Standards of the Dental Team

Question 1

Principle 1

Answer 1

Put the patients interests first

Question 2

1.1 Listen to your patients

Answer 2

1.1.1 Discuss tx options with patients and listen. Allow for discussion and questions

Question 3

1.2 Treat every patient with dignity and respect at all times

Answer 3

1.2.1 Tone of voice and body language

1.2.2 Take patient preferences into account and be sensitive to needs and values

1.2.3 Treat with kindness and compassion

1.2.4 Manage pain and anxiety appropriately

Question 4

1.3 Be honest and act with integrity

Answer 4

1.3.1 Justify the trust that patients, public and colleagues place in you by acting honestly and fairly. Applies to business, education activities and professional dealings

1.3.2 Don’t bring profession into disrepute

1.3.3 Advertising, promotional material and information is accurate, not misleading and complies with GDC ethical advertising guidance

Question 5

1.4 Take a holistic and preventative approach which is appropriate to individual patient

Answer 5

1.4.1 Holistic approach = consider patients overall health, psychological and social needs, long term oral health needs and desired outcomes

1.4.2 Provide treatment that is in the patients best interest, providing OH advice that follows clinical guidance. Balance OH needs with desired outcomes. When desired outcomes are not achievable/in best interest then explain risks and benefits and likely outcomes.

Question 6

1.4 Take a holistic and preventative approach which is appropriate to individual patient

Answer 6

1.4.1 Holistic approach = consider patients overall health, psychological and social needs, long term oral health needs and desired outcomes

1.4.2 Provide treatment that is in the patients best interest, providing OH advice that follows clinical guidance. Balance OH needs with desired outcomes. When desired outcomes are not achievable/in best interest then explain risks and benefits and likely outcomes.

Question 7

1.5 Treat patients in a hygienic and safe environment

Answer 7

1.5.1 Know the laws and regulations that you must follow. Including disposal of waste, radiography, health&safety, decontamination, medical devices

1.5.2 Necessary vaccinations and follow BBV guidance

1.5.3 DME guidance and training issues by Resuscitation Council

1.5.4 Record all patient safety incidents and report to appropriate national body

Question 8

1.5 Treat patients fairly, as individuals, without discrimination

Answer 8

1.6.1 No discrimination against - Age, Disability, Gender, Marriage/Civil Partnership, Pregnancy/Maternity, Race, Religion, Sex, Sexual Orientation, Nationality, Special Needs, Health, Lifestyle

1.6.2 Aware of and adhere to all your responsibilities set out in equalities legislation

1.6.3 Consider patient disabilities and make adjustments so they receive care to meet their needs. Or refer if adjustments cannot be made to treat safely.

1.6.4 Do not express personal beliefs in any way that exploits pt vulnerability or causes them distress

Question 9

1.7 Put patients’ interests before your own (or colleague, business or organisation)

Answer 9

1.7.1 Patients interests > financial, personal or other gain

1.7.2 Work in a practice that provides NHS and private. Make clear which treatments can be provided under which.

1.7.3 Do not mislead patients into believing their treatment is only privately available. Ensure patients know you are a private only practice before they attend.

1.7.4 Do not pressurise patients into having private treatment if it NHS available.

1.7.5 Refuse gifts, payment or hospitality if accepting could affect professional judgement.

1.7.6 Referrals must be in patient’s best interest and no for financial gain or benefit.

1.7.7 If patients at risk because of your health, behaviour or professional performance or that of your colleague or clinical environmental, take prompt action.

1.7.8 If ending professional relationship with patient due to trust issues, be satisfied your decision is fair and justifiable. Write to patient with reasoning. Take steps to ensure their care continues elsewhere.

Question 10

1.8 Have appropriate arrangements in place if patient’s harmed and seek compensation

Answer 10

1.8.1 Appropriate insurance or indemnity in place so patients can claim compensation if entitled to.

1.8.2 Keep to T&Cs of your insurance/indemnity and contact as soon as claim is made.

Question 11

1.9 Know and Follow laws and regulations that affect your work

Answer 11

1.9.1 Data protection, Employment, Human Rights & Equality, Registration with other regulatory bodies

Question 12

Principle 2

Answer 12

Communicate effectively with patients

Question 13

2.1 Communicate effectively with patients, listen, give time to consider and take their individual views and communication needs into account

Answer 13

2.1.1 Treat patients as individuals. Take their specific communication needs and preferences into account. Respect cultural values and differences.

