12 April 2011

Q. A new patient has registered with our NHS practice and has requested that she remains with the hygienist at her old private practice with whom she has a good relationship. The hygienist has rightly said she needs a prescription from me as her new dentist but I am cautious about referring to a hygienist I haven't worked with. I prefer the team approach to working and we do have a hygienist here. Can I refuse or do I have to agree to the patient’s wish?

You may have already answered the question yourself when you referred to the service at your practice where you have “a team approach”.

It surely must be easier to look after a patient’s care when all the practitioners are located at the same address so that the team approach can be progressed.

Having said that there is no legal reason why you should not prescribe to a hygienist in another practice if you can satisfy yourself that the hygienist works in a way which is acceptable to you and they will co-operate with you in the patient’s overall treatment plan.

It does seem somewhat strange that the patient has transferred to you as a dentist and it is not impossible that the patient has an issue with the previous dentist who was treating her at the old practice. If that is indeed the case then surely your prescriptions to the hygienist at the old practice could be criticised by the dentist there and of course that would be in nobody’s interest.

It might be a good idea for you to write a gentle letter to the patient explaining why you would prefer the hygienist at your practice to carry out the treatment in accordance with your established team approach.

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