Dental professionals have contacted the DDU with a variety of dentolegal concerns about the COVID-19 health crisis. Leo Briggs answers some of the most common queries below.
What if a patient complains due to appointment cancellations?
Most people recognise that routine dentistry is on hold at the moment. But good communication by your practice will help avoid misunderstandings.
If you haven’t already, update your website and practice answerphone messages. Explain the measures you have taken to safeguard patient safety. Explain how your patients can access dental services during the coronavirus pandemic. This should be in line with the guidance from the relevant CDO and local arrangements. If a patient does complain, you can explain that you are following appropriate guidelines to safeguard their health.
The GDC has reassured practitioners: ‘Refusing to treat a patient when it is not safe to do so is a perfectly proper professional judgement, which we would not look to question.’
Is it OK to conduct consultations remotely?
During the pause in routine appointments, the NHS is asking practices to provide a basic telephone service for patients. But it’s important to be mindful of the limitations of remote consultations.
The GDC says that a key requirement is to make and record an appropriate risk assessment. This should takes into account: ‘The infection risk of COVID-19, both from and to the patient. As well as the apparent seriousness of the need for treatment and the extent to which it has been possible to make a clinical assessment.’
What if the patient requires pain relief, antibiotics or urgent treatment?
You can issue a remote prescription if you believe this is in the patient’s best interest and there is no viable alternative, according to the GDC’s prescribing guidance. In an emergency, you can ask pharmacies to supply the medication. This is on the condition that you will provide a prescription within 72 hours. As set out in the section 224 of the Human Medicines Regulations 2012.
If the patient’s condition is serious, you need to direct them to the local urgent dental care service, using arrangements in your area (check with your LDC or primary care organisation). On 8 April, the GDC said that it was aware of concerns that these arrangements were not fully established in all areas. Where that is the case, it advises: ‘A judgement can be made, based on an appropriate risk assessment, of whether there is treatment which can be offered safely.’ This should be with reference to the relevant public health advice, such as the latest guidance on infection control and PPE. The GDC added that it would: ‘Not look to question the outcome if a reasonable approach has been followed.’ DDU members can look to us for advice and support with complaints and claims arising from treatment provided in this situation.
I have stopped work because of the pandemic. Can I pause my defence organisation subscription?
All three dental defence organisations are reducing their subscriptions for members whose income has been affected by the COVID-19 lockdown. If you are a DDU member, email us with the date that your working arrangements changed. And (if applicable), the number of sessions per week you are now working. However, do check with your own defence organisation as arrangements vary.
Must I redeploy and who will indemnify me for this work?
The NHS framework for redeploying dental clinicians to support the NHS response to COVID-19 makes clear that redeployment is voluntary. Indemnity arrangements vary depending on the setting in which you are working. Find out what indemnity arrangements are in place from the organisation you are redeploying to.
The GDC guidance says it fully supports dental professionals who choose to draw on their skills and experience to help. It also says: ‘Registrants should satisfy themselves that they are competent to perform the tasks. Or that they are given the training necessary to equip them to do so.’ The framework (section 7) includes a table mapping from the skills of the different dental professions to roles and tasks in other settings.
Will the GDC investigate me if I depart from guidance?
To help you keep up-to-date with the latest authoritative guidance we recommend:
- Check relevant websites (the chief dental officers, the NHS and the GDC) regularly. The DDU has produced a dentolegal update on COVID-19, which includes relevant links
- Ask someone to check advice regularly and disseminate it to all concerned
- Log when you checked the COVID-19 advice so you can demonstrate what you have done to stay up-to-date
- Look at documents from the website, rather than relying on print copies, so you are working from the most up-to-date guidance
- Contact your dental defence organisation if you have dentolegal concerns.
You will need to use your professional judgement in circumstances not covered by the guidance. While it expects your decisions in line with current guidance, the GDC says it ‘won’t look to second guess judgements made on that basis’.
In the unlikely event that your practice faces criticism, DDU members can look to us for advice and support, however you have interpreted the guidance.
This information was correct at time of writing. To keep up-to-date with the latest information please visit www.theddu.com/coronavirus.