Returning to practice

Following the resumption of face-to-face care for patients, it's understandable to have questions about the dento-legal implications.

Given the backlog in patients needing treatment and routine appointments, I'm worried I will be faced with complaints about waiting times and delayed diagnosis.

Effective communication is essential to manage expectations and should cover areas such as arrangements for those requiring an appointment and the measures you are taking to protect them and members of your team.

Your practice may need to continue to remotely triage patients to determine the urgency and whether treatment can be provided safely. Consider proactively contacting patients whose appointments have had to be rescheduled to explain your plans for reopening and arranging a new date.

Finally, update your website and practice answerphone so patients have a consistent and current message. Be explicit about how you are following official guidelines designed to safeguard everyone.  

The coronavirus has compromised the standard of treatment I can provide and I expect this will lead to claims. Will I be indemnified?

From a DDU perspective, our role is to assist our members. If your clinical decisions are criticised at this difficult time, you can look to us for our advice and representation in the usual way.

The DDU has argued there should be immunity for dental professionals from COVID-19 related legal claims. Of course, dental professionals will be accountable for their actions but the unprecedented circumstances in which care was provided must be remembered when investigating dental negligence claims arising from the pandemic.

What should I do if a patient complains because their appointment has been cancelled?

Unfortunately, there may be instances where patients behave unreasonably, perhaps out of frustration or anxiety. In such cases, you might like to ensure that the advice you provide is in line with the guidance that has been issued by the CDO of the country where you work. Any complaint can then be responded to by explaining that you were following the appropriate guidelines that were in place at that time.

Clear communication with patients will also help so update your website and practice answerphone messages to make it clear how patients can access dental services during the coronavirus pandemic.

What do I need to consider when carrying out remote consultations?

When talking to patients by telephone, it's important to be aware of the limitations of this kind of consultation. Of course, it's harder to make a clinical assessment if you cannot pick up on non-verbal communication or carry out an examination.

The GDC directs dental professionals to its basic good practice principles for remote consultations. In the current situation, it says you should make and record an appropriate risk assessment which takes into account "the infection risk of COVID-19, both from and to the patient, as well the apparent seriousness of the need for treatment and the extent to which it has been possible to make a clinical assessment".  

The GDC's existing prescribing guidance says you can prescribe remotely if you believe this is in the best interests of the patient and you have no viable alternative. In an emergency, you can ask pharmacies to supply the medication on the condition that you will provide a prescription within 72 hours, as set out in the Section 224 of the Human Medicines Regulations 2012.

If the patient's situation is serious, they may need to be directed to the local Urgent Dental Care service, using arrangements in your area.

Will the GDC take action against me if I depart from guidance?

In the first place, it's important to keep up to date with the latest authoritative guidance from the Chief Dental Officers, the NHS and the GDC. We recommend that you:

  • check relevant websites regularly. We've produced a dento-legal update on COVID-19, which is available on our website and includes relevant links
  • appoint a lead person with responsibility for checking advice regularly and disseminating it to all concerned
  • keep a log of when you checked the COVID-19 advice so you can demonstrate what you have done to stay up-to-date
  • make sure you view documents from the website, rather than relying on a saved copy, so you are working from the most up-to-date guidance.

The GDC has acknowledged that its guidance will not cover every potential scenario.

It advises that dental professionals will need to exercise their professional judgement and carry out an appropriate risk assessment. At the same time, it recognises that, "in highly challenging circumstances, professionals may need to depart from established procedures to care for patients and that should concerns be raised, relevant environmental and human factors would be taken into account".

In the unlikely event of a GDC investigation, DDU members can look to us for advice and support, however you've interpreted the guidance.

Need more advice? See all of our coronavirus dento-legal guidance.

This page was correct at publication on 08/03/2021. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.

Leo Briggs deputy head of the DDU

by Leo Briggs Deputy head of the DDU

Leo Briggs qualified from University College Hospital, London, in 1989. He has worked extensively in the community dental service including a brief period overseas. He has also worked in general dental practice.

Leo gained a masters degree in periodontology from the Eastman in 1995 and is on the GDC specialist register for periodontics. From 1995-2017 he provided specialist periodontal treatment in both the salaried dental services and private practice. He started working for the DDU in 2005. Between 2007 and 2009 he worked part time at the DDU and part time as a clinical tutor at the School for Professionals Complementary to Dentistry in Portsmouth. In 2009 Leo went full time with the DDU. In January 2016 he became deputy head of the DDU.