5 April 2011
Q. I have just started work in a new practice where I have been asked to treat a number of patients who are unhappy about treatment provided by a dentist who has since left. Is it legally possible to refuse NHS treatment, if I feel that the patient is likely to complain in the future and so involve me in the complaint about a failed treatment that I did not provide?
Problems of this nature are always worrying, particularly if you feel that the circumstances are outside of your control. We do not know why your previous colleague left the practice, but if it was as a result of concerns raised by the practice as a whole, then it may well mean that you will find that there will be a considerable number of complaints and you will be asked to ‘pick up the pieces’.
Complaints about a previous practitioner should not influence the treatment you provide for a patient, as at all times you would be required to act in their best interest. If, in your clinical opinion, the patient requires a particular item of treatment, it is important that such treatment is provided for that patient.
Before undertaking that treatment it is important that you explain the situation very carefully to the patient without necessarily being critical of your colleague. That can be difficult, particularly if the error seems quite profound. If the patient does question you and perhaps presses you to make an observation, it is a question of explaining to the patient your findings and indicating that it would be difficult (and in some cases inappropriate) for you to comment on any previous treatment that had been done, for the simple reasons that you did not know the circumstances that prevailed at that time.
As for refusing to provide treatment to a patient who might complain about you in the future, then again you should be careful. Patients do have a right to complain and they should not be penalised for doing so. If you refuse to provide treatment to this patient simply on the basis that they may complain about you then you will probably find that they will indeed make a complaint to the PCT or the General Dental Council. You would then have to explain why you had discriminated against them.
Providing that you are acting in the patient’s best interests at all times and can justify the treatment plan you have put forward, then there should be little difficulty. It would be sensible to ensure that your dental records are good and that appropriate radiographs and photographs are taken to help demonstrate that the treatment you are proposing is correct. Similarly, you should make sure that you explain the treatment (and the reasons for that treatment) very clearly to the patient and that s/he understands the treatment before you begin. If problems do occur (for whatever reasons) then again you should make sure that you explain the situation to the patient and ensure that they are fully aware of the circumstances. Avoiding complaints is often the matter of good communication and good record keeping.