Q1. Do I really need indemnity?
Paragraph 1.6 of the General Dental Council's document, "Standards for Dental Care Professionals", makes it very clear that all registrants should ensure that "patients are able to claim any compensation they may be entitled to by making sure they are protected against claims at all times, including past periods of practice". In essence, this means that all clinicians on the dental register should have the appropriate indemnity.
It is well worth checking to see if you already have indemnity through your employer. This would probably be the case if you are an employee. This employer indemnity (vicarious liability) is however limited to assistance with claims in negligence, and is unlikely to provide you with any advice or help in the event of a complaint, an employment dispute or action against you at the GDC. Top up indemnity is therefore required. It is Dental Protection's recommendation then that all dental care professionals should have indemnity in their own right. A download of the subscription rates for DCPs is available on this website (click here) and gives information about the various options available. A failure to have the appropriate indemnity could lead a technician open to allegations of professional misconduct. Top
Q2. I own a laboratory, but cannot see why my process workers or laboratory assistants need to be registered with the GDC.
At the time of writing (June 2008) the GDC have made it clear that all persons involved in patient care should either be on the GDC's DCP register, or be in training towards an approved registerable qualification in their field of practice. After 31 July 2008 any dental technician who is not able to satisfy this requirement and continues to work as a Dental Technician will be committing a criminal offence and could leave themselves open to prosecution. Similarly the employing laboratory owner might also find similar proceedings, together with disciplinary action at the GDC if they are registered.
At present the situation in respect of process workers and laboratory assistants is the subject of some debate and it is likely that the GDC will develop more detailed guidance in respect of the limited scope of activity which unregistered individuals can undertake and the conditions upon which they are employed. Until that guidance is published, the need for registration still remains. Top
Q3. What if I am concerned about the standard of work being forwarded to me by a dentist?
The guidance produced by the GDC for DCPs makes it very clear that registrants should put patients' interests first, ahead of those of colleagues, organisations or businesses. It follows then that if you do have concerns about the standard of work being provided for you by another dental professional you should raise this formally with the management of your laboratory or, if you are the laboratory owner, you should perhaps contact the dentist and explain your concern. In doing so it is best to be constructive, rather than destructive, and offer suggestions on how the matter can be addressed or improved. If, following this conservation, you still remain concerned for whatever reason, then you have a duty to bring your concerns to the attention of the GDC. Before making this decision however, it is best to contact Dental Protection and ask for our advice. Top
Q4. A dentist has raised a complaint against me in relation to a crown I made and indicates that the patient is not happy. Do I have to respond to the patient?
This very much depends on the nature of the complaint. Your responsibility, as a dental technician, does not necessarily end when the work is forwarded to the dentist. It is in fact not until the work is fitted in the patient's mouth that the responsibility passes to the dentist. The dentist should only fit the work once he or she is satisfied that it is of the appropriate standard and in the patient's best interests. You would be wise therefore to liaise with the dentist in relation to the complaint and to provide any help and assistance you can in responding. It is unlikely that a dental technician would be asked to respond directly to a patient unless there was a good reason for doing so (ie, when an appliance continually fractures). Before taking any action then, it would be wise to telephone Dental Protection and explain the individual circumstances. Top
Q5. I am thinking of subcontracting much of the NHS work I do to a laboratory in China as they are significantly cheaper. Are there any regulatory problems from my point of view?
It is entirely up to you whether or not you would wish to undertake work within your own business or forward it to a third party either within the UK or overseas. The responsibility for that work in the eyes of the GDC however still remains with you. Similarly it would be wise to inform the dentist for whom the work is intended of your actions and obtain his/her approval. Dental laboratories outside the UK may well produce work of an entirely acceptable standard, but they do not fall within the UK regulatory requirements and, as such, there may be no check on such aspects as standards, materials, etc. If the work subsequently proved unsatisfactory for whatever reason and the fault was traced to the laboratory work, you might find yourself facing difficulties defending your actions at the GDC. Top
Q6. I've looked around and can find an insurance policy that seems to be a lot cheaper. I appreciate you get what you pay for, but is there really a difference?
There is in fact a very real difference. Most insurance policies are sold on a "claims made" basis. Essentially this means that the insurance policy will only provide cover for you provided the claim is made during the time the policy is current. If you let the policy lapse (through retirement, career break or perhaps to have children) you will need to continue to purchase the insurance policy year on year. The longer you stay with them the more expensive the policy gets and that's not counting the time you have a claim against you. The alternative is to purchase expensive "run off" cover.
By contrast Dental Protection provides "occurrence based" cover. This means that any incident that takes place during the period of which you are a member will be covered irrespective of whether you are a member today. The vast majority of the dental profession (dentists and DCPs) choose occurrence based cover as they believe it provides the safest, best and most comprehensive protection for them and their patients alike.
You also need to look closely at what your insurance premium buys. Is there anybody in the insurance company who will provide advice and assistance if you have a problem? Does that person know anything about dentistry or are they simply a call centre? What if you get a problem outside of normal office hours - will anybody help? If you end up at the GDC, will the company provide a solicitor and barrister to assist who know about dentistry and what a dental technician does (and the role of the GDC), or simply look for the cheapest available? Is the level of legal expenses allowed sufficient to cover the costs if this turns out to be a long and difficult case? What are the exclusions and small print on the policy and will they affect you?
The choice of course is yours but just make sure you know all the facts before you pay any money. Top
For further information on the difference between insurance and discretionary indemnity click here
If you're still confused give Dental Protection a call on 0845 608 4000 or email member.help@mps.org.uk