DDU

DDU successfully defends dentist in court against legal claim

A dentist who faced a very stressful clinical negligence claim after carrying out root canal treatment, has been successfully defended in court by the Dental Defence Union (DDU).

It was alleged that the DDU member, who was an experienced dentist, did not perform an adequate root canal treatment and provided an ill-fitting crown. However the judge agreed with the expert instructed by the DDU who, supporting the member’s actions, concluded that the treatment was carried out to a reasonable standard. The claim was won at trial as a result.

The claimant, who was represented by Dental Law Partnership, was seeking £18,000 in compensation and legal costs. However, with the dentist’s reputation on the line, the case was about much more than financial consequences as John Makin, head of the DDU, explains:

“Our dentists for dentists’ ethos means we understand the need to support the reputation of individual members and the wider profession. In this case, it may have been more economical to settle the claim out of court because of the legal fees involved in a trial. However, our experienced claims handlers were confident of mounting a robust defence of the members’ actions all the way to court and this approach proved justified.”

The dentist commented: “It was a very arduous time however throughout the process, the DDU team were very helpful and hard working. The court case lasted three days and the experience was like being on a rollercoaster with ups and downs. Hopefully this result will reduce the likelihood of claims and the resulting stress that we as dentists experience even when we have carried out treatment within best practice and to the best of our abilities. Thank you to the DDU for standing by me.”

John Makin concluded: “Despite the positive outcome for our member, it cannot be overlooked that the claim took more than two years to reach a conclusion and this was undoubtedly stressful for those involved. In addition, the legal costs, which were met by the DDU, were substantial.

“The DDU successfully defended almost 60% of dental claims over a recent 12 month period, and it is unusual for a case to reach a court hearing. Our role is to relieve the burden for our members, acting in their best interests and safeguarding professional reputations. We do not settle claims for the sake of expediency and put our members at the heart of decisions about how their case is managed.” 

* Maxwell v Valliani and ANOR. County Court (Manchester) [2021]

DDU survey finds that over three quarters of dental professionals feel stressed or anxious on a weekly basis

New research published by the Dental Defence Union (DDU) has seen 78 per cent of dental members surveyed state that they feel stressed and/or anxious on a weekly basis.

The DDU surveyed 396 members and also found that:

  • 45 per cent feel they are unable to spend adequate time with patients
  • 33 per cent feel they are unable to do their jobs effectively
  • 53 per cent would not feel confident in raising a matter regarding their health and wellbeing
  • Members were most likely to raise concerns with their family members (89 per cent), colleagues (47 per cent) and/or their GP (40 per cent)

Additionally, when compared with health and wellbeing research undertaken in May 2020, the DDU found that 55 per cent of respondents often go to work when they don’t feel well, up from 47 per cent.  

However, the number of respondents who believe they are making a positive difference to the lives of their patients increased from 72 per cent in May 2020 to 93 per cent in March 2021.

Moreover, 80 per cent believed that they felt supported by their colleagues while 67 per cent believed that relationships amongst colleagues were positive. 55 per cent also felt that they were able to spend suitable time with patients. The same number also stated that they had a good work/life balance.  

Lesley Taylor, dento-legal adviser at the DDU said:

“While dental professionals have always faced high-pressure situations, the long term implications of working during the COVID pandemic mean that many dental professionals have felt increasingly stressed and anxious.     

“Such feelings may have been compounded by keeping up-to-date with ever-changing guidance, adapting to new working practices and manging socially-distanced patient interactions.

“While reaching out for support and advice can be daunting and difficult, dental professionals shouldn’t have to ‘just deal with it’. At the DDU we recommend that dental professionals make the most of their support network to help them deal with stress, anxiety or depression.”

Click here to learn more about the sources of health and wellbeing support available to dentists.

DDU backs report calling for urgent need to reform healthcare regulators such as the GDC

The Dental Defence Union (DDU) has welcomed the findings of a review into the way healthcare regulators such as the GDC have responded to the Covid-19 pandemic.

