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Safeguarding vulnerable patients

Sarah Ide, dento-legal adviser at the Dental Defence Union (DDU), discusses how dental professionals can help in safeguarding vulnerable patients, particularly during the coronavirus pandemic.

Dental professionals are well placed to be able to observe, respond and report safeguarding concerns, particularly in relation to issues concerning the head and neck.

Media reports of the increased incidence of domestic violence have heightened concerns surrounding safeguarding during the COVID-19 pandemic. Unfortunately, vulnerable members of society may have found themselves at increased risk and it is imperative that dental professionals play their part in assessing patients appropriately.

Vulnerable patients attending the dental practice

It is important to remember that some vulnerable people will not have access to, or be familiar with, technology. In these circumstances communication by telephone may be more appropriate. Try to make sure that any patient preferences in relation to the mode of communication are appropriately recorded and updated. While the majority of patients have been asked to visit the practice alone during the pandemic, reasonable adjustments should be made for any patients who may require assistance from a family member or support worker.

The importance of safeguarding vulnerable patients

Every practice should have a safeguarding policy and a safeguarding lead responsible for ensuring the safeguarding policy and procedures are followed.

If you are faced with a situation where you have safeguarding concerns, you should discuss this with your safeguarding lead in the first instance.

The GDC supports this, stating in 8.5.1 of the Standards for the dental team1 that:

'You must raise any concerns you may have about the possible abuse or neglect of children or vulnerable adults. You must know who to contact for further advice and how to refer concerns to an appropriate authority such as your local social services department'.

Additionally, Public Health England has produced Safeguarding in general dental practice2 which provides an overview of safeguarding as a whole for the dental team.

This guidance also sets out the legal and regulatory framework, and provides information about training and other resources.

It includes the following recommendations for all dental practices to ensure they have the appropriate safeguarding arrangements in place:

  • Have a practice safeguarding policy that sets out the practice's commitment to protect patients which should then be regularly reviewed

  • Have a named safeguarding practice lead to ensure staff undertake appropriate training and have access to support and advice

  • Organise ongoing safeguarding training for both clinical and non-clinical staff that is appropriate for their role

  • Have a safeguarding reporting system in place that is known to staff

  • Ensure all members of staff know how to access the NHS Safeguarding app2 for local safeguarding contact details

  • Incorporate Safeguarding in general dental practice3 as part of the staff induction process to supplement existing safeguarding training

  • Discuss the guidance at team meetings and consider how training opportunities and resources can be embedded into the practice.

Confidentiality and vulnerable patients

Dental professionals have a duty to maintain patient confidentiality and to only use information for the purpose for which it was given. In the majority of cases, a patient's consent should be sought to share their information.

However, in exceptional circumstances you may decide to discuss confidential information about a patient with others if you consider this to be in the best interests of the patient or of the general public. For example, if you feel that a patient's safety may be at risk you may decide to discuss confidential information with an appropriate person, even if a patient declines to give you their permission to do so. You should try to include a patient with capacity, or the person with parental responsibility in the decision making process, unless you have concerns that this may put the patient at additional risk.

It is important to make detailed records of any discussions in relation to safeguarding concerns including your justification for disclosing information to a third party. Unfortunately, instances of abuse and neglect can be more common than we may think. Dental professionals have an important role to play in safeguarding vulnerable patients, and should be able to recognise potential signs and be equipped to take appropriate action.

For more information about safeguarding vulnerable patients visit www.theddu.com.

References

  1. 1.

    General Dental Council. Standards for the dental team. Principle Eight. Raise concerns if patients are at risk. Available at: https://standards.gdc-uk.org/pages/principle8/principle8.aspx (accessed March 2021).

  2. 2.

    NHS. NHS England Safeguarding app. Available at: https://www.england.nhs.uk/safeguarding/nhs-england-safeguarding-app/ (accessed March 2021).

  3. 3.

    Public Health England. Safeguarding in general dental practice. 3 April 2019. Available at: https://www.gov.uk/government/publications/safeguarding-in-general-dental-practice (accessed March 2021).

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Correspondence to Sarah Ide.

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Ide, S. Safeguarding vulnerable patients. BDJ Team 8, 22 (2021). https://doi.org/10.1038/s41407-021-0587-y

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