2.1.2 Be fluent in written and spoken English to communicate with all.

Question 14

2.2 Recognise and promote patient rights and responsibilities to make decisions

Answer 14

2.2.1 Listen & communicate effectively so they understand. Explain tx options, risks and benefits and costs.

2.2.2 Encourage patients to ask questions about tx options

2.2.3 Give full and honest answers

Question 15

2.3 Give patients information they need and understand to make informed decisions

Answer 15

2.3.1 Introduce yourself to patient. Explain role.

2.3.2 Involve other team members if they have knowledge of patient background or concerns where appropriate.

2.3.3 Recognise communication difficulties and meet particular communication needs. No jargon. Interpreter. Sign language assistance. Induction loop.

2.3.4 Be satisfied your patient understands the information. Ask questions and summarise.

2.3.5 Ensure patient has enough information and time for questions and decisions.

2.3.6 Written treatment plan, signed by patient.

2.3.7 Treatment plan includes; proposed tx, cost, if tx is NHS or private.

2.3.8 Continuously review tx plan and costs. Inform patient of changes. Update in writing.

2.3.9 Patients aware of emergency care and out of hours arrangements, should they require.

2.3.10 Ensure patients can contact you by their preferred method.

2.3.11 Clear information to patients regarding referral arrangements.

Question 16

2.4 Clear information about costs

Answer 16

2.4.1 Simple price list displayed that is visible.

2.4.2 Clear information on prices on website.

2.4.3 Tell patient if treatment is guaranteed, under what circumstances and for how long. Make clear when tx cannot be guaranteed.

Question 17

Principle 3

Answer 17

Obtain valid consent

Question 18

3.1 Obtain valid consent before starting treatment, explaining relevant options and costs

Answer 18

3.1.1 Have valid consent before treatment or investigation. Do not assume someone else has obtained it.

3.1.2 Document discussions of gaining consent from patient. Signature and discussion in notes.

3.1.3 Tell what the patient wants and needs to know. To include; options, r&b’s, consequences, reccomended tx & why, likely prognosis, cost, no tx, is the tx guaranteed?

3.1.4 Ensure and document patient understanding.

3.1.5 Pt can withdraw, refuse tx, ask to stop whenever. Acknowledge their right to do so. Explain consequences of not continuing tx. Patient is responsible for future complications which may arise. Record in notes.

3.1.6 Obtain written consent for conscious sedation or GA

Question 19

3.2 Ensure patients understand the decisions they are asked to make

Answer 19

3.2.1 Provide patients with sufficient information and give reasonable time to consider before making decision.

3.2.2 Tailor obtaining consent to patient needs. Help them make informed decisions about their care in a format they understand.

3.2.3 Encourage patients who have communication difficulties to bring a friend/relative/carer during consenting process.

3.2.4 Consider whether patients can make care decisions themselves. Avoid making assumptions about patient ability to consent.

Question 20

3.3 Ensure patient’s consent remains valid

Answer 20

3.3.1 Consent is a process. On-going communication between patients and team. Keep patients informed of their progress of care.

3.3.2 Gain specific consent at each appointment if treatment is ongoing.

3.3.3 Tailor how you confirm ongoing consent to each patient. Ensure they understand.

3.3.4 Document discussions with patients in process of confirming consent.

3.3.5 Obtain consent before changing agreed treatment or estimated cost.

Question 21

Principle 4

Answer 21

Maintain and protect patients’ information

Question 22

4.1 Keep Contemporaneous, Complete and Accurate patients records

Answer 22

4.1.1 Make and keep accurate patient records. Up-to-date MH at each appointment. Keep RG’s, consent forms, photographs, models, audio/visual recordings of consultations, lab prescriptions, conformity and referral letters.

4.1.2 Record detail of discussions with patients. Include evidence you’ve got valid consent. Include details of particular treatment needs where appropriate.

4.1.3 Meet responsibilities for patient info. Current regulations. Follow appropriate national advice on retaining, storing and disposing patient records.

4.1.4 Clear, accurate and legible documentation of your work/patient records. Operator name.

4.1.5 If amending patient records, ensure marked and dated.

4.1.6 Referring to other professional = accurate record of referral and prescription (if applicable).

Question 23

4.2 Protect confidentiality of patient info and use for purpose it was given

Answer 23

4.2.1 Confidentiality = trust. All patient records = confidential.

4.2.2 Non-registered members of team must be aware of confidentiality and keep records confidential.

4.2.3 No info/comments about patients on social media. Careful patients are non-identifiable if discussing anonymised cases on professional social media.

