COVID-19 - MDDUS dento-legal advice for members practising in England

After the recent revised lockdown arrangements announced by the Prime Minister, please read below for the MDDUS’ dento-legal advice for all its members practising in England

*Please note. The below advice has been superseded by the latest MDDUS advice of 28 May 2020, which can be viewed here.

 

Background

As England moves towards easing the lockdown imposed in March 2020, MDDUS has been approached by members seeking advice and guidance about how this change might impact upon their dental practices. In these circumstances MDDUS’ role is to ensure that members have been signposted towards the relevant guidance, to assist them in making an informed decision. It is not MDDUS’ role to approve or disapprove of any particular course of action or business decision.

MDDUS’ advice remains that members who are NHS Providers and/or Performers must follow the guidance issued by the Chief Dental Officer in the relevant jurisdiction. This guidance has been issued in the context of the public health emergency caused by the Coronavirus. It is designed to markedly reduce the movement of the population and the number of physical contacts in an effort to reduce the spread of the virus in accordance with The Health Protection (Coronavirus, Restrictions) (England) Regulations 2020.

The underlying principle is that the only dental care being provided in dental practice is for the management of urgent and emergency care. There should be no “routine” dental care in general dental practice, irrespective of the type of practice.

Members who provide services on an entirely private basis are advised to pay attention to the guidance issued by the CDO, reinforced by the GDC. 

Currently, the Chief Dental Officer’s (England) advice to dentists is that the position remains unchanged from her most recent letter of 15 April. Members will appreciate that this is a rapidly changing situation and are therefore advised to pay close attention to all developments notably those sent out by the Chief Dental Officer. MDDUS members are also advised to review professional guidance which is available from the British Dental Association, the Faculty of General Dental Practice, and the Scottish Dental Clinical Effectiveness Programme. These authoritative bodies provide appropriate guidance in terms of risk assessment, definition of emergency care and analgesic and antibiotic prescribing.

All practices that are open will need to comply with any requests for information or directions (including any enforcement action) made by the CQC, which are designed to protect patients and staff.

Challenges

MDDUS is fully cognisant of the extremely difficult position in which all dentists currently find themselves. When contemplating face to face dental care outside of the NHS network however, members should proceed with extreme caution. These are matters of professional judgement and should a challenge subsequently arise, members must be prepared to explain why they departed from the national guidance.

It would be anticipated in England that only in rare circumstances would it be necessary for a member to see a patient for face to face treatment in their own practice. This would be a last resort, having completed triage, AAA and where it has not been possible to refer the patient for treatment successfully at the local urgent dental care centre (UDC). Before deciding to see a patient, an individual risk assessment will need to have been carried out and a record of that decision kept.  Should a judgement be made to offer face to face treatment, as a minimum, the current standard operating procedures (SOP) should be followed.

It is our understanding that some private UDCs have been set up. These should be integrated into the local health network, and the CQC should be made aware of their existence. It is again incumbent upon members that a clear decision making process is established, SOPs are operational and evidenced. In these situations members should be supported by a team that is totally familiar with the SOP. A training log would be beneficial.

Indemnity

Indemnity for clinical practice is included as a member benefit. Members must appreciate however, that if departing from the authoritative guidance the ability to provide a meaningful defence when challenged by a third party, may be limited.

If a member’s practising arrangements in this period exceed 5 hours clinical activity per week (including triaging) it is imperative that they notify MDDUS, to ensure that adequate and appropriate indemnity is in place.

We hope that the above clarifies the current understanding of the Dental Advisory Team. Should you be an MDDUS member and have any queries, then please contact us on advice@mddus.com or call the Dental Advisory line.

Dental Advisory Team
Updated - 20 
May 2020

 

*Initial advice published on 14 May 2020. Subsequently updated on 20 May 2020.