Earn CPD by reading this dilemma and the sidebar resources and then taking the quiz linked below.

The scene

A therapist member called the advice line after they were asked by their practice owner to provide a Direct Access service, despite this not forming part of their contract.

As such, the member was reluctant to comply with the request and was thinking about leaving the practice. They called the DDU to discuss their concerns.

DDU advice

Our adviser told the member that they weren't obliged to provide Direct Access, and should only do so if they were confident they had the skills and competencies to treat patients under Direct Access.

If the member wanted to leave the practice, our adviser suggested they read their contract carefully in relation to any notice period. Unless the contract had been breached, and they had strong legal advice to confirm this , the notice period would likely need to be workedand the member should make reasonable attempts to comply with the terms of their contract.

GDC registrants have a duty of care to patients, so if the member was to leave suddenly, they would have to make sure that patients would not be disadvantaged as a result.

Our adviser suggested the member discuss their concerns with the practice owner outside practice hours to try and find a mutually agreeable and amicable way forward, without disadvantaging patients. If at all possible, it would be wise to avoid a dispute with the practice because of potential repercussions, which could include a formal legal dispute.

Our adviser explained it would be advisable to keep an audit trail of all discussions and confirm any agreements in writing. The DDU provide contract reviews for members, which can help clarify their obligations under the contract they have with a practice.

If we're unable to assist with any part of a request for assistance - for example, with formal legal disputes - we can still help by providing information about other organisations who will be able to assist. Our member was very reassured by the call and felt confident to now approach the practice owner.

Learning points

It's very important to be clear about what is being asked of you and any contractual obligations you may have

The GDC's Standards make clear that you should only accept a referral or delegation to treat the patient if you are trained and competent to carry out the treatment and you believe that what you are being asked to do is appropriate for the patient.

The GDC also makes it clear in its FAQs that Direct Access is not compulsory: "Employers should not expect a registrant to see patients direct if they do not feel competent to do so."

The Standards also stress that you should only delegate or refer to another member of the team if you're confident they have been trained, and are both competent and indemnified, to do what you are asking.

As well as this, if you delegate a task to another member of the team who doesn't feel they are trained or competent to carry it out, you must not take advantage of your position by pressurising them into accepting the task.

Members commonly call the advice line for guidance on leaving a practice. While we encourage members to use our contract review service to review contracts when starting at a practice, we also review contracts for members who are thinking about leaving a practice by explaining things they need to consider and any obligations they may have.

It's worth keeping in mind that as well as any contractual obligations, you are still a GDC registrant. This means the GDC would expect you to behave in a professional way and ensure patients aren't disadvantaged if you leave because of a dispute.

Get verifiable CPD

If you've read this article and the advice linked in the sidebar, you'll be ready to complete our assessment and get 45 minutes of verifiable CPD.

To get your CPD certificate you'll need to score at least 80% on the assessment. You'll also need to add your name, DDU membership and GDC registration number so they're included on your certificate.

Click here to take the CPD quiz.

Not a member?

Join us today and become part of the DDU. We provide reassurance and peace of mind to UK dental professionals.

To get your verifiable CPD certificate, simply provide your contact details when asked and then score at least 80%. One of our dental liaison managers will then get in touch to discuss your requirements and provide you a quote for DDU membership.

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