This is an exceptionally difficult and rapidly evolving situation and we wish to offer reassurance that MDDUS stands ready to assist, advise and support our members.
Dentists should ensure they remain aware of the latest guidance from the relevant government and health departments and follow those guidelines. You should be knowledgeable of General Dental Council (GDC) guidance, ensuring that this continues to be followed.
The GDC are clarifying and updating their guidance online, as matters proceed, which can be accessed at this link: https://www.gdc-uk.org/information-standards-guidance/covid-19.
At all times you should be in a position to justify your actions with reference to the available guidance, if later called upon to do so.
For further guidance, please watch both our webinars on dentolegal essentials where advice is provided on areas such as indemnity, triaging, remote prescribing, risk assessment and record keeping.
Link: COVID-19: dentolegal essentials
Link: COVID-19: dentolegal essentials 2
*For members practising in England, please read the latest MDDUS guidance here.
1. Can I be re-deployed in a non-dental role?
The NHS across all jurisdictions of the UK is seeking to utilise the skills of the dental team to support the wider COVID-19 response and to maximise the effectiveness of the existing healthcare workforce. NHS England Guidance on redeploying the clinical dental workforce to support the NHS clinical delivery plan for COVID-19 provides a non-exhaustive list of potential redeployment scenarios for the dental team. The Chief Dental Officer in Scotland has also outlined a list of settings in which the dental team can support the wider NHS and equivalent guidance has been issued in Wales.Close
When a dental professional is re-deployed, the same basic principles apply as in any other situation: the test is whether they are trained, competent and indemnified for the tasks they undertake.
The GDC has stated: “We expect registrants to make a considered judgement about whether they are trained and competent; we do not expect them to limit themselves to the specific activities set out in their scope of practice. That doesn’t make scope of practice irrelevant: it will be a useful starting point for considering what wider tasks are appropriate, but it does not in itself constrain dental professionals’ ability to support the COVID-19 response.”
2. Who will indemnify me if I am re-deployed to an urgent dental care centre or in a non-dental role?Many dental professionals have expressed concern regarding who will indemnify them for claims arising from work they do in an Urgent Dental Care Centre. The NHS England Guidance referred to above clarifies that, where dentists are redeployed, “…they should be reassured that they will be covered for any clinical negligence arising from their NHS activities (irrespective of where the NHS services are provided – in hospital, a clinic, on GP premises, etc)” by one of the existing schemes (CNST or CNSCP) or under the Coronavirus Act. Similarly, the Cabinet Secretary for Health and Sport in Scotland has written to Territorial Health Board Chief Executives to direct that NHS indemnity under the Scottish Government’s Clinical Negligence and Other Risks Scheme (CNORIS) must extend to “General dental practitioners and dental practice staff working in the urgent dental care treatment centres or deployed to wider COVID-19 response roles.”
There may, however, be some instances in which these arrangements will not apply and so if you have any remaining concern, please contact MDDUS for further advice on your claims indemnity requirements if you are working or planning to work in a redeployed role.
In addition, dental professionals should be mindful that NHS indemnity is not comprehensive – it covers clinical negligence claims but nothing else. MDDUS members will continue to benefit from 24/7 access to advice from leading dentolegal experts, as well as advice and representation for disciplinary matters, GDC hearings and Coroners Inquests / Fatal Accident Inquiries, amongst other benefits. Close
3. What should dentists consider when undertaking remote or online consultations rather than seeing patients face to face?
Remote consulting can be used safely, provided clinicians are aware of and manage the associated risks.
Dentists should be familiar with the principles of the GDC Guidance High level principles for good practice in remote consultations and prescribing, which sets out the high level principles of good practice expected of everyone when consulting and or prescribing remotely.
For more detail please see our published guidance on this topic: 'Remote consulting in the coronavirus outbreak'.
4. Dentists have reported concerns about increased dento-legal risk such as claims, complaints or GDC referrals. Will MDDUS support and defend dentists in that situation?
You can approach us for advice and guidance as usual at this challenging time.
The GDC has stated:
“Expert advice on the clinical aspects of COVID-19 will continue to come from the health authorities of the four nations and we will continue to signpost to this guidance as and when it is updated. But that guidance will inevitably not cover every potential scenario, and therefore, dental professionals will need to continue exercising their professional judgement and weigh the risks in any given situation. They will also need to continue to assess whether they are trained, competent and indemnified to carry out the activity in question.Close
“However, in the recent joint statement from the healthcare regulators we said that we understand that in highly challenging circumstances, professionals may need to depart from established procedures to care for patients and that should concerns be raised, relevant environmental and human factors would be taken into account.”
As the situation develops dentists should use the relevant guidance, at that time, to inform their decision-making, underscoring the importance of remaining up-to-date with the latest guidance.
Dentists are expected to behave responsibly and reasonably whilst exercising professional judgement in these unique and challenging times, balancing all the facts and considering the most up to date guidance to reach the decision you consider to be most appropriate at the time. It is good practice to document such decisions carefully, including the reasons for such decisions. This is all the more important in these unusual circumstances and where guidance may not be available that directly applies to the decision you are facing. If you are in doubt about any dento-legal or ethical aspects, please contact MDDUS for advice.
Should a complaint, claim or GDC referral arise from your actions, members can always turn to MDDUS for advice and support.
5. What should I do to keep up to date with guidance about the pandemic?Given the situation is rapidly evolving in light of new information, it is vital that you put processes in place to ensure you are kept up to date with the latest guidance.
You will need to check the relevant websites regularly so that you can ensure that you are up to date with the latest guidance. Viewing documents on the relevant websites rather than relying on a downloaded copy is essential to ensure that you are viewing the latest version in a rapidly changing situation.
Some practices find it helpful to have a lead person who is responsible for checking the relevant guidance regularly and ensuring the team is kept up to date.
It can also be helpful to keep a log of when the guidance was checked in order to demonstrate how and when you have kept up to date.
6. My practice owner is telling me to provide routine dentistry – what should I do?
Government policy UK-wide is that routine dental care is not to be provided. As an individual professional and a GDC registrant you have professional responsibility to act appropriately and to ensure the safety of your patients. You should follow appropriate guidance and signpost your practice owner to that guidance. Acting in accordance with a practice owner’s instruction in this way would not be an automatic justification to acting contrary to appropriate guidance. Remember - you are always individually responsible for your own actions.
Covid19 guidance and useful links
NHS England: https://www.england.nhs.uk/coronavirus/primary-care/dental-practice/
Northern Ireland: http://www.hscbusiness.hscni.net/services/3111.htm
RCS England: https://www.rcseng.ac.uk/dental-faculties/fds/coronavirus/