Hello, my name is Alison Large and I am one
of the dento-legal advisers here at the DDU and firstly I would like to thank you for
taking the time to view this short presentation. Today I would like to speak to you about remote
working. We are all very aware that the current COVID
19 Pandemic has significantly impacted upon the delivery of dentistry throughout the UK,
in a way that even a number of months ago we as a profession could not have imagined.
The Governments wider guidance and the statements issued by the Chief Dental Officers across
the four nations has resulted in many dentists having to now undertake their consultations
remotely. As a team of dento-legal advisers we are all
dentists ourselves and we are entirely sympathetic to the frustrations and challenges associated
with the current circumstances all our professional colleagues have found themselves in.
We appreciate that for many of our members undertaking an assessment and making a diagnosis
without having the opportunity to examine a patient is a very unusual situation. You
may have found that you have needed to rapidly adapt to an entirely new way of working.
As a result of this change we have received numerous calls to the DDU’s advice line
on this topic. In this presentation I plan to cover some
of the general dento-legal considerations associated with undertaking remote consultations.
Adjusting to undertaking an assessment of a patient without seeing them has been a rather
daunting prospect for many dentists. However, utilising current technologies may allow you
to overcome some of the challenges that remote consultations pose. Do remember that the same
core GDC principles apply to your remote consultation as would be applicable if you were conducting
a normal face to face appointment with a patient. It may be helpful to remember that the consultation
is simply being conducted in a different manner and therefore the DDU’s guidance on Confidentiality,
Consent, Record keeping, and Communication are all applicable. If you wish to access
the DDU’s guidance on any of these topics you can do so from the associated links.
It is also important to ensure you have appropriate Indemnity arrangements in place. We appreciate
that when routine dentistry ceased back in March, many members were unsure about the
roles they might be expected to undertake at the practice or in the wider NHS. If you
are providing remote consultations, including telephone triage for patients, please call
or email our membership department. The email address is [email protected]
We can ensure that your membership with the DDU has been appropriately updated to reflect
any activities you are undertaking during the coronavirus pandemic. This would include
providing any remote advice. I would also like to highlight to you a document
entitled “high level principles for good practice in remote consultations and prescribing”.
This document sets out the shared high level principles of good practice which are expected
of all healthcare providers, including dental professionals. The GDC was one of the co-authors
of this guidance and the relevant link is on the website.
The Government’s current guidance advises that everyone stays at home as much as possible
and that people work from home if it is possible to do so.
If you are advising patients from home, the Information Commissioner’s Office has provided
some guidance on working from home which states: Data protection is not a barrier to increased
and different types of homeworking. During the pandemic, staff may work from home more
frequently than usual and they can use their own device or communications equipment. Data
protection law doesn’t prevent that, but you’ll need to consider the same kinds of
security measures for homeworking that you’d use in normal circumstances.
Across the UK, the guidance to dentists from all the Chief Dental Officers is that patients
should be remotely triaged, offered advice and if appropriate, the prescription of analgesics
and antimicrobials. It may also be necessary to decide if the patient needs to be seen
face to face. If this is the case you should follow local arrangements with regards to
the provision of any clinically necessary urgent treatment.
We suggest that each practice appoints a lead person with responsibility for checking the
relevant covid-19 advice, including the appropriate referral pathways for urgent care. It would
be the lead person’s role to make sure that the information is up to date and shared with
the rest of the dental team. We are aware that changes in guidance are currently happening
at a significant pace and it is for this reason that we advise that you view documents from
a website rather than relying on a saved copy which may no longer be current.
In my next presentation I will set out some practical tips and considerations for conducting
a remote consultation and I also plan to focus in more detail on the record keeping aspects
of working remotely as well as details on prescribing remotely. I hope you will find
this helpful. I would also like to take the opportunity
to invite you to email in any other topics that you think it might be helpful for us
to cover in this series of presentations. Email them to [email protected] with the
subject “Coronavirus question” and we will try and incorporate them in one of our
presentations. Alternatively, if you are seeking any specific
advice please do not hesitate to call the DDU’s advice line on 0800 374 626. The advice
line is fully operational between 8am-6pm Monday to Friday and we would be more than
happy to take your call. For urgent enquires outside these times, including over bank holidays,
we additionally provide a 24 hour service. At this very challenging and truly unprecedented
time for the profession, I would like to reassure all of our members of the DDU’s ongoing
support and assistance.