5.0 PRE-APPOINTMENT BOOKING / CONFIRMATION PROCEDURES FOR PATIENTS

  • Upon reopening, CODE will be responsible for prioritising patient attendances at the practice based on infection risk versus clinical need. We will prioritise patients who require urgent attention or who were undergoing current treatment phases abandoned after 23rd March and where further delay may result in significant deterioration of their dental condition.

  • We would ask patients with non-urgent problems or requiring check-up appointments to please be patient and await appointments towards the end of the summer.

  • The most effective way of reducing risk of cross infection between individuals attending CODE is to assess relative risks and recent past experience and ensure those attending CODE are low risk.

  • All of our staff will be asked to complete a COVID-19 return to work risk assessment  

5.1 Patient risk groups

  • The NHS has provided a list of patients who are at high risk (clinically extremely vulnerable) and at moderate risk (clinically vulnerable) of COVID-19 and potential sequelae. Please refer to this list to assess if you are at risk and try to defer your dental appointment until the end of the summer if your dental condition does not require immediate attention. 

  • For patients who are in one of these risk groups but still require urgent dental attention please do contact the practice and we will make arrangements to alleviate your emergency in the safest possible way.

5.2 Medical and Dental Questionnaire (MDQ) completion

  • All patients to CODE are already asked to complete the following forms prior to their appointment

    • a comprehensive medical questionnaire

    • a dental questionnaire

    • Covid screening questionnaire

    • Covid consent form

  • The dental records software, SFD, will be incorporating a live portal which will be live from Monday the 8thJune 2020. This portal will send patients a link via text message, which will be encrypted, and will allow patients to complete their questionnaires securely and update their profiles automatically. As appointment reminders are sent a week before the appointment, the live portal system will only apply to patients booked on Monday 15th or Tuesday 16th June 2020.

  • During the week of 8 June 2020, these questionnaires will be sent manually to patients via email appointment reminders.

  • These questionnaires must be updated every time the patient attends CODE. Our current system now allows the existing form data to be recalled and edited only where circumstances have changed rather than having to re-complete the entire form each time. We know that this will be a relief for all of our patients, every time they attend.  

  • Please note that we reserve the right to decline to book appointments or to postpone appointments if the fully completed MDQ is not returned in time or we feel that you are at high risk of having been exposed to coronavirus in the last 2 to 3 weeks.  

5.3 Individual patient screening / risk assessment and prioritisation of patients

  • Upon receipt of a patient’s completed or updated MDQ, the clinician involved with their care will make an assessment of COVID-19 risk versus dental needs priority and advise reception and patient coordination as to the level of risk and urgency.

  • Patients will be classed as high, medium or low COVID-19 risk or as already having been infected and recovered pending proof of documentation. A copy of such documentation should be emailed to info@centreofdentalexcellence.co.uk

  • Patients will then be classed as high, medium or low priority in terms of the requirement for their immediate dental care

  • The clinician will then make an assessment of the balance between these two risks to prioritise available appointments. For example, a low COVID-19 risk patient with a high dental priority will receive an appointment before a high COVID-19 risk patient with medium dental priority.

  • Patients with high or medium COVID-19 risk will normally be asked to self-isolate and refrain from attending the practice for at least three weeks before they are asked to update and resubmit their MDQ prior to requesting a new dental appointment.

  • Patient bookings will be made into the diary based on a new staggered diary control system to reduce contact between patients arriving and leaving the practice and allow for longer periods between appointments. See section 5.5 below.

5.4 Patient communication/ phone or video contact / patient consent

  • The processes for patient communication, consultation, reporting and consent will continue as normal. Further information can be found on our website www.centreofdentalexcellence.co.uk

  • It is likely that we will make more use of video consultations, especially to answer patient questions or go over treatment reports and phases of treatment which we would normally do face-to-face at the practice. 

