Don’t break rules over dental nurses’ holidays

Dentists are reminded to have measures in place to cope with staff absences during the holiday season.
UK-wide dental defence organisation MDDUS is advising practices to always have available at least two practice staff members who can fulfil a designated role in an emergency.
As the summer approaches, dental nurses will look forward to their annual leave. But the resulting absence of clinical support staff can have a significant impact, particularly in practices which employ a small team.
While some dentists might occasionally be tempted to ‘soldier on’ on a single-handed basis, most are aware that the provision of dental treatment without assistance is not only impractical – and potentially hazardous – but is also likely to be in breach of GDC guidance.

At this time of year, MDDUS receives an increased number of enquiries as to who can provide holiday cover.

According to GDC guidance, a second person who is trained to deal with medical emergencies should be present throughout treatment, while a third person who can fulfil a designated role in an emergency should be on hand in the practice.
MDDUS dental adviser Doug Hamilton said: ‘Failure to comply with these obligations can be justifiable in exceptional and suitably risk-assessed circumstances. However, it is clear that routinely working without a chaperone may compromise patient safety, leave the dentist open to accusations of misconduct and contravene the GDC’s Principles of Dental Team Working.
‘The simplest way to manage this problem is to re-assign an existing staff member from administrative to clinical duties. This option is convenient, but would only be permissible if the staff member was already registered, had received appropriate immunisation and had remained up-to-date with required CPD before re-entering the clinical setting.’
If this is not possible, then another approach might be to hire fully trained nurses on a temporary basis from an agency.
Practice owners may also consider the possibility of offering a temporary employment opportunity to someone who has no previous experience in this field, but there are a number of restrictions to bear in mind.

‘This might appear to be a mutually beneficial arrangement,’ added Doug “However, the GDC’s definition of an in-training nurse is very restrictive. In order to fulfil the required criteria, these employees must currently be on a training course which will lead to registration or be employed while awaiting the commencement of a placement on a GDC-approved course.
‘Furthermore, they must have completed an induction and work under the supervision of a designated registrant who will be ultimately responsible for any adverse events involving the trainee. Otherwise, the prospective nurse cannot commence chairside duties.
‘GDC rules prevent the deployment of schoolchildren who are work-shadowing as they are only allowed to observe in a dental practice – subject to a specific risk assessment, induction and confidentiality agreement.’
The question that follows, however, is whether a dental student would be caught by the same restrictions. Could a dental student step into the breach without risking a very early chat with the GDC?
He advised: ‘The student should already be inoculated, will ideally be free from studies for at least part of the summer and may already have acquired a degree of experience in chair-side assistance. Most importantly, dental student status would seem to be compatible with the GDC’s ‘in-training’ criteria.
‘However, the practice owner would be well advised to have completed a thorough risk-assessment and induction course, while students must remember that their conduct must meet the standards which are set out by the GDC.’
One final note of warning, the most carefully planned holiday rota may be ruined if the DCP’s annual registration fee has not been paid by the end of July.

‘If this is overlooked, then DCP cannot work in the clinical environment until all of the necessary re-registration paperwork has been processed,’ he said.
‘Even if this is completed correctly, it will stop clinical work for up to two weeks. In the meantime, the employer must organise a suitable replacement and consider how the period of unregistered nursing should be explained to the GDC.’

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