Sue N’Jie discusses factors you should consider when dealing with vulnerable patients.
Now more than ever, it’s important for dental professionals to be aware of their vital role in protecting at-risk patients.
Although there’s no universal definition of a ‘vulnerable patient’, dental professionals can be in a good position to notice patient abuse or neglect. They can also take appropriate action or help the patient take appropriate action.
What does the GDC say?
In section eight of Standards for the Dental Team (GDC, 2013), the GDC places a general professional obligation on all dental professionals to put patients’ safety first, act promptly if patients are at risk, take measures to protect them, and take appropriate action if they have concerns about the possible abuse of children or vulnerable adults.
That is in addition to the general common law duty of care owed to all patients, a breach of which can result in a negligence claim.
What does the law say?
As a result of the 2008 Health and Social Care Act, all dental practices in England are required to register with the Care Quality Commission (CQC) and comply with its requirements for safeguarding patients.
Similar statutory bodies and requirements exist in Wales, Scotland and Northern Ireland.
Failure to comply with any of these bodies’ requirements on safeguarding could result in loss of registration and closure of one’s dental practice.
Policies and procedures
Every dental practice should have a written safeguarding policy and a safeguarding lead. Every dental professional should know who to contact for further advice and how to refer concerns to an appropriate authority, such as the local social services department.
Additionally, every registrant should know about local procedures for the protection of vulnerable individuals. They should follow those procedures if they suspect that a vulnerable person is at risk because of abuse or neglect.
Dental professionals may have limited training in safeguarding before qualification. The GDC recommends that registrants take part in regular CPD to keep their knowledge up to date on safeguarding children, young people and vulnerable adults.
Members of the dental team may suspect abuse or neglect from the patient’s behaviours, general appearance, and physical signs and symptoms upon presentation.
A considerable amount of guidance is available from the NHS website and elsewhere on how to recognise abuse or neglect and how to address it. If abuse or neglect is suspected, full clinical records will, as always, be invaluable.
Factors to consider when treating a vulnerable person
During the Covid-19 pandemic, particular issues may have risen in relation to remote triaging and consultations.
It’s important to be aware of the risk. The limited information available during remote consultations may have made it more difficult to pick up on abuse and neglect. So, when you next see the patient, a full history is important.
If you’re concerned that a patient may be abused or neglected, your first and foremost duty is to that patient and that patient alone. The fact that the patient’s parent or carer may also be a patient is irrelevant.
Issues of confidentiality may arise. However, they shouldn’t get in the way of taking the action needed to protect the patient from further harm.
The GDC and the law recognise that a breach of confidentiality may be justified to protect a patient from harm. However, patients with the capacity to consent should generally be informed of concerns you may have and actions you propose.
In the case of minors or vulnerable adults without capacity, it would be usual to discuss your concerns with the parent/person with parental responsibility or carer and explain what action you propose taking – unless you believe that doing so might put the patient at additional risk.
References
GDC (2013) Standards for the Dental Team
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