Protecting at-risk dental patients

Debbie Herbst, dento-legal adviser at the Dental Defence Union (DDU), explains the significant role dental professionals play in protecting at-risk patients.

Given the nature of the role, dental professionals are well placed to notice potential patient abuse or neglect and to take appropriate action and/or help the patient to take appropriate action. Indeed in its Standards for the dental team,¹ the General Dental Council (GDC) states that dental professionals 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'.

Dental professionals are well placed to notice potential patient abuse or neglect and to take appropriate action.

The GDC also recommends that registrants should take part in regular CPD to keep their knowledge up to date on safeguarding children, young people, and vulnerable adults.

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Safeguarding in the dental practice

It is vital that practices have a safeguarding policy, in line with local safeguarding procedures. There should be a safeguarding lead in the practice who is responsible for ensuring the safeguarding policy and procedures are followed and that this policy is easily accessible and kept up to date.

If a dental professional has any safeguarding concerns, they should be discussed with the local safeguarding lead. However, the GDC also recommends that registrants should take part in regular CPD to keep their knowledge up to date on safeguarding children, young people, and vulnerable adults.

Guidance and advice on how to recognise signs of abuse and neglect and how to safeguard patients is widely available across the devolved regions.

Safeguarding guidance in England

• ‘Adult Safeguarding: Roles and Competencies for Health Care Staff' sets out the competency framework for training healthcare staff: https://www.rcn.org.uk/Professional-Development/publications/adult-safeguarding-roles-and-competencies-for-health-care-staff-uk-pub-007-069

• ‘Health matters: child dental health' from Public Health England describes issues relating to child dental health: https://www.gov.uk/government/publications/health-matters-child-dental-health/health-matters-child-dental-health

• ‘Safeguarding in general dental practice' also produced by Public Health England provides an overview of safeguarding to dental teams: https://www.gov.uk/government/publications/safeguarding-in-general-dental-practice

• ‘NHS England Safeguarding': https://www.england.nhs.uk/safeguarding/

• ‘The CQC Dental mythbuster 29: Safeguarding children and young people at risk': https://www.cqc.org.uk/guidance-providers/dentists/dental-mythbuster-29-safeguarding-children-young-people-risk

• ‘The CQC Dental mythbuster 28: Safeguarding adults at risk': https://www.cqc.org.uk/guidance-providers/dentists/dental-mythbuster-28-safeguarding-adults-risk

• The Department of Education's ‘Working together to safeguard children': https://www.gov.uk/government/publications/working-together-to-safeguard-children--2

• NICE guidance: ‘Child maltreatment - recognition and management': https://cks.nice.org.uk/child-maltreatment-recognition-and-management#!topicsummary and updated ‘Child abuse and neglect': https://www.nice.org.uk/guidance/ng76

• The Royal College of Paediatrics and Child Health (RCPCH): ‘Safeguarding children and young people: roles and competencies': ‘https://www.rcpch.ac.uk/resources/safeguarding-children-young-people-roles-competencies'.

Safeguarding guidance in Scotland

• National guidance for child protection in Scotland from the Scottish Government, provides current national framework for child protection: https://www.gov.scot/publications/national-guidance-child-protection-scotland/

• ‘Getting it right for every child' (GIRFEC) also produced by the Scottish Government: https://www.gov.scot/policies/girfec/

• ‘Children and young people (Scotland) Act 2014: statutory guidance on part 3: children's services planning' - second edition 2020 provides advice and information on children's services planning: https://www.gov.scot/publications/children-young-people-scotland-act-2014-statutory-guidance-part-3-childrens-services-planning-second-edition-2020/

• ‘The Adult Support and Protection Code of Practice 2014' outlines how practitioners should implement the Adult Support and Protection Act 2007: https://www.gov.scot/publications/adult-support-and-protection-revised-code-of-practice/.

Safeguarding guidance in Wales

• ‘National Safeguarding Team (NHS Wales) Guidance for Dental Teams on Safeguarding Children & Adults at Risk' highlights the aspects of safeguarding relevant to dental practices in Wales: https://phw.nhs.wales/services-and-teams/national-safeguarding-team-nhs-wales/guidance-primary-care/guidance-for-dental-teams-on-safeguarding-children-and-adults-at-risk/

• Safeguarding guidance: https://gov.wales/safeguarding-guidance

• ‘Working together to safeguarding people (2021)' - https://gov.wales/sites/default/files/publications/2019-05/working-together-to-safeguard-people-volume-i-introduction-and-overview.pdf - is the statutory guidance in relation to Part 7 of the Social Services and Well-being (Wales) Act 2014 (https://www.legislation.gov.uk/anaw/2014/4/contents) which covers the protection of adults and children

• ‘Wales Safeguarding Procedures and Practice Guides' provides child and adult protection procedures and practice guides for every safeguarding board in Wales: https://www.safeguarding.wales/

• The All Wales Practice Guides on safeguarding children provides guidance on specific issues for practitioners working with children and young people: https://www.safeguarding.wales/en/chi-i/chi-i-c6/.

Safeguarding guidance in Northern Ireland

• ‘Safeguarding is everyone's business' from the Safeguarding Board of Northern Ireland provides comprehensive advice and guidance: https://www.safeguardingni.org/

• ‘Co-operating to Safeguard Children and young people in Northern Ireland' (Department of Health, 2017) provides the policy framework for safeguarding children and young people in Northern Ireland: https://www.health-ni.gov.uk/publications/co-operating-safeguard-children-and-young-people-northern-ireland

• ‘Adult Safeguarding Partnership (NIASP) Training Framework' (revised June 2016): http://www.hscboard.hscni.net/download/PUBLICATIONS/safeguard-vulnerable-adults/niasp-publications/NIASP-Training-Framework-revised-7-June-2016.pdf

• ‘SBNI Child Safeguarding Learning and Development Strategy and Framework 2015-2018': https://www.safeguardingni.org/resources/sbni-child-safeguarding-learning-and-development-strategy-and-framework-2015-2018

• ‘Children and Young People's Strategy 2020-2030' (Department of Education, 2021) sets out the framework to improve the wellbeing of all children and young people in Northern Ireland: https://www.education-ni.gov.uk/publications/children-and-young-peoples-strategy-2020-2030

• ‘Revised regional core child protection policies and procedures for Northern Ireland' (Safeguarding Board for Northern Ireland, 2018) explains the actions that must be taken when there are concerns about the welfare of a child or young person: http://www.proceduresonline.com/sbni/contents.html#core

• ‘The Adult Safeguarding Policy for Northern Ireland' is for all organisations working with, or providing services to, adults and sets clear safeguarding expectations for a range of organisations: https://www.health-ni.gov.uk/articles/adult-safeguarding-prevention-and-protection-partnership.

Safeguarding patients and maintaining confidentiality

If you think a patient may be subject to possible abuse or neglect, it might be appropriate 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 public. An example of this could be to discuss a patient if you feel that their safety may be at risk, even if they decline to give their consent to do so. Where possible, patients should be involved in the decision-making process, unless they lack capacity, or you have concerns that this may put the patient at additional risk. If a patient lacks capacity, seek advice from your dental defence organisation.

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