10 June 2020

Price Of PPE: Updated Analysis By DD

Summary

Price of PPE per patient prior to Covid-19: Non-AGPs = £0.16; AGPs = £0.33
Price of PPE per patient 9 June 2020:
- Non-AGPs = £1.71
- AGPs using DoH discounted FFP2s (sessional use) = £7.64
- AGPs using non-discounted FFP2s (sessional use) = £9.21
- AGPs using non-discounted FFP3s (sessional use) = £13.36

Context

Previously, DD carried out an analysis, on 28 April 2020, to compare the price of PPE per dental patient prior to Covid-19 and post-lockdown.

DD published its report stating:

Price of PPE per patient prior to Covid-19: Non-AGPs = £0.16; AGPs = £0.33
Price of PPE per patient post lockdown: Non-AGPs = £1.60; AGPs = £38.60

As predicted, PPE prices have moved given that the supply chain is beginning to ease. As it stands, current prices are not dramatically different to April 2020, however, they indicate the general direction we are moving in.

Accordingly, an updated analysis is presented below, to include various options using different types of respirator mask, as well as the impact of using respirators and gowns on a sessional basis.

Assumptions for calculations below

1. Amount of PPE used, and price of PPE is estimated for procedures in general dentistry (excluding orthodontics and implants). Calculations have been made on a per patient basis. However, for AGPs the calculations now reflect sessional use of respirators and gowns given that official guidance stipulates this is acceptable. It has been estimated that 3 patients will be seen per session for AGPs (to allow for fallow time and cleaning of the surgery).

2. It was previously assumed that a single NHS dentist will carry out 6 AGPs and 12 Non-AGPs per day. For the purpose of the revised calculations, the scenario of a 2-surgery practice is used, with “Dentist 1” seeing 12 Non-AGP patients per day and “Dentist 2” in a separate surgery seeing 6 AGP patients per day. This is to allow for a 1-hour fallow period in between AGPs, allow adequate cleaning between all patients and stagger appointments to enable social distancing, as recommended by official guidance.

3. It is assumed that 1 patient will be treated by 2 staff members requiring PPE e.g. dentist and nurse / dental therapist and nurse. PPE for the receptionist has also been included in the updated analysis. This is assumed to be one Type IIR surgical mask per session (therefore one Type IIR per every 9 patients, assuming 3 AGPs and 6 Non-AGPs are booked in per session is a 2-surgery practice).

4. It is assumed that the clinician already has their own visor frame (sunken cost), so the price of the shield only has been considered. Shields may be disinfected between patients and re-used (according to manufacturer instructions). Assume 1 visor shield per every 18 patients for each wearer.

5. Prices used in this document are relevant today, they are likely to increase or decrease based on supply and demand and fluctuations in the cost of materials as a result of the pandemic. Average market prices have been used for the purpose of these calculations.
6. This document focuses on PPE only, it does not look at the price of other dental materials e.g. composite filling materials, or infection control items e.g. wipes/disinfectants which are typically used as part of a treatment. Nor does it look at the impact of air filtration, high volume suction or rubber dam, which may reduce the fallow time in between AGPs.

7. All capital and running costs have also been excluded.

8. PPE recommendations in line with current official guidance for Non-AGPs and AGPs have been used. These could be subject to change in future.