Today’s publication of the Professional Standards Authority for Health and Social Care’s (PSA) Learning from Covid-19 review found a number of reforms have taken place at the regulators because of the pandemic. These include a greater use of technology to enable remote participation in fitness to practise proceedings. However the PSA concludes that the crisis has reinforced the urgent need for regulatory reform, to make healthcare professional regulation more agile.

John Makin, head of the DDU, said:

“Dental professionals have waited a long time to see the GDC reformed. We agree with the PSA that the pandemic has highlighted the need for that reform to be delivered at pace. This cannot be delayed any longer. While the GDC has adapted fitness to practise and other processes during the pandemic, it is constrained by outdated legislation.

“The government is now consulting on detailed proposals to reform the healthcare regulators however, the GDC is not included in the first priority group for reform. The GDC must not be put to the back of the line. Dental professionals deserve a fitness to practice process that is as fair, robust and swift as possible.

“Today’s report from the PSA notes that organisations like the DDU have been concerned about the prolonged process of reform. We strongly urge the government to commit to introduce the necessary legislation to reform the GDC without further delay.”

Coronavirus pandemic leads to increase in queries to DDU’s employment advice line

The coronavirus pandemic has led to a significant number of dentists contacting the Dental Defence Union’s (DDU) free employment law advice line for support and advice on issues including staff grievances, personal conduct and sick leave.

From the first national lockdown in March 2020 until February 2021, the advice line, which the DDU has run in collaboration with global HR and employment law consultancy Peninsula since 2008, received 1,045 enquiries (both calls and emails) from DDU members. The top five reasons for dental professionals requesting advice were:

  • Terms and conditions of contracts – 173 enquiries (17 per cent)
  • Redundancy – 169 enquiries (16 per cent)
  • Conduct – 137 enquiries (13 per cent)
  • Absence – 125 enquiries (12 per cent)  
  • Other enquiries on issues including furlough – 122 enquiries (12 per cent)

Resigning from practice was another reason why DDU members contacted the employment law advice line. Such enquiries rose from 27 in 2019/20 to 49 in 2020/21.

John Makin, head of the DDU, said: “The pandemic has been a challenging time for dental professionals as they deal with increased anxiety levels and extraordinarily difficult circumstances. At the DDU, we support our members and are by their side throughout their career. The employment law advice line means that members have 24-hour access to a resource which can address all their questions and concerns.”

Nicola Morgan, head of marketing at the DDU, explained: “Dentists are becoming increasingly aware of employment law and want to make sure they follow good practice and comply with the law and regulations, such as those laid down by the GDC. It is reassuring to know that our members can access expert advice on employment issues that might affect the running of their practice during these challenging times.”

Kate Palmer, HR Advice Director and Consultancy Director at Peninsula, said: “Employment law and HR can be daunting and dentists are naturally keen to minimise the risk of getting embroiled in an employment tribunal. By collaborating with the DDU, we are delighted to be able to help members, through our expert advice, understand how to apply the laws and regulations in their organisations and to ensure any issues are dealt with timely and appropriately.”

DDU members have access to the free 24-hour employment law advice line as part of the DDU’s GROUPCARE program. More information on how to set up and access the GROUPCARE scheme can be found at: https://www.theddu.com/groupcare

DDU welcomes proposals to reform GDC fitness to practise process

The DDU welcomes the publication of long-awaited government proposals to streamline the way healthcare professionals are regulated. Reacting to the publication today of the government consultation on Regulating professionals, protecting the public John Makin, head of the DDU, said:

“For many years the DDU has been calling for the GDC to be given the powers necessary for it to be a more agile and efficient regulator. Many of the proposed reforms are centred around changes to the fitness to practise procedure. Being investigated by the regulator is stressful for dental professionals, so any reforms that can deliver a fairer and swifter process have the potential to be positive.

