Code of Practice

Question 1

About NHS Dentist

Answer

NHS Dentist is one of the largest single dental contract holders in central London, caring for people with a wide range of dental health needs. We provide a broad range of services to treat people with a variety of dental health needs. In basic terms, these services include examination, assessment, advice, treatment of long-term conditions such as periodontitis (gum disease), preventive dentistry, child friendly dentistry and restorative treatment. We are here to provide support for people through every stage of life. Where NHS treatments are not available, such as white restoration in back teeth or cosmetic treatment, we offer a number of different options to our patients with very reasonable fees. We also provide implant treatment, Invisalign treatment (see-through braces) and Inman aligner (a removable orthodontic appliance). We are committed to providing services that meet the needs of the people who use them, and we actively encourage the involvement of our staff in local schools to help make a difference to the local community.

Question 2

Our Values

Answer

Trust: We aim to earn our patients’ trust with the high quality care and respect which we demonstrate. We place a great deal of emphasis on continuous professional development to enable us to completely satisfy the patient’s needs. Respect: We value the diversity of both the people we support and our staff. To create a respectful and supportive working environment we will take the time to communicate clearly to ensure mutual understanding and inclusion. Care: We will involve people in deciding their future dental treatment and care, working together and alongside carers and families to create practical solutions that meet individual needs. We will give our staff the support and opportunities they need to grow and develop. Pride: Recruiting, retaining and developing a skilled and motivated workforce that is proud to work for NHS Dentist and that NHS Dentist is proud to employ.

Question 3

1. Responsibilities

Answer

We aim to provide care that is consistent. We work to a system which is based on defining our goals and then training staff to take responsibility for their own role whilst assisting their colleagues in theirs. The Principal and the Practice Manager are responsible for the proper operation of the policy and working systems at NHS Dentist. All the dentists, hygienists and staff working in the practice have agreed to comply with the policy and working systems, as part of their contracts with the practice. Training to enable them to do so is provided, where necessary.
Individual dentists and hygienists have responsibility for their own clinical performance and clinical judgement (allowing for hygienists taking written instructions from dentists before treatment). However, everyone has to recognise that practice systems are essential for the delivery of good quality treatment and it is therefore essential that professional staff comply with systems and that employees support the professional staff.
The Practice Manager is responsible for maintaining practice systems and is the contact point for outside agencies concerned with practice systems. Clinical practice systems are the main responsibility of the Principal. Above all, this practice is based on a flat hierarchical system, using teamwork to enhance patient care and quality of working life for all staff. Each member of staff should work on the basis that “the buck stops here”

Question 4

2. Clinical Decision Making

Answer

We examine you, then propose a course of treatment. We discuss it with you and allow for your individual needs and wishes. No treatment is compulsory. We explain the written treatment plan to you. We encourage questions. We provide you with a written treatment plan and estimate of costs. Should this need to change we will explain why and provide you with another written treatment plan and estimate before treatment if possible. Treatment is provided under NHS Regulations. Patients are advised when making an appointment of the costs of NHS treatment. Treatment plans and written estimates are provided after the initial appointment. In the unlikely event that private treatment is requested then the costs will be explained to patients in advance. Sometimes things occur during treatment that cannot be anticipated; you will then be told what has happened, what options you have and about any increased cost. Proposed treatment plans are discussed with patients in the surgery and treatment options are discussed. Interpreters are found from staff where possible, friends and family are welcome to accompany patients. Dentists ask for professional judgements and advice from each other and agree types of risks to be identified to patients. Dentists and hygienists have regular meetings to share professional concerns and information. Patients are asked whether they want injections for pain control. Record-keeping notations are discussed to ensure consistency and comprehension. Regular checks of record-keeping are carried out by the Practice Manager and dentists to ensure that records are accurate and precise. The practice has discussed and formally adopted “Selection criteria for dental radiography” (FGDP, 1998) as a guide to x-ray use. Regular checks of the quality of radiographs are carried out. Patients are referred to specialists and hospitals, where appropriate and after discussion and the referrals are checked daily by the dentists.

Question 5

3. Protecting General Health

Answer

We ask you to complete a medical questionnaire when you first come to see us and every year after that. We also ask that you tell us if your general health alters in any way. We need to know this as it may affect the type of treatment or medicines we give you. This information is kept confidentially. We ask you to give us details of your smoking and drinking habits, this is to help us assess your risk of getting oral cancer. We screen you for oral cancer when you have your routine checkup. The practice uses the pro forma British Dental Association medical history questionnaire which includes all the questions recommended for protecting patients. It is updated as and when the BDA recommends changes. New patients are required to complete a medical history sheet. Patients are asked if their medical health has altered since they were last seen by a dentist or hygienist. We also ask patients to complete a new medical questionnaire each year. The dentist or hygienist will then update the computer medical history file. We ask for further information on a patient’s medical health if the professional deems it necessary. This may require us or you to obtain a letter from a hospital or doctor. Notes are made on file if information is provided by telephone, we record the doctor’s name, the contact telephone number and date. The practice keeps drugs for use in medical emergencies as recommended in the Dental Practitioners’ Formulary. These drugs are checked on a regular basis for “use by” dates by the Head Nurse. The practice keeps essential equipment for resuscitation and all staff undergo regular training in CPR annually. The practice holds unannounced “crash” tests for all staff. Training follows any shortfall observed. Antibiotic prophylaxis follows recommendations in the Dental Practitioners Formulary unless a patient’s doctor gives specific alternative instructions.

