We have received a number of queries from individual members working in England and various professional groups seeking clarification on Dental Protection’s position in relation to the re-opening of private practices in England.
We can assure members that we are continuing to offer the same level of support we have always done – both within the NHS and private sector.
The situation with NHS practices is clear because there is a general and widespread acceptance that the Chief Dental Officer’s guidance will be followed. The position regarding private practice in England is less clear. The decision to re-open rests with the individual practice owner(s), and Dental Protection cannot make this decision for members. We can however advise members of what they should consider when making their decision:
- The GDC statement that ‘Practitioners providing NHS services will of course need to adhere to the directions given by their nation’s Chief Dental Officer; other practitioners will want to take that into account in making decisions.’ More recently the GDC has said that it has ‘no powers to direct a professional either to offer treatment or to refuse to offer treatment. That decision can only be taken by the professional responsible’.
- The CQC has stated that it ‘ cannot require providers of dental care services to close, unless we find clear evidence of a breach of our regulations that requires consideration of the use of our powers under the Health and Social Care Act 2008 and associated regulations. It has also said that ‘The decision to offer dental care services is one for the provider to take.’
- The need to adhere closely to central Government guidance on social distancing and to the most recent dental guidance documents from various agencies including PHE and the CDO. If you operate in the private sector, you will need to review existing guidelines and standard operating procedures (SOPs) and take these into account when developing your own protocols – individually or within groups – and ensure those protocols/SOPs meet the standards set in the prevailing guidance.
- Undertake a thorough clinical risk assessment of the operating environment and of the patient journey.
The following documentation would also be needed to strengthen a member’s position if they were challenged in any aspect of the care they had provided:
- Written SOPs consistent with and at least as robust as those issued by the NHS.
- Evidence of understanding and adherence to the SOPs by all team members.
- Clinical records which, in additional to usual record keeping requirements, clearly state the process of care as well as the aspects of the clinical intervention with details of the PPE used together with details of the relevant guidance used in your clinical decision making.
Any gaps/omissions are likely to be identified during any inquiry/investigation, and this will undoubtedly have an impact on the final outcome.
We have also been asked to comment on the clinical aspects of care. We are not the arbiters of clinical opinion because we recognise that the gathering and distillation of clinical opinion is the remit of other agencies and it would not be appropriate to interfere with that process. We advise members to apply the guidance judiciously and comply with clinical protocols that emerge from that evidence. This advice is consistent with what we have always said.
Our team at Dental Protection includes experienced clinicians, associates and practice owners and we understand the myriad challenges facing members during the current crisis including the welfare of their staff, their patients and themselves. We also recognise the financial pressures members may be facing whether they are a practice owner, associate or DCP, which is why we recently offered members the equivalent of 2 months’ subscription relief.
We want to reassure members in England that should they decide to re-open their practice, we can offer support and advice if needed, and that in the event that a complaint or claim arises from the decision to re-open, we will be here if they need to request assistance. Because we offer comprehensive and discretionary indemnity, we have the flexibility to be able to help in unusual circumstances that could not have been foreseen at the start of the year, and to support members in establishing new practising norms.
Members who are returning to practice and had previously moved into a deferred category of membership due to their practice closing, will need to contact us and move back into active membership to ensure they have appropriate indemnity arrangements in place for the work they are doing. Similarly, if a member had notified us of a reduction in their hours or scope of practice during the COVID-19 crisis and this will now change, they will need to contact us at firstname.lastname@example.org and provide us with updated information.
We understand that the current level of uncertainty is unsettling, but it is important to remember that this is a time for vigilance not complacency. We may not know what the future looks like, but we are committed to protecting our members as the situation evolves. We have supported members for over 125 years, and our commitment to continue doing so is as strong today as it has ever been.