Covid-19 Policy
The policy aims to:
Reduce the transmission of Covid-19 by providing accurate, timely and authoritative advice and information
(that complements wider national messages) to our patients and team.
Ensure the continued delivery of essential services for patients with Covid-19 (where possible) and safe
routine care for uninfected patients.
Reduce the impact of Covid-19 on patients, the team and the dental practice as far as possible.
Important note: Viral infections can present rapidly changing circumstances. In the event of a rapidly
changing situation relating to the Covid-19 pandemic, national guidelines will supersede the guidance in
this policy.
Introduction
COVID-19 is caused by SARS-CoV-2 which is from the family of coronaviruses. It was identified in Wuhan, China towards the end of 2019 and is a novel virus.
It was declared a pandemic by the World Health Organisation on 12th March 2020. Clinical presentation
ranges from mild-to-moderate illness to pneumonia or severe acute respiratory infection and death. Some
people may have no symptoms at all.
Several measures have been implemented around the world to attempt to reduce the spread of COVID-19 and
minimise the risk of severe illness and death, including the COVID-19 vaccine.
Our patient and staff safety is of paramount importance to us at Graystone Referral Centre and we want our practice to remain a safe place for all our patients and staff.
In producing this policy we have carefully considered advice and guidance published by multiple dental, medical and government sources. This includes but is not limited to; the Care Quality Commission (CQC), the General Dental Council (GDC), the Office of the Chief Dental Officer (OCDO), PHE England, British Dental Association (BDA), Scottish Dental Clinical Effectiveness Programme (SDCEP), the Facility of General Dental Practice (FGDP) and specialist dental societies such as the British Society of Paediatric Dentistry (BSPD).
This is a working document and so, as the guidance changes, we will update this policy where necessary.
It is not known at this time whether any of these procedures are temporary or whether some of them will become a permanent feature of the way dental practices must be run to ensure patient and staff safety in the future. We will of course be providing dental care to all of our patients in the safest possible environment. We greatly appreciate your assistance with our procedures at the practice.
Prior to your appointment Booking
Our telephone lines are open and this is our preferred method of booking appointments.
If you prefer to book in person at Graystone Referral Centre, our reception is open for you to enter. We have a large reception space that allows adequate social distancing. We ask that you adhere to social distancing requirements still in place in healthcare settings and that you wear a facemask unless you are medically exempt.
Remote Triage
All patients will be contacted prior to their appointment at Graystone Referral Centre by a member of the clinical team to conduct a remote risk assessment. We ask that you update your medical history form using our online patient portal beforehand. The form contains a section which will allow us to assess your level of risk of coronavirus infection and whether you are at increased risk if you developed Covid-19. We ask that you limit the number of people accompanying you to your appointment to one other person when necessary. We will also carry out a remote risk assessment for the person accompanying you to your appointment.
If following the remote risk assessment, you fall into a high risk category of having Covid-19, we will need to re-schedule all elective treatment. If urgent treatment is required we can still provide this care but we will need to schedule your appointment to avoid contact with other patients.
If following the remote risk assessment, you are found to be extremely clinically vulnerable to Covid-19, we will discuss this with you in order to make a shared decision about your care. If you wish to attend for treatment we will schedule your appointment to avoid contact with other patients.
Arriving for your Appointment
Where possible, we would appreciate it if you could arrive at the time of your appointment to reduce the amount of people in the clinic at any one time.
You may either wait in your car or outside our practice until your appointment time or you may also wait in our waiting room. We ask that once inside the practice you adhere to 2 meters social distancing, adhering to our floor markers and wear a face mask unless you are medically exempt.
Our practice undergoes regular cleaning in order to reduce the risk of transmission of Covid-19 including cleaning the area in which patients have sat whilst waiting for their appointment between patients. The patient toilet will be regularly cleaned between patients. We have alcohol gel available at our entrance and at our dental reception and we encourage good hand hygiene and ask that you use this when entering and leaving the practice.
During and After your Appointment
During your appointment, the dentist and dental nurse will be wearing full PPE in line with current guidance. The PPE requirements vary depending on whether it is an aerosol generating procedures (AGP) such as drilling or ultrasonic scaling and non AGP procedures such as examinations. Our enhanced PPE for AGP procedures consists of a full length gown, face masks (FFP3) face shield and gloves. All clinical staff have been fit tested for an FFP3 mask. Once seated in the dental chair you will be invited to remove your mask. We ask that any escorts wear a mask unless medically exempt whilst in the dental surgery.
Once treatment is complete you will be asked to put on you facemask and you will be guided to a designated spot at reception. Our reception team will organise your next appointment if required and take payment for your appointment. To reduce the handling of cash and decrease the risk of transferring any germs, we would like to encourage our patients to make any payments by card. However, we will accept cash as well. The reception team will show you out of the practice once you are ready.
Our Procedures
Risk Assessment
In order to safeguard the health of our staff and minimise the risk of infection, all of our staff have undergone Covid-19 risk assessments. These are regularly reviewed and appropriate measures put in place to minimise exposure to risk and support safe working. We update our staff risk assessments in light of changes to individual staff circumstances e.g. pregnancy, medical changes or local or national risk of COVID-19.
PPE
Our staff all wear a clean set of clinical scrubs each day which are laundered separately from other washing at least 60 degrees Celsius and then either tumble dried or ironed. Scrubs are only worn within the practice and not to travel to or from work. All staff have access to our separate changing room.
All staff wear appropriate PPE for the procedure required as mentioned in detail previously.
We implement safe donning and doffing of PPE measures.
Hand Hygiene
Staff wash their hands with soap and water or use of at least 60-80% alcohol based hand rub before and after caring/treating a patient, entering and leaving the surgery and after removal of PPE.
Staff Isolation
All staff showing symptoms of COVID-19 will stay at home until a negative PCR test result is obtained in line with current government guidance.
If a member of staff becomes unwell whilst at work, they will be advised to put on a surgical face mask immediately, inform the practice owners Emma and Arijit Ray-Chaudhuri, return home and organise a PCR test.
If a staff member tests positive for Covid-19 they will isolate in line with government guidance.
If a member of a staff member’s household has symptoms or tests positive for Covid-19 they will isolate in line with government guidance.
If a staff member is notified as a contact of a positive Covid-19 case by the Test and Trace service or the NHS Covid-19 contact tracing app they will isolate for the recommended interval.
The government has indicated that the rules on self-isolation for contacts will change on 16 August as more people become vaccinated.
Staff are advised to pause their NHS COVID-19 contact tracing app whilst in surgery and when wearing full PPE in line with government guidance.
Cleaning
We have removed all non-essential items, such as toys, books, newspapers and magazines from our waiting room.
All areas of our practice are subject to an enhanced cleaning regime during the Covid-19 pandemic of at least twice daily. Frequently touched sites/points, in particular waiting rooms/dental chair, are cleaned between patients.
Ventilation & fallow time
We are a newly built practice and have installed a brand new ventilation system to ensure we achieve a minimum of 11 air changes per hour in all clinical rooms. In addition, we employ other aerosol reduction measures such as the use of high volume suction and rubber dam isolation when appropriate.
After each AGP we allow a fallow time calculated for each procedure between 10 – 15 minutes. Following this fallow time the clinician’s AGP PPE is safely removed., the surgery is fully cleaned including the mopping of all floor surfaces.