“While the GDC is not included in the first priority group for regulatory reform, we nevertheless note the government’s continued stance that it favours a reduction in the number of healthcare regulators. An independent review has been set up to examine this. The DDU is clear: we strongly believe that the GDC should remain the dedicated regulator of dental professionals. We will be making this point throughout these consultation exercises.

“These are complex issues, so we will be considering the fine print carefully and responding to the consultation on behalf of members.”

Top five reasons for dental complaints during the coronavirus pandemic revealed by the DDU

As the one year anniversary of the UK’s first lockdown approaches, the Dental Defence Union (DDU) has analysed the top five reasons for patients to raise complaints about pandemic dental practice. 

The DDU supported dental practitioners with over 500 advisory and complaint cases between the start of lockdown in March to the end of 2020. In the majority of cases, members wanted advice on an aspect of patient care in order to pre-empt problems. Just 9% of cases were about complaints, and of these treatment availability was the most common reason for a patient to be dissatisfied.

However, the DDU says it anticipates that complaint numbers are likely to increase because of delays in treatment caused by the pandemic. John Makin, head of the DDU said:

“Most patients have been understanding about the unavoidable compromises in dental provision during the pandemic but practices still had to respond to a significant number of complaints. Unfortunately, the possibility of complaints and claims is likely to increase as patients experience the detrimental consequences of treatment delays or become frustrated by the continued restrictions on routine dental practice. This risk can best be mitigated with pro-active and consistent communication which will help to manage patient expectations.”

The DDU examined the cases to identify the most significant themes and to help dental professionals understand where difficulties can arise. Findings included:

  • 92% of files concerned general dental practice. The remainder were specialist dental practice, community and hospital dentistry.
  • Dentists featured in 72% of the files with dental therapists and hygienists and specialists making up 18% and 5% respectively. 

The top five reasons for complaints were:

  1. Treatment availability – delays caused by the closing of practices and the limitations on patient numbers after practices reopened.
  2. Dissatisfaction with treatment – allegations of poor treatment outcomes and delayed diagnosis due to the pandemic.
  3. Fees and refund requests – patients requesting a refund or compensation for treatment delays or incomplete treatment.
  4. Communication issues – patients who felt they had not been properly informed about delays, cancellations and arrangements for urgent care during lockdown.
  5. COVID-secure measures – issues such as infection control, PPE and the use of face masks.

John Makin, continued: “When responding to patient complaints due to the pandemic, it is important to highlight the circumstances prevailing at the time of treatment. We advise dental professionals to refer to the relevant guidance, regulations and standard operating procedures that impacted upon the care provided. Context is vital.

“The DDU is continuing to support members working under the current difficult circumstances with reassurance, support and advice.”

Learn more about complaints handling in the DDU’s free, online learning module worth two hour of verifiable CPD.

Dental professionals feel it is harder to gain patient consent during a remote consultation, finds DDU survey

More than half of dental professionals (52 per cent) surveyed stated that it was more difficult to obtain consent during a remote consultation compared to a face-to-face consultation according to new research published by the Dental Defence Union (DDU).

The DDU surveyed 255 dental members about their use of remote consultations during the pandemic and found that the majority of remote consultations were phone consultations (91 per cent) that were being undertaken in the workplace (64 per cent) as opposed to at home (13 per cent).  

The DDU also found that when undertaking a remote consultation, members were most concerned about:

  • Ability to assess the patient (38 per cent)
  • Indemnity coverage for this type of work (19 per cent)
  • Communication problems (9 per cent)
  • Maintaining confidentiality (6 per cent)
  • Taking contemporaneous notes (6 per cent)
  • Obtaining patient consent (6 per cent)

Leo Briggs, deputy head of the DDU said, “The use of remote consultations has increased dramatically during the pandemic. While much face-to-face dentistry has resumed, remote consultations are still useful, particularly when triaging patients and when helping to protect vulnerable patients. However, they still present some challenges for dental professionals.   

