What 5 things make consent valid?
- Given voluntarily.
- Given by an individual who has capacity.
- Given by an individual who has been fully informed about the issues bearing in mind the obligations of Montgomery and GDC standards.
- Given anew when material risks change or when treatment options or treatment changes.
- Given with the patient’s knowledge that they can withdraw consent at any time
What is the age of legal capacity in Scotland?
16 years old
What 5 things can be used to avoid complaints?
- CLEAR
C - connect (vocab, tone, offer help)
L - listen (open-ended questions)
E - empathise (summarise and acknowledge)
A - ask (expectations, concerns, knowledge, permission for closed questions)
R - review and check (confirm, correct, wellbeing, closure) - Professionalism
- Effective communication
- Compassionate care
- Managing expectations
What does the 2017 NHS Complaints Handling Procedure involve?
Stage 1
- local level
- early resolution - dealt within 5 working days
Stage 2:
- investigation
- acknowledged in 3 days via letter
- completed investigated response in 20 days
- patient is given details of PASS and SPSO
- NHS boards shld have a complaints+feedback officer
- display details of PASS and SPSO prominently
- reporting is mandatory following a complaint
What should a response to a complaint include?
- An explanation of how the complaint has been considered
- An apology if appropriate
- An explanation based on facts
- Whether the complaint in full or part is upheld
- Conclusions reached & any residual action that the organisation considers to be appropriate
- Confirmation that the trust/board is satisfied that has been or will be actioned
- Where possible, response about any lessons learnt
- Information and contact details of the PHSO/SPSO as the next stage of the NHS complaints process
To prove negligence, what 3 things must there be?
- Duty of Care
- Breach of duty
- Causation of harm
What is a claim for compensation?
A claim for something (typically money) in recognition of loss, suffering, or injury.
What must you have in place to cover yourself when a claim is made?
Insurance and Indemnity
If a claim has been made against yourself, when must you contact your insurance/indemnity provider?
Immediately after the claim has been made
What is very important for you to do daily in order the prevent yourself from getting into trouble when a claim has been made?
Ensure you have good note writing
Which treatments can commonly lead to claims for compensation?
Endodontics
Complexed fixed pros
Undiagnosed/untreated perio disease
Implants and associated procedures
Cosmetic dentistry of all kinds
Facial aesthetics
Adult orthodontics - particularly short term
Failure to diagnose
Consent issues across all treatment types
How should you handle a claim for compensation?
- Send a copy of the patient notes to a solicitor
- must gain patient’s consent to send their notes - have 30 days to do so
- this is carried out via your indemnity company - Respond to the letter of claim with a very simple response
- carried out via indemnity company - Must cooperate with your indemnity company
- meetings
- your thoughts on what happened
- pass all further correspondence (letters etc) to them
What are the different outcomes that can come of claims?
- Settled without admission of liability
- Patient/patient solicitors no longer pursue case
- Defend - out of court settlement
- Defend - court (win or lose)
Are claims for compensation covered by the NHS in secondary care settlements or the PDS?
Yes - NHS covers your indemnity for any claims in negligence in secondary care/PDS
Which organisation deals with claims?
The Central Legal Office
Which 3 existing legislations are relevant to our Duty of Confidentiality?
- Common Law
- Human Rights Act 1998
- Data protection Act 2018
In which cases can confidentiality be breached?
If the patient has given consent
In which case does the GDC advise you to breach confidentiality in the public interest?
When a patient puts their health and safety at serious risk
OR
If you think that you have confidential information which would help prevent or detect a serious crime
If you have to release confidential information for any reason, what must you do?
- Try to achieve patient consent if possible - ideally in writing
- Release the minimum information necessary for the purpose
- Be prepared to justify your decisions/actions
- Seek advice if in doubt
What are the 7 principles regarding data protection?
Personal data must be:
1. Processed lawfully, fairly and in a transparent manner in relation to individuals
2. Collected for specified, explicit, and legitimate purposes
3. Adequate, relevant, and limited to what is necessary
4. Accurate and kept up to date
5. Limited - only what is necessary
6. Secure
7. Accountable
What local data protection policies are available in dundee?
NHS Tayside Data Protection Policy
UoD Data Protection Policy
What is duty of candour?
Honesty with the patient if something has gone wrong
How might you approach a scenario if treatment has gone wrong?
- Put matters right if possible
- Offer an apology written and verbal
- Explain fully and promptly what has happened and the likely short-term and long-term effects
