What are the 9 GDC standards?
- Put patients interests first
- Communicate effectively with patients
- Obtain valid consent
- Maintain and protect patients information
- Have a clear and effective complaints procedure
- Work with colleagues in a way that is in patients best interest
- Maintain, develop and work within your professional knowledge and skills
- Raise concerns if patients are at risk
- Make sure your personal behaviour maintains patients confidence in you and the dental profession
Who do the dental standards apply to?
- dentists
- dental nurses
- dental hygienists
- dental therapists
- orthodontic therapist
- dental technicians
- clinical dental technicians
What happens if you do not meet the standards?
You may be removed from the GDC register and will not be able to work as a dental professional
3: Consent
- obtain valid consent before starting treatment, explaining all the relevant options and the possible costs
- make sure that patients (or their representatives) understand the decisions they are being asked to make
- make sure that the patients consent remains valid at each stage of investigation or treatment
What’s the difference between competence and capacity?
Competence = legal judgement (understand information, make rational decision)
Capacity = medical judgement (formally assessed to conclude that patients are able to understand their management, comprehend the risks and benefits, retain information and make a decision)
When should competence and capacity be assessed?
Both at same time in conjunction with the care plan and at each stage of treatment
What do you do if the patient lacks capacity?
The dentist should act in the patients best interest without discrimination and try to involve the patient wherever possible
It is also best to involve more senior experience colleagues to provide advice on how best to treat the patient
3 types of consent
- Voluntary
- Verbal
- Informed
What is voluntary consent? E.g.
Pt decides without consultation
No pressure is imposed
The patient can refuse treatment or withdraw at any time
An example is the patient opening his or her mouth for examination
What is verbal consent?
Patient states verbally the he or she is happy with the procedure
Discussion regarding the risks and benefits of a proposed patient
Continuous discussion aided by information over a period of time
What is informed consent?
Discussion regarding risks and benefits of proposed treatment
Continuous discussion aided by information over a period of time
There is a clear agreement on contract and charges with any amendments reconsented
E.g. Treatment planning for FP17 all treatment to be carried out on this form in language understandable to patient, outlines risk and benefits of treatment and includes both NHS and private costs of treatment, pets keep a signed copy for themselves
When is verbal consent enough?
If they agree to minor procedures
When is written consent needed?
Any operative dental treatment and larger procedures e.g.
- complex procedures - surgical extraction
- general anaesthetic
- IV or nasal sedation
- the majority of paediatric procedures
- when clinical care is not primarily the purpose of the procedure e.g. Aesthetic treatments
- when treatment is for research
- when clinical photography is to be taken
4 confidentiality
- make and keep contemporaneous, complete and accurate patient record
- protect the confidentiality of patients information and only use it for the purpose for which it was given
- only release patients info without their permission in exceptional circumstances
- ensure patients can have access to their records
- keep patients information secure at all times whether your records are held in paper or electronically
When does patient confidentiality need to be breached?
- To other healthcare professionals or careers involved in patients overall care e.g asking dental colleague for second opinion, referral letter, liaison with GP
- divulging information as required by law e.g. Through court order even if against pts wishes
- releasing the information for the sake of public interest and safety, protecting the patient or others who are at risk of harm or death in not doing so
With cases such as child abuse who do you also need to contact?
Share info with other agencies = social services and police
Who can you seek advice from with breaking confidentiality?
Senior colleagues or indemnity provider
When should you not inform the patient about breaching confidentiality?
You feel that by informing the patient of the breach it may cause further harm and risk to either the patient or someone else, it is important you gain advice from your union and other senior colleagues who may be able to help before disclosing any information
5 have a clear and effective complaints procedure
All practices must have a complaints procedure for patients and staff members to follow:
- must be visible
- it should allow complaints to be addressed speedily
- it should allow complaints to be investigated fully and fairly
- it should respect confidentiality
- it should be clearly written
- there should be no dental jargon
- it should clearly explain outcomes
- it should lead to improved service
The complaints procedure
- Acknowledge the complaints and provide the patient with the practice complaint procedure
- Inform the dental defence organisation if you require advice
- Inform the patient of timescales and stages involved
- Acknowledge the complaint in writing, by email or by telephone as soon as you receive it - 3 working days max but ideally within 24 hrs
- Respond to the complaint within 10 days (if circumstances arise that prevent this, ensure the pt. is aware of different timescales ensuring you regularly update him or her (at least every 10 working days))
- Hold a staff meeting for peer review, audit and feedback on the outcome of the complaint
What is the REACH approach for responding to complaints?
R - recognition E - empathise A - apologise C - compensation H - honesty
What is the scope of practice?
A comprehensive list of what each dental care professional can and cannot do
7 maintain, develop and work within your professional knowledge and skills
Foundation dentists cpd cycle starts in Jan of their foundation yr
Need 250hrs of cpd of which 75 are verifiable
Cpd themes include:
Legal considerations and ethics Dental materials Photography Business Complaints handling Techniques Oral medicine Perio Medical emergencies Infection control Radiography and radiation protection