  • Our admin and clinical team will arrange video consultations where required:

 

5.5 Diary management and changes to scheduling:

  • The following changes will be introduced into the diary management system for CODE from 8th June which will be our first “soft-opening” day after lockdown

  • These measures are being undertaken in line with the ‘alert level 4’ and will be eased as the alert level is lowered by the government

    • During the weeks of 8th June and 15th June 2020, only clinician will be working in the practice with clinical nurse and will have access to two surgeries

      • This ensures that there are less people in the building at any one time and we follow social distancing measures

      • Diaries will be kept ‘light’ in bookings as this will allow all staff members to familiarise themselves with the protocols in place

      • The diaries will be reviewed and it is likely that we may start to operate from both surgeries in the next 2-4 weeks

    • Non-AGP procedure

      • Whilst the guidance suggests that no fallow time is required, clinicians will be required to alternate between surgery 1 and surgery 2

      • This will allow the infection control nurse to clean the surgery not in use and set it up in preparation of the next appointment

      • Mopping the floor is not required after every patient but this should be risk assessed on individual case by case basis. 

    • AGP Procedures

      • AGP procedures should only be undertaken with the right PPE in place

      • Fallow time of 60 minutes is recommended from the time we stop generating aerosol.

      • The first two weeks of the opening will not be an issue as we have one clinician alternating between surgery 1 and 2; inherently this will allow fallow times of 60-90 minutes after each patient

      • At a time when two clinicians are working on any one day, we will have to review the bookings and allow sufficient fallow times between AGP procedures

      • It is the clinicians responsibility 

        • to review their diaries at least one week before (remote access has been provided to all clinicians) and to advice the reception staff if any changes are necessary

        • to allow sufficient time after every procedure for the nurse to doff and clean the surgery in preparation for the next patient.

        • To inform reception via the buzzer system if they are running late for any reason, so we can advise the patient to wait in the car and await a phone call. 

    • The protocols will be subject to changes and we will aim to resume to normal clinical activity when we are down to an alert level 2. 

 

5.6 Appointment bookings and treatment slots

  • For patients requiring multiple procedures, we will strongly recommend that longer appointments to get multiple procedures completed as far as is possible be prioritised. 

  • Our receptionists will inform you of the available treatment times required for your particular case and we would be most grateful if you could follow their lead and allow them to arrange your appointments as most appropriate for your case at the times they recommend. Your flexibility on this subject to allow CODE to maintain social distancing between patients and keep a tight control of diary times will be most appreciated.

 

5.7  Changes to payment methods / PPE charges

  • CODE already works by a system where each treatment phase is paid in advance. This will not change and will continue as normal.

  • We would be grateful if payments for all appointments are processed via phone or bank transfer (BACS).

  • We would be grateful for your cooperation in ensuring that all fees are paid in advance prior to attending for your appointment. This is to reduce the need for use of payment terminals and prolonged time spent at reception before or after your appointment.

  • We encourage payments to be made over the phone or bank transfer (BACS). Once the bank transfer has been processed  we will be able to confirm your appointment via usual way.

  • Please note that our normal terms and conditions continue to apply. You will be updated if there are any subsequent changes to CODE’s current Terms and Conditions

  • The following changes will be introduced into the diary management system for RDC from 8th June 2020 which will be our first “soft opening” day after lockdown:

  • All minimally aerosol generating procedures as listed below will have an additional 15 minutes buffer period introduced after the appointment. This will cover the following procedures and there will be no charge for this additional 15 minutes of time:

    • dental consultations and examinations

    • removal of sutures

    • fitting of removable appliances such as whitening trays, occlusal deprogramming devices, fitting of orthodontic devices and dentures

  • All other procedures including hygiene visits and all operative dental procedures will have an additional 60minutes buffer period introduced after the

  • Whilst we will not be charging additional fees for the donning and doffing times, we will need to introduce a surcharge for the PPE that we need to invest in for the safety of our patients and staff. The table below outlines the additional charges, per visit. We will encourage, where possible, to have longer appointments to have treatments done in one visit to reduce the number of surcharges you will incur.

    • £15 for non AGP procedures

    • £45 for AGP procedures

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52 Church Rd, Stanmore, Middlesex HA7 4AH

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