The legal eagle – speaking up for patient safety
Allowing practitioners to raise concerns in the dental practice is an important part of healthcare, John Makin says.
October’s Speak up Month is a timely reminder that raising concerns effectively is an important element of ethical practice in the NHS and private sector.
The initiative by the National Guardian’s Office aims to foster a healthcare culture ‘Where people can speak up and feel confident practices will listen to them and that action will follow.’
The NGO wants all healthcare staff and managers to complete its free Elearning modules. These cover how to raise concerns and how to listen to and act on concerns.
Raising concerns where patients are at risk has long been an ethical and professional duty. It is stipulated in Standards for the Dental Team.
It’s important that practices put clear reporting processes in place. And that they take concerns seriously and support staff when they speak out.
Your dental defence organisation can advise you of the steps to take when raising a concern.
Wherever possible, raise concerns locally in the first instance, which is in line with the GDC’s guidance (Standard 8).
If raising a concern via your employer or manager isn’t possible, or no action is taken, the next step may be to involve the local commissioning body or a regulator such as the CQC or Health Improvement Scotland.
Concerns should only go to the GDC where action at a local level is impractical or has failed. Or when the issue is so severe that the GDC needs involvement.
Whistleblowing to the GDC
Nevertheless, according to the latest joint whistleblowing disclosures report by the main healthcare regulators, the GDC received 100 whistleblowing disclosures in the year to 31 March 2021.
Of these cases, 93% resulted in some form of regulatory action. The GDC notes it received a higher number of disclosures than other regulators in comparison to the size of the register.
The report explains one reason for this is that primary care dentistry is: ‘Outside the more robust clinical governance frameworks that characterise some other forms of healthcare. Which may mean that alternative disclosure routes are less present in dentistry.’
There may be other reasons for the discrepancy, however. Namely that it is not clear how regulators classify a whistleblowing concern. A wider definition by one regulator could therefore account for a higher number of disclosures.
The GDC for example, includes reports from members of the public in its whistleblowing disclosures. Whereas in the regulator’s overall fitness to practise report for 2020, there are separate categories for those concerns raised by members of the public, whistleblowers and registrants.
Improving the practice
No practice or practitioner is perfect. No one should be averse to hearing about the things we could do better. And everyone in the dental team should contribute to this process of improvement.
Your dental defence organisation is a great source of support and advice.