Simon Kidd, dentolegal adviser at the Dental Defence Union (DDU), looks at what dental professionals need to know with regards to adult and child protection in Scotland.
The abuse and neglect of adults and children is an emotive, sensitive, and often very difficult issue for dental professionals to deal with. There is an ethical and legal duty to act. It helps to be aware of relevant guidance and available support.
The structure of safeguarding varies across the individual nations. In Scotland, the terms ‘adult protection’ and ‘child protection’ are used by organisations including:
- The Scottish Government sets out policy, legislation and statutory guidance on how the adult and child protection system should work
- Health and Social Care Partnerships (HSCPs) are organisations formed to integrate services provided by Health Boards and Councils in Scotland. The NHS and local authority jointly run each partnership
- General Dental Council: ‘Standards for the dental team’, Principal 8, describes the need to raise concerns if patients are at risk.
Safeguarding arrangements in the dental practice
Firstly, it is imperative that there is a named lead for adult and child protection. They can organise training, advise staff and oversee the reporting of concerns. Also, it is important to have adult and child protection polices which are regularly reviewed.
Adult and child protection policies that set out the practice’s commitment to protect vulnerable patients should be in place and then regularly reviewed. Staff training should also be provided so that individuals are aware of their personal responsibility to report concerns and know the reporting process.
Also, incorporate adult and child protection guidance into team meetings and ensure all members of staff know how to access local safeguarding contact details.
Additionally, employers are obliged to obtain Disclosure Scotland checks if staff work with vulnerable groups. Your duties as an employer also include providing information to Disclosure Scotland about employees who may pose a risk, or who have harmed children or vulnerable adults.
Raising safeguarding concerns
If you have reasons to believe a person is being abused, neglected or is at risk, then consider the following steps.
Firstly, if your concerns arise during a consultation, establish the facts and the extent of the abuse as far as you can. But only if it is safe to do so. From there, discuss with your local relevant protection lead and implement protection procedures as appropriate.
Any concerns should be documented in the patient’s record. Actions and outcomes should be documented. Records should be factual, contemporaneous, and avoid speculation or opinion.
However, if you’re unsure whether or how to raise concerns, seek advice from your local adult and child protection lead, adult or child protection committee or your defence organisation.
Sharing information with third parties
Information can be shared lawfully within the parameters of the Data Protection Act 2018 and the General Data Protection Regulation (GDPR).
For example, if the authorities request information about a vulnerable patient, you can share relevant information with the patient’s consent. This is in line with local information-sharing protocols.
However, if information is shared against the patient’s wishes (for example, to protect others at risk), the rationale for decision-making should be recorded.
If you decide to disclose information without consent, you should inform the patient first, if it is safe and practicable to do so.
Multiple agencies may share information. For example social care services, police, health visitors, schools, health providers, family justice system and the probation service.
Allegations against healthcare staff
Although it is rare in a dental setting, if you believe vulnerable patients are at risk within a healthcare setting, either from neglect or poor professional practice, you have a duty to raise your concerns.
Principle 8 of the GDC’s Standards for the Dental Team discusses raising concerns if patients are at risk. While the Scottish National Whistleblowing Standards set out how the Independent National Whistleblowing Officer (INWO) expects all NHS service providers to handle concerns that are raised, and which meet the definition of a ‘whistleblowing concern’.
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