Dento-legal experts slam new local anaesthetic laws

Dental indemnity experts have slammed the recent changes in the law concerning dental hygienists and therapists and the prescription of local anaesthetic (LA).

A spokesperson for Dental Protection claims that the amendment made to the Medicines Act 1968 fails to ‘create a situation that is universally applicable to dental hygienists and therapists’.

The new rules create different rules between NHS care and private treatments for the administration, for example, of fluoride varnish and LA.

Legislation came into force on 1 June 2010 and dental hygienists and therapists can now perform the following functions in certain circumstances:
• The administration of local anaesthetics
• The sale, supply or oral administration of fluoride supplements and toothpastes with high fluoride content.

But these can only be administered by dental hygienists and therapists independently from a dentist via a patient-group directive (PGD) – a method primarily designed for use in NHS settings – and the Department of Health is now advising that PGDs are not valid for treatment that is provided privately.

So, if they do not administer via a PGD, hygienists and therapists may fall foul of the new guidelines.

Apart from being confusing to the clinical team involved, the situation seems somewhat illogical, Dental Protection is claiming.

A spokesperson adds: ‘It also flies in the face of the Department’s long-held view that there should be no negative comparison drawn between NHS treatment and private treatment.   

‘In this situation there is an almost total disconnect in the nature of the contract between the patient and the clinical team and the ability of the dental hygienists and therapists to safely and legally undertake the supply of the treatment(s) in question.

He adds: ‘Indeed, the only common aspect connecting these two elements is the inability of the regulators of the profession and the Department of Health to ensure that the legislation is suitable for purpose and facilitates the prescription of these items by dental hygienists and therapists regardless of the method of payment adopted by the patient.’   

Dental Protection is citing a Health Service circular from the NHS Executive dated 9 August 2000 which made it clear the Department was well aware even then of the difficulties in applying patient group directives in the private sector and indicated that further legislation was to be proposed in ‘due course’.

Such proposals have not been brought forward.

Dental Protection is now pressing the Department to immediately bring forward proposals to resolve the issues.

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