Guidance

[Withdrawn] Appendix B: guidance on claiming reimbursement for COVID-19 PPE-related costs in dental practice

Updated 11 March 2022

This guidance was withdrawn on 7 March 2023

This page has been withdrawn because the deadline to submit claims has passed.

Applies to England

Due to the dental reimbursement scheme being operated by the NHS Business Services Authority (NHSBSA), information on how to complete a claim will be provided via the NHSBSA COMPASS portal prior to the scheme going live on 18 January 2021.

Claim dates

Dental practices will be able to claim for personal protective equipment (PPE) between 18 January and 20 February 2021, which means no claims will be accepted after 20 February 2021. Claims can only be made for PPE purchased between 27 February and 31 December 2020 for use in the delivery of NHS dental services as a result of COVID-19 infection control guidance.

COVID-19 PPE items for dentistry are defined as:

• type IIR masks

• FFP2/3 masks

• gowns (sterile and non-sterile)

• aprons

• gloves

• eye protection (visors and goggles)

• hand sanitiser

• clinical waste bags

Items of PPE not included above (for example, higher-grade PPE) can still be submitted but will be considered exceptional claims and should have supporting risk assessments submitted with the claim.

Claims must be for PPE that is intended for use prior to 31 March 2021.

Dental practices should already be obtaining their COVID-19 PPE free of charge through the DHSC portal and no further reimbursement will be made for PPE purchased after the date of 31 December 2020.

Dental practice eligibility

Prior to the COVID-19 pandemic, 16.75% of NHS dental contracts was designated for variable costs for consumables, including PPE. NHS England and NHS Improvement have continued to give dental providers 100% of their contract value throughout the year to date to account for the additional costs required to deliver services during the COVID-19 pandemic, including enhanced PPE. As a result, dental providers that have delivered less than 45% of their pre-COVID-19 contracted activity value should not need to claim for reimbursement of their PPE costs between 27 February and 31 December.

Practices which have delivered over 45% of their pre-COVID contracted activity should submit a claim for any additional PPE costs they have incurred, and which is not already covered by the full contract payment or pre-COVID PPE costs. For non-UDC (urgent dental care) practices, this period of activity is between the reopening of dental practices on 8 of June to 31 of December, meaning this threshold is equivalent to 26% of annual contracted delivery between 1 April and 31 December. For practices which are UDCs, this period is from 27 February 2020 to 31 December 2020.

Where a practice has delivered below 45% of their pre-COVID contracted activity but believes they have incurred legitimate PPE costs over the threshold set out, they should submit a claim. This will be considered an exceptional claim. More information on exceptional claims can be found below.

Claims will be subject to an amendment to account for the full contract payment already made to cover additional PPE costs. More information will be provided on this via the NHSBSA COMPASS system when it is live.

Dental claims process

Dental practices should submit their claims via the COMPASS system, which is administered by NHSBSA.

The PPE reimbursement scheme go-live dates will be communicated as soon as possible.

The information the NHSBSA COMPASS System will require to process your claim are as follows:

• quantity and type of PPE purchased being claimed in this process

• time period of purchasing

• associated evidence of spend, for example invoices

• staff risk assessments and clinical assessments to support claims for any items not listed above

• claims declaration form

All claims will need to be submitted with associated evidence of spend, for example invoices in line with the guidance.

The NHSBSA will approve claims for PPE reimbursement in line with the eligibility criteria within this guidance.

Practice claims will be defined as either standard or exceptional claims:

• standard claims: the practice is a UDC or has delivered over 45% of their contracted dental activity and is claiming for the period between 27 February and 31 December 2020

• exceptional claims: cover any PPE purchased between 27 February 2020 and 31 December 2020 in excess of the standard claim value and/or outside the standard COVID-19 PPE items and to be used prior to 31 March 2021. Practices delivering less than 45% of their full contractual dental activity, but who believe they are entitled to reimbursement fall into this route

The thresholds for standard claims are based on modelling to benchmark valid monthly costs that practices would have incurred for medical-grade PPE as outlined in infection control guidance.

Standard and exceptional claims

Where a standard claim is received for COVID-19 PPE that NHSBSA has determined satisfies the reimbursement criteria and is within the claim thresholds detailed above then payment can be made.

Where an exceptional claim is received that exceeds the claim thresholds or does not meet the reimbursement criteria then the NHSBSA may require explanation or further evidence to be submitted.

NHSBSA will assess all claims against the following criteria before authorising payment:

• invoices for the period covered

• practice open during the claim period

• PPE costs for the practice are not already covered by variable costs proportion of their undelivered activity (activity delivered to date is over 45% of their contract value)

• date practice signed up to the PPE portal to receive free COVID-related PPE

For any claims that fall outside of standard criteria and are exceptional, the NHSBSA may in some cases request further evidence such as:

• staff risk assessments for any higher-grade PPE used.

• activity levels for the claim period.

• whether the practice is a designated UDC site

Where claims relate to PPE that is outside the standard – type IIR masks, FFP2/3 respirator masks, gowns, aprons, gloves, eye wear (visors and goggles), hand sanitiser and clinical waste bags – the practice will need to be able to evidence the clinical need for that PPE if requested to do so. 

The NHSBSA when reviewing the claim will undertake checks to ensure any duplicate or previously paid claims are disregarded.

Where more information is required before the claim can be approved, the NHSBSA will reject and return to the practice to review and resubmit if appropriate. 

Should a practice exceed claim threshold by 25%, NHSBSA will refer to the claim for review to a commissioning support unit.

Where a claim significantly exceeds the threshold or is contentious in nature, it may be referred to the Department of Health and Social Care.

Assumptions underpinning modelling of ‘standard’ claims

Modelled costs within ‘standard’ claim thresholds take into account the following:

• activity assumptions based on:

  • average face-to-face activity based on FP17 submissions

  • adjustment by proportion of contractors registered on the PPE e-Portal by September 2020

• PPE requirements based on assumed activity under Public Health England infection prevention and control (IPC) guidance

• cost of PPE based on March to June wholesaler prices