The Dental Defence Union (DDU) has appointed Dr Caroline Fryar as professional services director to lead the team guiding, supporting, and defending healthcare professionals with ethical and dento-legal issues. Dr Fryar has worked at the Medical Defence Union (MDU), the parent company of the DDU, for seventeen years in various roles. Most recently Caroline was director of medical services and she previously worked as a GP.

The DDU has also expanded its team of dentists who provide expert advice to members involved in complaints and dento-legal incidents.

Caroline will head up a team of over 100, including the new team members. The professional services team provides key services DDU members rely on, such as the 24-hour advice lines, education, guidance and support with complaints. The team is also responsible for defending members in regulatory proceedings and clinical negligence claims. Caroline takes over the role from Dr Hugh Stewart, who has retired after more than 20 years with the defence organisation.

Caroline commented: “It’s a great honour to take on the role of professional services director and I look forward to continuing Hugh’s achievements in developing the services we provide to doctors and dentists across the UK. Our members are working under incredible pressure, and I intend to champion their dento-legal interests so they can focus on safely caring for patients. I am proud to lead such an outstanding professional services team.”

The new members of the DDU team are Anne Budenberg and Shruti Chopra.

Anne is combining her role as a dento-legal adviser at the DDU with her work as a training programme director in the North West and specialty dentist at Manchester Dental Hospital. Anne was previously an educational supervisor, a practice owner and general dental practitioner and held clinical assistant posts in orthodontics and sedation. She also mentors UK and international graduates.

Anne commented: “I am a strong advocate for dental education and have developed risk management programmes for dental practitioners. I am looking forward to using these skills to support DDU members.”

Shruti combines her work for the DDU as a telephone adviser with working as a practice owner, having been in general dental practice for 15 years. She has previously been an educational supervisor and is involved with foundation dentist training and mentoring dental care professionals.

Shruti commented: “As a practising clinical dentist myself, I can empathise with members and offer genuine support and guidance. This is a rewarding role and members feel reassured to be speaking to a colleague who understands the challenges they face.”

The team of dental and medical advisers took almost 22,000 advice line calls from members in 2023 and the claims handling team closed the majority of dental claims without a payment of damages.

The Dental Defence Union (DDU) has today showcased the work of one of its members, John Lewis, trustee of the charity ConfiDental, a confidential signposting helpline available to dental professionals.

In the latest edition of the DDU journal, John, who is also a practice owner and CQC adviser, describes how professional isolation is a barrier to good mental health in dentistry and the importance of active listening and giving people the time and space to reflect on professional and/or personal challenges.

In particular, John notes the significant role of senior managers to notice warning signs and act if they are concerned about the mental wellbeing of a colleague. He says:

“It might be someone has become quieter than usual, or they suddenly go over the top about something, or they look tired because they aren’t sleeping. You could see a depreciation in the quality of their work, such as not getting referrals and other paperwork done on time, which might easily lead to complaints, and the final stage might be alcohol or substance misuse.”

Worryingly, over a third of calls to the helpline have come from dentists who qualified in the last five years and are now thinking of leaving the profession which John believes is partly due to Covid. “I speak to dentists who didn’t do any dentistry in their fourth year of training, who only had six months as an FD or missed out on their FD year entirely. It’s not been a nice introduction to professional life,” he states.

Additionally, John also emphasises the damaging impact of myths and misinformation, often shared on social media, on the dental profession. He shares “One thing I find a lot is that people worry that their subscription will go up if they contact their dental defence organisation for dento-legal advice, and I always reassure them this simply won’t happen.”

Indeed, the DDU, in its role as a dental-defence organisation, offers a wide range of health and well-being support services as part of its membership to compliment the services provided by ConfiDental. For example, the DDU’s peer support programme, which connects members with a reassuring colleague who has been through a similar experience, as well as the personalised support provided to members by both the DDU’s knowledgeable dento-legal advisers and in-house legal team. Additionally, the DDU offers a contract checking service which provides support to associates and principals with a growing range of issues arising from associate agreements.