“It can sometimes be difficult to ascertain whether consent has been given. Another problem can be developing a rapport with a patient using remote methods as the patient may not be familiar with this style of consultation and may feel uncomfortable. It is therefore important to put them at their ease from the outset. This in turn will benefit the consultation by making it easier for the patient to provide relevant information and respond to questions.

“The DDU provide indemnity for members who carry out remote consultations during the pandemic. Members do not need to let us know they are carrying out this work unless it increases the number of sessions they work.”  

The survey was held as part of the DDU’s Remote consultations webinar which focused on topics including:

  • Dento-legal implications of remote consultations
  • The importance of consent, confidentiality and recording keeping when consulting remotely
  • The role of administrative systems and procedures prior to conducting a remote consultation.

Available for a limited time only, dental professionals can watch the webinar on-demand here. If they successfully complete the quiz at the end they can receive one hour of verifiable CPD to help meet the GDC’s learning objectives A, B and D.

Dentists advised by the DDU to offer recall appointments on a case by case basis

The Dental Defence Union (DDU) has today issued advice stating that dental professionals should offer recall appointments on a case-by-case basis.  

In the latest edition of the DDU journal, the DDU argues against a total ban on recall appointments noting that dental professionals should instead offer an appointment on the basis of a risk benefit analysis of that individual patient’s needs.

By doing this, not only is the patient given a choice but it also reduces the risk of future allegations that a practice’s policy has given rise to issues such as a late diagnosis or deterioration in condition or prognosis.

John Makin, head of the DDU commented: “Patients are entitled to make their own decisions as to whether they choose to accept such an invitation and attend. Indeed, given the current circumstances many patients will have their own view as to the appropriateness of recall appointments. Also, some patients may complain if they are offered a recall appointment and others if they are not.

“For some patients with high clinical needs, the risk of deferring might outweigh the risk of attending, while for others it may be possible to confidently extend the recall period without greatly adding to the risk.”

It is clear that as the coronavirus pandemic continues to have a significant impact, deciding to offer a recall appointment is one of many difficult decisions that dental professionals will have to make for the foreseeable future.

With regards to decision making, the DDU recommends members to be aware of and follow current guidance from a responsible body of opinion. However, members who act in good faith can seek clinical assistance whatever their clinical decision may be when caring for patients during the pandemic.

John Makin, continued: “When considering how to approach decision-making, it’s often useful to ‘start with the end in mind’ – in other words, to ask yourself, If I follow this particular course of action and I receive a complaint, what would I say in response?

“If, when answering that question, you can confidently point to a decision-making process that put patients’ best interests first and is in accordance with a responsible body of opinion (such as a current standard operating procedure), then the risk of justifiable criticism is greatly reduced.”

Read the full DDU journal at: https://ddujournal.theddu.com/

Covid-19: Regulators’ joint statement and new GDC supplementary advice

A joint statement has been released from the chief executives of several statutory regulators of health and social care professionals. The General Dental Council (GDC) is joined by the General Chiropractic Council, General Medical Council, General Optical Council, General Osteopathic Council, General Pharmaceutical Council, Health and Care Professions Council, Nursing and Midwifery Council, Pharmaceutical Society of Northern Ireland, and Social Work England in their agreement.

The statement and GDC supplementary advice can be found here.

Ian Brack, Chief Executive and Registrar at the GDC, states: “As the pandemic continues, we know that dental professionals continue to work in very difficult situations and under extreme pressures, as do health and social care professionals in other disciplines. I think it is important to acknowledge the care that all dental professionals have continued to provide to patients through these very difficult and challenging circumstances.

“With the production and distribution of Covid-19 vaccines underway, some dental professionals are playing a vital role in the effort to vaccinate people as quickly as possible, but most continue to sustain dental services while needing to manage the increased risks and constraints imposed by the pandemic. The current surge in cases means that those challenges will inevitably continue for some time to come and dental professionals may continue to have concerns about decisions they need to take in order to provide the best care in challenging circumstances.