4.2.4 Don’t talk about patients or treatment where overhead by public

4.2.5 Ensure patients know circumstances when you need to share info to others. Let them know what info, why releasing and outcome of releasing. Patients can withhold their permission to share. Records in notes if they do or don’t give permission

4.2.6 Ensure whoever sharing with knows the info is confidential

4.2.7 if people ask for info on patient or if you want to use their photos; patient knows how their info is used for, patient understands what they’re agreeing to, obtain+record patient consent to use, release minimum info necessary, patient can withdraw. Anonymous where possible.

4.2.8 Patient info confidential even if patient dead.

4.2.9 Confidential duty also covers recordings/images of patients such as; photos, recordings, original+copies, off mobile phones. Nothing recorded without permission.

Question 24

4.3 Only release patient info without permission in exceptional circumstances

Answer 24

4.3.1 Only release confidential if in best interest of public/patient. If patient safety or others at risk. If info used for preventing/detecting crime. Try get patient permission to release. Encourage patient to release the info themselves. Document efforts to obtain consent for release in notes.

4.3.2 If gaining consent to release confidential info from patient no possible (patient doesn’t permit/not appropriate), get advice from defence organisation before releasing.

4.3.3 If you have info that a patient is at risk of harm/suspect of abuse, inform social care agencies/police.

4.3.4 Can be ordered by court/statutory duty to release info about patient w/o permission. Release minimally to comply.

4.3.5 Document reasons and prepare to explain/justify in any circumstance why you release confidential info.

Question 25

4.4 Ensure patients have access to their records

Answer 25

4.4.1 Patients don’t own their records. They have right to access under DP legislation. Arrange their access promptly, in accordance with law, if asked.

4.4.2 Possible to charge patient fee for record access. Charge depends on if paper or electronical.

Question 26

4.5 Keep patient info secure at all times.

Answer 26

4.5.1 Ensure patient info not accidentally revealed to anyone without authorised access. Don’t leave records where they shouldn’t be.

4.5.2 Send confidential info securely. Electronically must be encrypted.

4.5.3 Computerised records need back-up copies.

Question 27

Principle 5

Answer 27

Clear & Effective complaints procedure

Question 28

5.1 Effective complaints procedure available for patients. Always follow that procedure.

Answer 28

5.1.1 Deal with complaints properly+proffessionally. Ensure effective written complaints procedure. Follow procedure. Respond within time limits set by procedure. Constructive responses.

5.1.2 Everyone in team knows and understands complaints procedure. Staff training for handling complaints.

5.1.3 Follow NHS/hospital complaint procedure if working for them.

5.1.4 Private practice should have and follow similar standards and time limits to NHS.

5.1.5 Complaints procedure; visible to patients, clear+plain language, understandable, info of other independent contactable organisations, prompt+efficient response, full+fair investigation, explain possible outcomes, respect patient confidentiality.

Question 29

5.2 Respect patient right to complain

Answer 29

5.2.1 Do no act defensively to complaints. Listen. Involve them is procedure. Find out patient expectations from complaint.

Question 30

5.3 Provide prompt and constructive response.

Answer 30

5.3.1 Give pt copy of CP when acknowledging their complaint.

5.3.2 Deal in calm and constructive way.

5.3.3 Resolve efficiently, effectively and politely.

5.3.4 Respond in time limits of CP

5.3.5 Tell patient when you’ll respond if you need more time

5.3.6 Regular 10 day updates in exceptional circumstance where complains can’t resolve in scale.

5.3.7 Deal with all points raised and provide solution.

5.3.8 Offer apology + practical solution where possible.

5.3.9 If justified complaint, offer fair solution - putting things right at own expense/time.

5.3.10 Respond in writing, set out findings + practical solutions. Letter= clear, deals with concerns+easy to understand.

5.3.11 If pt not satisfied despite best efforts to resolve, explain other avenues open to them. Ombudsman for health service complaints or Dental Complaints Service if private.

