A Guide to General Dental Practice

v. 1, Relationships and Responses

Nick Priest, Hardev Seehra, Murray Wallace

• Publisher: CRC Press
• Year: 2020
• ISBN:
  9781315343150
• Edition: 1
• Topic: Medicina
• Subtopic: Teoria, pratica e riferimenti medici

This work includes a foreword By Hew Mathewson, President, General Dental Council. This book is an excellent ready reference for every dental practice to have on hand. Full of practical advice and helpful tips, it offers independent and impartial guidance, especially for new dentists and other staff. It assists competence and provides a thorough understanding of all areas needed for good patient care and professional responsibility. It covers aspects of care including history taking and prescribing, and topics including law, ethics and clinical governance. This completely up to date resource is an essential handbook for all dentistry students and recent vocational training graduates, as well as dental vocational trainers. "Leaving VT to move into practice is an exciting and challenging step and this guide is one of those things you will never know you needed until you cannot find it. It is an incredibly useful collection of information produced by a small group of your colleagues. Until such time as you really need it why not look through it, you will find it helpful and reassuring." - Hew Mathewson, in the Foreword.

Section 1

1 Law and ethics

The General Dental Council (GDC)

The General Dental Council (GDC) is the regulatory body responsible for the dental profession charged with protecting patients. In June 2005 the council produced new guidance for the dental team. A standard for dental professionals sets out a framework of principles and values within which the dental profession should operate. It provides guidance on how to make decisions within that framework. Six core principles are at the heart of the guidance.

1. Putting patients’ interests first and acting to protect them.
2. Respecting patients’ dignity and choices.
3. Protecting the confidentiality of patients’ information.
4. Co-operating with other members of the dental team and other healthcare colleagues in the interest of the patient.
5. Maintaining your professional knowledge and competence.
6. Being trustworthy.

A dental professional must be prepared to justify their actions, they must be willing and able to demonstrate that they are aware of these principles and have upheld them in their practice of dentistry. Supplementary guidance booklets have been published (Principles of Patient Consent and Principles of Patient Confidentiality) and further are planned later in 2006 (Principles of Team Working and Principles of Complaint Handling). You must read and be familiar with all these, which the GDC will send to you.

The GDC aims to register all dental care professionals and is setting up a private complaints scheme, which was launched on 24 May 2006.

The National Health Service (NHS) complaints scheme is also being looked at closely and a new ‘Practice Advice and Support Scheme’ (PASS) is being developed. The purpose of this scheme is to help dental practitioners whose performance is causing concern and may result in more serious consequences for that practitioner and their patients unless problems are resolved. The PASS scheme will be initiated by the primary care trust (PCT) clinical governance lead and will be linked with continual professional training by the postgraduate dental deans’ involvement. It is hoped it will act as an extra link between practice-based complaints and the disciplinary procedures acting to reduce the cases proceeding to these or GDC involvement. Occasionally, dentists may have increasing patient complaints through ill health, behavioural problems or skill deficits.

The National Clinical Assessment Service (NCAS)

The National Clinical Assessment Service (NCAS), previously the National Clinical Assessment Authority (NCAA), was established as a special health authority in April 2001, following recommendations made in the Chief Medical Officer for England’s report, Support Doctors, Protecting Patients (November 1999) and Assuring the Quality of Medical Practice: Implementing Supporting Doctors, Protecting Patients (January 2001). In April 2003 the NCAS expanded its services to include salaried dentists and from April 2005 has provided a full service to all NHS dentists.

In order to help practitioners in difficulty, NCAS provides advice, takes referrals and carries out targeted assessment where necessary. The NCAS’s assessment involves trained medical and lay assessors. Once an objective assessment has been carried out, NCAS will advise on the appropriate course of action. NCAS does not take over the role of an employer, nor does it function as a regulator.

NCAS is established as an advisory body, and the NHS employer organisation remains responsible for resolving the problem once the NCAS has produced its assessment.

The NCAS Advice Service can be accessed 24 hours a day. NCAS is not set up to take referrals directly from the public. This is because performance management needs the active cooperation of the employing authority, as they must take ownership of the situation, www.ncaa.nhs.uk.

Complaints

Many instances of patient dissatisfaction never develop into a complaint because the dentist gives a prompt explanation or a courteous apology.

Since April 1996, every practice providing NHS treatment has had to have an in-house complaints procedure (NHS (GDS) Amendment Regulations 1996). Complaints should be acknowledged in writing within three working days of receipt, and a full response should be made within ten working days of receipt, following a full investigation. If there is to be a delay in the investigation and full response, for example because a member of staff involved in the patient’s care is on holiday, the patient should be informed of the reason for the delay, and when to expect a response.

The practice complaints officer or dentist responsible for the patient’s treatment should give an explanation, an apology if appropriate and an indication of the action that will be taken to remedy the situation and to make sure that it does not happen again. The GDC endorses the NHS Executive and British Dental Association (BDA) guidance on handling complaints.

The patient is always entitled to a prompt, sympathetic and, above all, accurate account of the facts. An appropriate apology is an act of common courtesy and not admission of liability. Most patients who are given a prompt explanation and apology do not pursue their complaint or make a claim for compensation.

Communication

In the Dental Defence Union’s (DDU) experience, complaints and claims seldom arise solely from problems with clinical management. They can be caused by deficiencies in administration systems, procedures and lines of communication. The GDC expects dentists to provide a high standard of care. Failures in communication or organisational systems can have an impact on the delivery of high-quality healthcare. Clear paths of communication are essential between you and:

• your patients
• the dental nurse
• the receptionist
• the laboratory
• all other members of the dental team.

In general, good communication with patients is aided by:

• not talking down to patients – treat them as equals
• allowing patients to state their problems, listening and allowing the...