“When the pandemic began last year, all the professional regulators across the UK set out how we would carry out our roles during this time. We are setting out our approach again in the joint statement below, which re-iterates the principles we said we would rely upon, and will continue to rely upon, as the pandemic continues.

“As further reassurance, I am also publishing today the supplementary advice I am giving to GDC case examiners about the factors they should take into account in considering the impact of Covid-19 on a professional’s ability to deliver care.”

The joint statement’s first concern expressed is for ‘the individuals on our registers will be the care of their patients and people who use health and social care services’. Health and social care professionals are encouraged to work in partnership with each other and people using their services to use their professional judgement to ‘assess risk and to deliver safe care informed by any relevant guidance and the values and principles set out in their professional standards’.

The statement recognises ‘that in highly challenging circumstances, professionals may need to depart from established procedures in order to care for patients and people using health and social care services’, going on to note that ‘regulatory standards are designed to be flexible and to provide a framework for decision-making in a wide range of situations’.

In response to any anxiety faced, the joint statement concludes: ‘Individuals on our registers may feel anxious about how context is taken into account when concerns are raised about their decisions and actions in very challenging circumstances. Where a concern is raised about a registered professional, it will always be considered on the specific facts of the case, taking into account the factors relevant to the environment in which the professional is working.’

The industry has already responded to the statement, with John Makin, head of the DDU, stating: “We welcome that the GDC recognises the challenging circumstances faced by dental professionals at this time. A recent DDU survey found that 60 per cent of respondents were concerned about facing a complaint, claim or GDC investigation relating to the pandemic. It is important that context is indeed taken into account by decision makers when considering concerns raised particularly as this can often be months or even years after the event.”

Meanwhile, Raj Rattan, Dental Director at Dental Protection, also welcomes the GDC supplementary advice for GDC decision makers when dealing with Covid-19 related cases: “Dental Protection has been calling for guidance detailing how to take the context created by Covid-19 into account, and we are pleased that the GDC has issued such guidance for decision makers. “From our member survey we know that 40% of dentists fear investigations arising from difficult decisions made during Covid-19, and we hope this will reduce stress for the profession during this period, in the absence of further PSA guidance which would detail how regulators will ensure a proportionate approach.”

DDU survey finds majority of dental professionals feel that patients have been understanding of changes during the pandemic

The majority (95 per cent) of dental professionals surveyed stated that patients have been understanding of the changes that have been made during the pandemic, according to new research published by the Dental Defence Union (DDU).

The DDU surveyed 538 dental members about their working circumstances during the pandemic and found that while patients were understanding, this has not alleviated concerns within dentistry. The DDU found that 60 per cent of respondents were concerned about facing a complaint, claim or GDC investigation relating to the pandemic.

Other key findings included 55 per cent believing that remote consultations will remain in place following the end of the pandemic. Additionally, 59 per cent also found it easy to stay up-to-date with the latest guidance issued during the pandemic.  

Leo Briggs, deputy head of the DDU commented, “Dental professionals are used to dealing with stressful, high pressure situations. Nevertheless, the pandemic has heightened some existing challenges while presenting many new ones.

“Working practices have dramatically changed during the pandemic and it is good that the majority of patients have been understanding. However, it’s clear that dental professionals are concerned about the risk of a future complaint or claim as a result of treatment undertaken or postponed during the pandemic.”

The survey was held as part of the DDU’s Ethics in practice webinar which focused on topics including:

  • Dento-legal implications of working during a pandemic.
  • The challenges of keeping up to date with new and changing guidelines.
  • Managing patient expectations and responding to COVID-19 related complaints.
  • Dento-legal considerations when carrying out remote consultations.

Available for a limited time only, dental professionals can watch the webinar on-demand here and receive one hour of verifiable CPD to help meet the GDC’s learning objectives A and D.