Rheumatology Tutorial

Question 1

Are you aware of any legislation which exists to enable the access and provision of care for all individuals and groups of people?
1) List the key pieces of legislation

Answer 1

• National Health Service (Scotland) Act 1978
• Equality Act 2010
• Patient Rights (Scotland) Act 2011
• Adults with Incapacity (Scotland) Act 2000
• Children and Young People (Scotland) Act 2014
• Mental Health (Care and Treatment) (Scotland) Act 2003
• Carers (Scotland) Act 2016

Question 2

The concept of reasonable adjustments is present within the legal framework
i. Attempt to define and explain the concept of reasonable adjustments
ii. Suggest one example of a reasonable adjustment which a dentist might make to a dental practice
iii. Suggest one example of an adjustment which would be unreasonable to make to a dental practice
iv. What would you do if you were unable to make any reasonable adjustments to enable Mrs Smith to
access your practice?

Answer 2

Reasonable adjustments are changes made to ensure that individuals with disabilities or other needs are not placed at a disadvantage compared to others when accessing services, including healthcare. Under the Equality Act 2010, healthcare providers are legally required to take steps to accommodate individuals, provided these changes are practical and proportionate.

ii) Installing a portable ramp to provide wheelchair access to the practice for patients with mobility impairments.

iii) Demolishing and rebuilding the entire practice to make it fully accessible if the costs are disproportionate to the size and resources of the practice.

iv) If no reasonable adjustments can be made, I would arrange alternative care by:

Referring Mrs. Smith to a more accessible dental practice or community dental service equipped to meet her needs.
Ensuring the referral process is smooth and that Mrs. Smith receives the care she requires.

Answer 3

Hoist

Positives: Provides a safe and efficient method for transferring patients with significant mobility issues; reduces risk of injury to both patient and staff.
Limitations: Expensive to purchase and maintain; requires space and training for proper use.

Transfer Board

Positives: Simple, portable, and cost-effective; can facilitate self-transfer with minimal assistance.
Limitations: Requires a certain level of upper body strength and cooperation from the patient.

Adjustable Dental Chair with Wheelchair Tilt

Positives: Allows treatment without the need for transfer; maintains patient dignity and comfort.
Limitations: Limited to practices with specialized equipment; may not be feasible for all procedures.

**Stand Aid **

Positives: Provides safe transfer with mechanical support; reduces strain on staff.
Limitations: Requires some patient mobility and space; can be costly.

Turntable (Transfer Disc)
Positives: Compact, affordable, and allows easy pivoting for partial mobility.
Limitations: Requires the patient to bear some weight; unsuitable for severe impairments.

Question 4

a) What measures would you put in place to maximise her preventative regime?
b) What if this person is unable to hold a toothbrush due to her Rheumatoid Arthritis? Can you suggest any modifications or advice you would give to her?

Answer 4

a) Measures to Maximise Preventative Regime
* Educate on oral hygiene practices.
* Recommend high-fluoride toothpaste and fluoride varnish.
* Provide dietary advice to reduce sugar intake.
* Suggest antimicrobial mouthwash.
* Schedule regular check-ups.

b) Modifications for Rheumatoid Arthritis
* Use an electric toothbrush with an ergonomic handle.
* Add grip aids to standard toothbrushes.
* Recommend floss holders or interdental brushes.
* Suggest fluoride mouthwash as an alternative.