Question 6

4. Infection Control

Answer

Cross infection control is essential in a medical environment. Every member of staff is trained to understand the importance of contamination control and in line with HTM-01-05 guidance. This practice has a written infection control policy. A copy is available from the practice manager or reception. New staff are provided with a copy of the policy. The Principal is responsible for keeping the policy in line with current BDA advice and the Practice Manager is responsible for ensuring that everybody in the practice knows about the changes. These are discussed at staff meetings and changes are placed on the staff room notice board. Changes to infection control procedures are noted on the minutes of the staff meeting to ensure consistency throughout the practice. All members of the practice are trained as part of their surgery training in infection control. The policy states clearly who is responsible for answering queries. At all times the Principal may be asked questions. Uniforms and protective equipment are provided. The hepatitis B status of clinical staff is monitored. It is a condition of their employment that they keep all the recommended inoculations up to date. Any staff who find they carry a blood-borne virus or other serious transmissible infection will inform the Principal in confidence and discuss any changes in clinical practice which may be necessary in accordance with GDC guidance. Patient’s health will be this Practice’s priority. This practice adheres to stringent and consistent infection control precautions.

Question 7

5. Internal Communications

Answer

This practice has regular general staff meetings, dentists, nurses, reception and hygienists meetings. The Principal and Practice Manager attend and agendas are prepared and minutes written. All members of staff are encouraged to add items to the agendas. All new developments are discussed at staff meetings before decisions are made and suggestions from staff are incorporated into new procedures, policies and employment practices. Staff meetings are held regularly. All staff are encouraged to make suggestions and to comment on present practice, clinical or administrative. The aims of our staff meetings are to impart information, increase knowledge and improve our procedures. Minutes are written up and available to all staff. We use a Problem follow-up system on the minutes to ensure that matters discussed and problems identified are rectified within the time space allotted. Members of staff who are absent from staff meetings are provided with a copy of the minutes and are expected to read them. Questions should be addressed to the Practice Manager.

Question 8

6. Patient Feedback

Answer

We make it a practice to talk to our patients at reception and in the surgeries. We listen to their comments, both bad and good and welcome suggestions as to how to improve our service. We have a comments book freely available at reception and we have patient surveys twice a year, the results of which are publicly displayed in reception. Complaints are answered in writing usually within two days and we ask all members of staff involved in a complaint to be part of the team, which answers the complaint. Lessons are learnt and apologies given where we feel we have let a patient down. This practice undertakes an anonymous patient survey twice a year. The first 100 patients in a random day are asked to complete a questionnaire. The results are analysed by the Practice Manager who will report the findings to the next staff meeting for discussion and possible improvement of services. We will also discuss the composition of the next survey. New questions may need to be asked in light of the results or because of new services that we may be able to offer. We use a complaints procedure based on BDA advice and we usually write a complete and comprehensive reply to a complaint within 48 hours. The Practice Manager is responsible for dealing with complaints about any aspect of our service. Reception complaints can also be handled in the first instance by any of our receptionists. All complaints are discussed at a meeting with the involved parties, including reception, professional and nursing staff. Changes in systems or working practices will be discussed and incorporated in training and the current staff retrained. These identified problems will be logged on our staff meeting agenda. We have a complaints procedure with easy to follow steps should a patient wish to air any concerns or dissatisfaction.

Question 9

7. Continuing Professional Development

Answer

This practice volunteered to register for Lifelong Learning before it became compulsory. Our dentists and hygienists continue to attend courses on new developments and we have a consistently high training record. Dentists engage in peer review within the practice to ensure that dentists keep informed and adhere to our high standards. Dentists are expected to rely on their colleagues for second opinions, advice and criticism. Systems are in place to deal with any concerns that arise.
All professional staff comply with the General Dental Council’s requirements for continued certification.The Practice Manager keeps the file. Absence for training is co-ordinated with other professionals through the Practice Manager. Professionals identify their training needs in annual discussion within a group meeting. At the next meeting, the implementation and success of the training is discussed. Information from this training is shared with other practice members at staff meetings and evening training sessions. All professionals keep in touch with current practice through peer review group and are encouraged to gain membership of a professional association. Each professional reads professional journals and discussions are held between professionals on a regular basis to share findings.

Question 10

8. Training and CPD Generally

Answer

All staff are trained in confidentiality, data protection, cross-infection control, radiation, crash procedures, first aid, fire, practice security, health and safety, equal opportunities, in addition to numerous protocols. We hold annual performance/training reviews with all staff. All staff are encouraged to go to college to obtain qualifications. We have sponsored our nurses to do so. We have a general induction programme for all staff and then specific induction programmes for dentists/hygienists, nurses and receptionists. We have written our own training manuals for receptionists and nurses. We have been awarded the “Investors in People” mark between 2008-2018 due to our consistent and continuous commitment to training our staff. References are taken up to establish that the individual is suitable for work within health care. Everyone joining the practice receives induction training which includes training in the procedures described in this system. Specific training then follows the induction. Staff are appraised once a year and training is discussed in light of problems that have developed in performance and in identifying future goals and personal development. The practice encourages all staff to belong to their relevant national association to keep them in touch with developments outside the practice. Between annual reviews, under performance will be pinpointed, discussed and training considered. Disciplinary action will be taken where necessary. Crash tests will be undertaken without notice to the staff to ensure high standards. Annual CPR training will take place at the practice’s expense for all staff. Professional staff will be invited to attend at their expense.
Where any failure in the system is identified, a review will take place to ensure a recurrence does not take place.

Care Trust Respect Pride.

Code of Practice

About NHS Dentist

Our Values

Our Practice Policy

1. Responsibilities

2. Clinical Decision Making

3. Protecting General Health

4. Infection Control

5. Internal Communications

6. Patient Feedback

7. Continuing Professional Development

8. Training and CPD Generally

Patients Complaints Procedure

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