Question 31

6.1 Work effectively with colleagues. Contribute to good teamwork.

Answer 31

6.1.1 Ensure any team involved works together to provide appropriate dental care to pts.

6.1.2 Treat colleagues fairly with respect. Do not bully, harass, discriminate.

6.1.3 Treat colleagues fairly in financial transactions.

6.1.4 Value and respect contribution of all team members.

6.1.5 Ensure patients know involved team members names and roles.

6.1.1

Question 32

6.1 Work effectively with colleagues. Contribute to good teamwork.

Answer 32

6.1.1 Ensure any team involved works together to provide appropriate dental care to pts.

6.1.2 Treat colleagues fairly with respect. Do not bully, harass, discriminate.

6.1.3 Treat colleagues fairly in financial transactions.

6.1.4 Value and respect contribution of all team members.

6.1.5 Ensure patients know involved team members names and roles.

6.1.6 You may be held responsible for actions of other staff not registered with GDC (receptionists, PMs, lab assistants). Ensure they’re trained+competent.

Question 33

6.2 Supported appropriately when treating patients

Answer 33

6.2.1 Do not provide treatment if circumstances mean its unsafe for pt.

6.2.2 Always work with another appropriately trained staff when treating. Exceptions; treating in out of hour emergency, tx as part of public health programme, exceptional circumstance (doesn’t include absences form training/sickness/leave)

6.2.3 Assess risk of treating patient if appropriately trained member isn’t available.

6.2.4 Support from GDC/health registrant when treating in hospital setting.

6.2.5 Support from GDC registrant when providing care in domiciliary setting/care.

6.2.6 Ensure 1 person available in environment in case medical emergencies.

Question 34

6.3 Delegate + refer appropriately

Answer 34

6.3.1 Delegate responsibility, not accountability. You could still be responsible if something goes wrong. Only refer/delegate to competent/trained.

6.3.2 Do not pressurise someone into accepting the task.

6.3.3 Refer if treatment is outside stope of practice.

6.3.4 Clear request with all info when asking colleague to provide dental appliance, treatment or clinical advice.

6.3.5 Explain reason for referral and process to patient. Record in notes.

Question 35

6.4 Only accept referral/delegation if trained, competent and think its appropriate for patient

Answer 35

6.4.1 Ensure it’s clear what is being asked to do and you have the knowledge+skills if colleague asks you to provide tx, dental appliance or clinical advice.

6.4.2 If you don’t think its appropriate, discuss with colleague. Only go ahead if satisfied its appropriate. Otherwise seek advice.

Question 36

6.5 Communicate clearly and effectively with other team members/colleagues in interests of patients.

Answer 36

6.5.1 Document any discussions with colleagues regarding patient tx. Include decisions changed/reached.

Question 37

6.6 Demonstrate effective management and leadership skills

Answer 37

6.6.1 All none GDC registered must have; induction, performance management, learn+develop opps, hygienic+safe+non discriminatory work environment, feedback, raise concern

6.6.2 Relevant team members + training members are appropriately registered with GDC/healthcare reg. Also idemnified.

6.6.3 Encourage team members to follow this guidance.

6.6.4 Communicate regularly with team members

6.6.5 Encourage, support and facilitate continuing professional development (CPD) of team.

6.6.6 Medical emergencies; 2 people available always, all staff know their role if happens, appropriate staff are trained

6.6.7 Ensure team has good leadership, clear/shared aims, understanding of their R+R’s

6.6.8 All members know their R+R’s. What has been delegated to them (actions+decisions).

6.6.9 Discuss all new policies and procedures with colleagues. Ensure understanding + responsibility to comply

6.6.10 Display info of team members (reg number) visible to patients.

6.6.11 Display that you’re regulated by GDC and 9 principles visible to patients.

Question 38

Principle 7

Answer 38

Maintain, develop and work within your professional knowledge and skills

Question 39

7.1 Provide good quality care based on evidence and authoritative guidance

Answer 39

7.1.1 Know and follow current evidence + best practice which affects your work, premises, equipment and business.

7.1.2 Record + justify if you ever deviate from guidance.

Question 40

7.2 Work within knowledge, skills, professional competence and abilities

Answer 40

7.2.1 Carry out treatment that you’re trained for. Must be competent, confident + indemnified. Must be able to perform safely.

7.2.2 Only deliver tx+care if confident you have the rightt training and are competent. Otherwise refer to appropriately trained.

