Q A dental practice manager is tasked with updating the practice website. She wants to highlight the dentists’ considerable experience in treating older patients and plans to include details on the site that they "specialise in denture work". She calls MDDUS to check if this is allowed.
A An MDDUS adviser tells the PM that the General Dental Council have introduced strict new rules on what can be published on websites. Only dentists who are on one of the GDC’s 13 specialist lists can use the title ‘specialist’ or describe themselves as a ‘specialist in…’ Under these rules, the practice website cannot use the phrase ‘specialise in denture work’ as the GDC says this may mislead patients by implying specialist status. Various other information, including the dentists’ GDC numbers, professional qualifications, GDC contact details and the practice complaints procedure, must now also be included on practice websites. See Principles of Ethical Advertising for more details.
Q A practice has been asked for a copy of all complaints correspondence by the health service ombudsman relating to the case of a delayed diagnosis of renal cancer in a 74-year-old patient. The PM prepares his response and gathers together all relevant emails and letters, including those between the practice and MDDUS. He calls an adviser before sending the bundle
A Although the ombudsman has asked for all correspondence relating to the complaint, MDDUS correspondence with members should NOT be included. All letters and emails sent between MDDUS and our members are privileged and do not require to be disclosed. There is no requirement to disclose to anyone the advice MDDUS has given to members to assist them in responding to a complaint appropriately.
RECORDS AFTER DEATH
Q The daughter of an elderly patient who died two years ago has requested access to her late mother’s medical records to find out more about the treatment she received before her death. The deceased patient’s husband, who is the executor of her estate, has not given consent for the disclosure. The PM asks MDDUS if she is obliged to provide the daughter with access.
A In the case of a deceased patient, the patient’s personal representative (the executor/administrator of their estate) and any person who may have a claim arising out of the patient’s death has a right to access their medical records. If the daughter is merely seeking information about her mother then the practice requires consent from the patient’s personal representative – in this case the patient’s husband – in order to grant access to the records. However, if the daughter intends to make a claim on her mother’s estate, the Access to Health Records Act (1990) allows for the information to be divulged without the consent of the patient’s personal representative. All requests should be considered on a case-by-case basis.
POWER OF ATTORNEY
Q A GP is approached by the brother of a patient who has lost capacity and can no longer make decisions about her treatment. The brother says he has power of attorney and wants to discuss his sister’s care and future treatment. The GP is unsure if he is allowed to discuss the patient’s case with her brother.
A If you have confirmed the patient has lost capacity then the next step is to clarify which type of attorney power the brother holds. These can be for financial or welfare decisions or both. If the brother has powers covering welfare then this would permit you to have discussions regarding medical treatment decisions. Legislation varies in Scotland and England but common themes state that any decisions must be made on the basis of most benefit to/best interests of the patient, the least restrictive option should be preferred, account should be taken of the patient’s previous expressed wishes if known, and the views of relatives and carers should be taken into consideration.
Q A practice manager wants to open a practice account on the social networking site Twitter to keep patients informed about holiday closures, flu jabs/ vaccination schedules and other relevant information. She does not want the Twitter account to be used to contact patients or as a means for patients to contact the practice. She asks MDDUS for advice.
A There are no specific rules barring practices from using social media to communicate with patients, provided patient confidentiality is always respected. You must never ‘tweet’ (make public via your Twitter account) confidential patient information and patients should not be contacted individually through Twitter. Be mindful of patient confidentiality when seeking to advertise the Twitter feed to patients. It is also worth clearly stating on the Twitter page that this is not a means for patients to book appointments or contact practice staff with clinical queries, and alternative practice contact details should be clearly posted. Refer to Twitter user guides to ensure your account does not allow ‘followers’ of your feed to send you direct messages.
Q A practice has employed an agency worker for the past four months to fill in for a receptionist on maternity leave. The practice has recently agreed to increase employees’ annual leave allowance by one day but does not intend to include the receptionist as she is only an agency worker. The manager asks MDDUS if this is allowed.
A New legislation came into force in October 2011 that granted agency workers the right to equal treatment after 12 weeks on assignment. Because your receptionist started after this date and has worked for more than 12 continuous calendar weeks, you must include her when awarding an extra day’s annual leave.