John Makin, head of the DDU, said: “Sometimes it can be difficult to reach out for professional support and advice. However, dental professionals shouldn’t have to ‘just deal with it’ and wellbeing services, such as those provided by the DDU and ConfiDental are invaluable in providing an understanding and supportive environment in which to discuss difficult topics.

“At the DDU we recommend that dental professionals make the most of their support network to help them deal with stress, anxiety or depression.

“I encourage any member to call the DDU if they require any sort of dento-legal support or advice. It will not affect your subscription but may help alleviate any concerns or difficulties you have.”

If you need to talk to a fellow dental professional in confidence, call ConfiDental on 0333 987 5158. DDU members can also contact its team of expert dento-legal advisers.

Click here to learn more and to read the full DDU journal.

Responding to recently announced proposals by the Department of Health and Social Care on provisional registration for overseas-qualified dentists, John Makin, head of the Dental Defence Union (DDU), said:

“It’s important that the GDC makes the process of registration for colleagues who qualified overseas as smooth as possible while discharging its key duty, that of ensuring patient safety.

“The implications of the proposals, following hot on the heels of recent changes to the requirements for entry to Performers Lists, are significant. The challenges include the need to arrange appropriate supervision of potentially significant numbers of provisionally registered dentists.

“In light of this, we’ll be carefully reviewing the government proposals, assessing the potential risks to those involved and contributing to the consultation on behalf of members.

“Our members will want to ensure public safety comes first, as will all healthcare professionals reviewing these proposals.”

Dental professionals are being reminded to speak up about inappropriate patient advances by the Dental Defence Union (DDU).

The DDU issued the advice after several dental professionals reported receiving inappropriate gifts from patients, including Valentines flowers and cards.

A DDU survey on receiving gifts from patients found one in ten (11%) of the members who responded had concerns about the reason for gift giving, including that the gift was inappropriate. Some of those responding reported receiving cards and flowers on Valentine’s day from patients. 

Alison Large, DDU dento-legal adviser said:

“It is not uncommon for dental professionals to be in a situation where they feel uncomfortable because a patient is behaving in an inappropriate way towards them. This can range from suggestive comments and inappropriate gifts or Valentine’s cards to intrusive questions and in some cases, sexual propositions. None of this is acceptable for healthcare professionals to face in the workplace and they should take action to prevent such behaviour from escalating.

“GDC Standards place a duty on dental professionals to maintain appropriate boundaries in the relationships they have with patients. With this in mind, it’s important to be alert to signs that a patient may be trying to overstep the professional boundary. This could include flirtatious direct messages, texts and calls or invitations to meet socially.

“If a patient behaves in a sexual way towards a dental professional it’s important to tell the patient their behaviour is inappropriate and ask them to stop as long as it is safe to do so. If this doesn’t work, dental professionals should seek help and report the incident in line with workplace policies.

“We would also advise those affected to keep a record of what happened and to get support from colleagues and your dental defence organisation.”

Holding all GDC hearings remotely would disadvantage certain dental professionals undergoing a fitness to practise investigation, the Dental Defence Union (DDU) has said.

The DDU made the comments in its response to GDC proposals that all practice committee and registration appeal committee hearings will be held remotely by default.   

Under the proposals, dental professionals would have to make a specific request for a hearing to be held in person, something the DDU strongly objects to.

John Makin, Head of the DDU, said: “In many instances, a remote hearing is preferable for all parties but we believe it is wrong for it to be a default position. It should not be necessary for a dental professional wanting an in-person hearing, to first make a case for that, when they are already under the considerable pressure of responding to the allegations being made.

“The arrival of remote hearings in regulatory and judicial proceedings is still relatively new and the GDC needs more time collate the evidence before proposing such a far reaching, permanent change.

“For example, how would such a change impact dental professionals with sensory impairments or who cannot access appropriate technology? And what about complex cases where the facts are contested and it is necessary to call a number of witnesses?

“Making this change would also put the GDC at odds with the approach taken by other healthcare regulators and in criminal and civil cases.