7.2.3 Work within mental and physical capabilities.

Question 41

7.3 Update + develop professional knowledge + skills

Answer 41

7.3.1 Know how much CPD activity is required to maintain registration. Carry out within time scales set.

7.3.2 Take part in activities to maintain/update your knowledge+skills. CPD should improve your practice.

Question 42

Principle 8

Answer 42

Raise concerns if patients @ risk

Question 43

8.1 Always put patient safety first

Answer 43

8.1.1 Raise concern if pt@risk from; health, behaviour, performance of colleague, environment, someone asking you to do something that conflicts your duties to protect pt. Raise even if you can’t control or influence. Duty to raise>personal/professional loyalites.

8.1.2 Don’t agree to contract with ‘gagging clause’ = stops you raising concerns

Question 44

8.2.Act promptly if pt or colleague @ risk. Protect.

Answer 44

8.2.1 Act on concerns quickly, to reduce serious risk to pt safety. Consider short/long term impact if you don’t raise. Raise if in doubt.

8.2.2 Don’t need to prove concerns for it to be investigated. If investigation indicates no problem, it should not be held against you as long you can justify raising. Put patient interest first+protect.

8.2.3 Raise concerns first with employer/manager.

8.2.4 If not possible to raise in house, or they fail to act. Raise concern with local commissioner/appropriate body. CQC, Health Inspectorate of Wales, Regulation + Quality Improvement Auth, Healthcare Improved Scotland.

8.2.5 If public/patients need protecting from registered GDC dentist, refer concern to GDC. Appropriate when in house not practice/has failed, problem is so severe, fear of victimisation/deliberate concealment, registrant not fit to practice due to health/conduct/performance.

8.2.6 Refer concerns about other healthcare professionals to relevant regulator

Question 45

8.3 Employ, manage or lead team that encourages+supports a culture where staff can raise concerns without fear

Answer 45

8.3.1 Promote openness to aid raising concerns

8.3.2 Embed openness into policies+procedures. Staff training and induction.

8.3.3 Encourage all staff to raise concerns re pt safety.

8.3.4 Do not offer ‘gagging clause’ contract that would prevent staff raising concerns.

Question 46

8.4 Ensure if you employ, manage or lead team that there is effective raising concern procedure that’s readily available.

Answer 46

8.4.1 Written procedures in place to enable concern raising. Be aware+adhere to current L+Rs. Support team members who raise. Steps to tackle shortfalls in standards and performance. Systems in place for staff having problems with their health/behaviour/professional performance.

8.4.2 When team member raises concerns; Take seriously. Maintain confidentiality. Investigate promptly. Unbiased assessment of concern. Keep member advised of progress. Monitor the action that is solving.

Question 47

8.5 Take appropriate action if concerned about abuse of children/adults

Answer 47

8.5.1 Raise concerns of abuse or neglect. Contact for further advice and how to refer concerns to appropriate authority.

8.5.2 Know local procedures for protection of children and adults. Follow if you suspect they’re at risk.

Question 48

Principle 9

Answer 48

Personal behaviour maintains patient confidence in you and dental profession

Question 49

9.1 Ensure work and personal life conduct justifies patient trust in you

Answer 49

9.1.1 Treat all team members/colleagues/public fairly+with dignity.

9.1.2 No disparaging remarks about other dental team members in front of patient.

9.1.3 Don’t publish anything that can affect patient+public confidence in you/profession. No personal, innaccurate, derogatory comments online.

9.1.4 Maintain appropriate boundaries with patients.

Question 50

9.2 Protect patients + colleagues from risks posed by health, conduct or performance

Answer 50

9.2.1 If you suspect pt is at risk of your health, behaviour or performance, consult qualified colleague immediately.

9.2.2 Do not reply on own assessment of risk you pose to patient. Seek occupational health advice.

Question 51

9.3 Inform GDC if you’re subject to criminal proceedings or a regulatory finding is made against you (Anywhere in world)

Answer 51

9.3.1 Inform GDC immediately if subject to criminal proceedings

9.3.2 Inform GDC immediately if subject to fitness to practice procedures of another healthcare regulator.

9.3.3 Inform GDC immediately if finding has been made against your registration by another health care regulator.

9.3.4 Inform GDC immediately if placed on barred list held by Disclosure and Barring Service or Disclosure Scotland

Question 52

9.4 Co-operate with relevant formal or informal inquiry and give full + truthful info

Answer 52

9.4.1 If receive letter form GDC in connection with concerns about fitness to practice, respond within time specified. Seek advice from indemnity.

9.4.2 Co operate with; Commissioners of health, healthcare regulator, hospital trusts carrying out investigation, coroner, regulatory bodies, health+safety executive, solicitor/barrister representing patients/colleagues.