment of one or a few staff members and furloughing others, or claiming under the Scheme in respect of all staff but only against the proportion of their working time that reflects the practice’s proportion of private of income whilst covering the rest of their pay with the continued NHS funding. Ensuring there is no duplication of funds will be key, and therefore contemporaneous record keeping of workings out and decision making will be important.
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