“We hope the GDC will reconsider these proposals. The consultation is open until 12 February and we encourage dental professionals to review the proposals and respond with their views on this important issue.”

The Dental Defence Union (DDU) says the GDC must take concerted action to reduce the amount of time taken to process fitness to practise decisions to safeguard the health of dental professionals. This comes as the regulator was found in a review last month to have failed to meet the standard for the timeliness of fitness to practise cases. The Professional Standards Authority’s review found the GDC was still taking too long to deal with cases and there had been no improvement on this since the previous year.

However, the DDU said it welcomes the GDC’s updated guidance on professional indemnity cover, which comes into effect in February 2024.

John Makin, head of the DDU, explained: “This is the sixth year in a row that the regulator has found the GDC is not meeting the standard for timeliness of fitness to practise cases. That is not good enough and the GDC must do more to improve its performance. The DDU is aware of a number of dental professionals caught up in protracted investigations. Not only are these delays highly stressful for individual members; they are not in patients’ interests, particularly at a time when there are gaps in provision.

“We have raised this issue repeatedly with the GDC and hope 2024 will be the year when we see real improvement in this area. We also call on the government to play its part by publishing long awaited legislation which will allow the GDC to modernise and become a more flexible regulator.

“Meanwhile, we are pleased the GDC’s latest guidance on professional indemnity cover not only reiterates the basic requirement for dental professionals to have access to adequate indemnity in the event of a claim, but also that colleagues consider the level of support they could themselves expect. No one should have to face such stressful life events alone and the reason the DDU exists is to support members facing a whole range of dento-legal issues, including claims and regulatory action.”

The GDC has issued  statement, titled Seeking clarity on the interpretation of when immediate and substantive suspension orders commence and expire, on its website.

Healthcare regulators must do more to root out complaints without merit to succeed in restoring faith in healthcare regulation, according to the head of a leading dental defence organisation.

Speaking at the Westminster Health Forum event on Priorities for dentistry in England, John Makin, Head of the Dental Defence Union (DDU) told attendees that too often he witnessed dedicated dental professionals undergo the stress of a protracted investigation needlessly because of a groundless complaint.

John explained: “When concerns are raised about a dental professional that might impact patient safety or confidence in the profession, it’s right they are investigated.

“However, we see a number of cases in which the concerns being raised have no foundation. We highlighted such a case involving a member in a recent journal.  The whole process can be extremely stressful and protracted, especially in cases where there are several investigations into the same incident. We have reached a situation where the process in and of itself is a sanction regardless of the eventual outcome.

“It is incumbent on those bodies investigating dental professionals, such as the General Dental Council (GDC), NHS England, CQC, and the Parliamentary and Health Service Ombudsman, to have the courage to firmly and robustly close down cases quickly where concerns have no foundation. This will not only safeguard the mental health of the individual practitioners involved but also give a morale boost to the profession as a whole.

“For its part, the GDC has introduced a pilot scheme aimed at speeding up the resolution of certain cases. However, without reform of the outdated Dentists Act, the GDC only has the power to make limited improvements to fitness to practise procedures. We need the government to fix a timetable for that reform without further delay and before the next election.”

Read more about the work the DDU is doing to campaign for a fair deal for dental professionals in the latest DDU journal.

A recent legal judgement in which an employee was awarded £65,000 compensation after an employer failed to make reasonable adjustments when her role was affected by menopause symptoms, illustrates the importance for dental practices of having a menopause policy in place for staff.

The warning comes from Dental Defence Union (DDU) HR partner Peninsula, which provides a free employment law helpline for DDU principal members.

Vicky Kitney from Peninsula said it was seeing an increase in enquiries from dental principals about accommodating staff with menopause symptoms.

Ms Kitney said: “From 1st June 2023 to 31st August 2023, Peninsula received over 120 calls and emails from DDU members requesting advice on a range of HR matters.

“With the growing awareness of the need to support women with menopausal symptoms, we are seeing a steady stream of enquiries from dental practices about this issue. These account for a small but significant number of cases and the trend is increasing.

