Healthcare Law and Professionalism COPY Flashcards
what are the potential issues with the GDC.
Fear: of the GDC and getting struck off
Relationship with other bodies
annual retention fee
skill mix on panel
cumbersome and lengthy process
“GDC culture of fear ensures that nobody in dentistry now chooses to broadcast their errors”
what issues might this cause for dentist
dentist cannot reflect
cannot learn from mistakes - Bill Schaeffer, written evidence to UK Parliament GDC accountability hearing, February 2015
“many of us are now too scared to undertake advanced dental procedures for fear that we make mistakes, the GDC will destroy our livelihood”
prevents us from developing skills.
GDC - Standards for the dental team include.
- 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 interests
- 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 can complaint to the GDC
Patient
colleague
member of public
what is the next stage in process once a complaint to the GDC has been made?
letter to registrant from GDC Caseworker advising of fitness to practice
what should you do when you receive a letter to registrant from GDC Caseworker advising of fitness to practice?
contact your indemnity organisation if you have one.
if you work in a hospital setting you are only covered for what with the hospitals insurance?
you are only covered for claims for compensation - NHS Indemnity
what must you not do when you have received a letter to registrant from GDC Caseworker advising of fitness to practice
do not email caseworker
do not give any information relating the incident.
what happens during the initial triage stage?
patients will be asked to complain to original dentist, which gives dentist opportunity to deal with it.
Patient can reject this proposal and proceed with GDC.
the complaint case is handled by case examiners which are part of the investigating committee, they include two members which include?
1 lay
1 registrant
case examiners have allot of power, with these powers they can do the following:
- Take no action
- Send a letter of advice
3.Agree undertakings (take further training)
- Issue a published warning, posted on GDC Register on website or unpublished warning
- Send forward to a Practice Committee
If cant agree refer to full Investigating Committee
the interim orders committee runs parallel to other processes, what can they do?
interim orders such as conditions or suspension, may be imposed for up to 18 months where IOC are ‘satisfied that is necessary for the protection of the public or is otherwise in the public interest, or is in the interests of the person concerned…’
there are three practice committees what are they?
- Professional Conduct Committee
- Professional Performance Committee
- Health Committee
what is the worst sanction that can be placed on a registrant?
erasure - cannot apply for restoration for 5 years.
the professional conduct committee do a two stage test as to whether there is impaired fitness to practice, what do they assess?
- do the proven facts amount to misconduct
- is the registrant’s fitness to practice currently impaired?
the following is a list of?
- perform a basic periodontal examination
- diagnose the presence of periodontal disease
- undertake detailed periodontal assessment in light of the BPE score of 3 in four sextants recorded by the hygienist
- treat patients periodontal disease
- accurately record patients bone loss
- provide further periodontal assessment and/or treatment
Typical GDC periodontal charges
what is meant by insight?
the capacity to gain an accurate and deep understanding of something.
-admission of deficiencies and reflective learning is required.
what is meant by remediation?
the act or process of remedying something that is undesirable or deficient
it is important that you can demonstrate to the GDC that you now understand where you went wrong and that you have remedied or are actively remedying the situation.
what can you do to prove that you have undertaken remediation?
- proof of CPD
- Audit
- Awareness of Guidelines
- peer review and mentor
- PDP/reflective log improvements in records
examples of non-clinical and other issues considered by the GDC include?
- criminal charges
- illegal practice
- dishonesty
- operating out of scope
- professional disputes
- behaviour on social media
what should you do when a patient contacts you through your private profile?
you should explain that it is not appropriate to mix social and professional relationships and where appropriate direct them to your professional profile.
if you use professional social media to discuss anonymised cases for the purpose of discussing best practice what must you ensure?
you must ensure that the patient or patients cannot be identified.
as a registrant when using social media, you must?
a. Maintain and protect patients’ information by not publishing any information which
could identify them on social media without their explicit consent.
b. Maintain appropriate boundaries in the relationships you have with patients.
c. Comply with any internet and social media policy set out by your employer.
it is important that when you share something online it will be there permanently.
when referring what must you consider?
- when to refer
- how to refer
- urgent or routine
- who to refer to
when should you refer?
- when you dont know what to do
- when there’s something that’s very worrying
- when you mess something up.
- when the patient wants another opinion
- when guidelines tell you to
how should you refer?
how you refer is different depending on the system available such as:
- electronically by standard form
- letter
- phone - no evidence of phone call so make sure you follow up with letter.
- secure email - recipient can be on holiday or sick, so may receive late, so make sure you follow up with email.
- combination
- dialing 999
if a referral is urgent what must you do?
if urgent state plainly why?
what are the degrees of urgency required to get a referral
cancer is suspected
potentially airway threatening swelling
life-threatening sepsis
medical emergency in surgery
major child/adult protection issue
suicide risk
ulcer present for 4 weeks, what would be the referral pathway for this
guideline for urgent referral
who can we refer patients to?
dental hospital
district general hospital
another GDP
private dental specialist
general medical practitioner
other health professional
medical specialist
what are the key features of a referral letter?
- contact details of patient
- are you looking for advice only or treatment
- state priority
- compact summary of major issues & history
- RELEVANT social/medical history
- any other concerns you may have
- relevant enclosures - may need to send pictures
- may need to copy the letter to anyone else
- try not to blame
- keep it courteous - this letter may be seen by others.
when writing to patients how must you write?
write in plain language
what is crown indemnity
is indemnity provided by the hospitals
when you qualify you are put on a cycle - how long is this cycle
5 year cycle
mandatory annual reporting by a deadline
specific criteria (development outcomes)
recommended topics
mandatory reflection
if a development outcome does not appear on a form, what does that mean?
it means it is not valid as a CPD
Why do we appraise?
The appraisalprocess allows provision of positive feedback as well as identifying areas for improvement and barriers eg health issues. It gives an opportunity to discuss a personal developmental plan to enhance skills. It motivates people.
Why is appraisal important in healthcare?
Appraisal is essential to maintain the public, employer, self and other healthcare workers confidence in the safety & effectiveness of the dental profession
the abbreviation HIS stands for
health improvement scotland: a body that visits practices and sets standards
the abbreviation CQC stands for
care quality commision - same as HIS but for england instead.
the abbreviation NES stands for
NHS education for scotland
the abbreviation NHSBSA stands for
NHS Business Authority - they payout for NHS primary dental care in england.
the abbreviation SPPA stands for
Scottish Pension payment agency
what are the 4 main groups of barrier to raising concerns?
cultural/systemic
workplace
personal
process barriers