“Typical scenarios include practices who want to accommodate staff experiencing symptoms like hot flushes, as well as enquiries about supporting those who may be struggling with performance issues like forgetfulness.

“The recent legal judgement  is a reminder for all employers to ensure they make adjustments and support employees with menopause symptoms. 

“Fostering an open, inclusive environment where employees feel they can raise concerns about how the menopause is affecting them with no stigma or embarrassment, will help practices in becoming menopause friendly employers.”

Debbie Herbst

Debbie Herbst, DDU dento-legal adviser said:

“It’s encouraging to know that practices are seeking out expert advice on this issue. They are doing their utmost to deliver quality patient care in difficult and pressurised circumstances and will be only too aware of the need to support and retain team members.

“Research has shown that 10% of women leave their jobs and many more are reducing their hours or passing up promotions because of their menopausal symptoms. Ensuring colleagues feel supported is an important part of addressing this concern. It should also help in meeting the overall commitments set out in NHS England’s Long Term Workforce Plan, which emphasises the need to retain valued employees by encouraging them to stay in the workplace.”

The DDU website has further advice for practices on how to support staff with menopause symptoms.

DDU principal members get free access to an employment law helpline from Peninsula, a leading provider of employment law and health and safety services in the UK.

The Dental Defence Union (DDU) has welcomed the announcement by the government that it is to cap legal costs in lower value clinical negligence cases. The leading not for profit indemnifier says this is likely to make some impact on disproportionate legal costs.

John Makin, Head of the DDU, said: “We welcome that the government has finally responded to this much anticipated consultation, however, this development should only ever be seen as the start.

“The DDU has always believed that for this scheme to have a meaningful impact on rising clinical negligence costs, it should be far more ambitious. Rather than just applying to claims up to £25,000, it should include claims up to £250,000.

“However, this is an important first step given that disproportionate legal costs are one of several defects in the current litigation system and affect lower value claims.

“In DDU cases, during 2022 the average sum paid in claimants’ legal costs on dental claims settled for up to £10,000 was over £12,300, while for claims settled between £10,000 and £25,000, the average was around £21,000. It cannot be right for legal costs paid to claimants’ lawyers to regularly exceed the damages paid to claimants.”

Dental professionals involved in stressful General Dental Council (GDC) investigations are being offered a new peer support service from the Dental Defence Union (DDU).

Launched in 2020 to help medical professionals undergoing GMC investigations, the service has now been expanded to include DDU members. The peer support programme connects members with a reassuring colleague who has been through a similar experience.

The DDU made the announcement to coincide with its parent company, the Medical Defence Union (MDU), publishing its latest annual report for 2022. Dr Matthew Lee, MDU chief executive, said: “We are delighted to be able to extend the peer support programme to our dental professional members. The programme connects members who are struggling with a GDC investigation with a colleague who has been through a similar process. These colleagues offer personal support, guidance and reassurance.

“Members have told us time and again that dealing with incidents can impact both their professional and personal lives. Having a conversation with a colleague who has been through something similar and come out of the other side, can be a huge comfort.”

Dr Tom Norfolk

Dr Tom Norfolk MDU vice president, said: “The peer support service is an important part of the wellbeing services we offer to members. Undergoing a GDC investigation is one of the most stressful experiences a dental professional can face, and talking to a colleague who has been through a similar experience can really help.

“As well as the peer support programme, our dedicated team of dento-legal and medico-legal advisers took over 21,000 calls on our advice lines in 2022.

“As a mutual, defence organisation we are owned and led by healthcare professionals who know what it’s like to be on the frontline of patient care. At a time of such pressure, members’ interests are at the heart of everything we do. The steady growth in members we have seen in 2022 is testament to our strengths.”

Further results highlighted in the MDU’s annual report for 2022 include:

• 50% of dental member cases at the GDC Practice Committee were concluded with no finding of impairment. The equivalent GDC figure for outcomes overall is 27% (for 2021).
• During 2022, 66% of dental claims were closed without damages being paid. For medical and dental cases that made it to trial, we had a success rate of 60%.
• 99% of calls to our dento legal advice lines were answered within 20 seconds.