Legal And Ethical obligations OT

Question 1

Professional Duty of Candour

Answer 1

• Every healthcare professional must be open and honest with patients when something goes wrong with their treatment or care which causes or has potential cause, harm or distress.

Question 2

Statutory Duty of Candour

Answer 2

• Organisation which provide healthcare have statutory duty of Candour
• Organisation have duty to support their staff to be open and honest with patients when something goes wrong .

Question 3

Statutory duty of Candour introduced when ?

Answer 3

-2014 applied in 2015 by NHS bodies

• Applies duty on organisation

Question 4

GDC 9 standards

Answer 4

1- Put patient interest first
2- Communicate effectively with patient.
3- Obtain valid consent
4- Maintain and protect pt informatio
5- have clear and effective complaint procedure
6- work with colleagues in way for pt best interest
7- Maintain, develope and work within professional knowledge and skills
8- Raise concern if patient at risk
9- Make sure our personal behaviour maintain confidence in us and dental profession

Question 5

Which GDC standards for dental team already require?

Answer 5

1- Put patient interest first
1.3- be honest and act with integrity
5.3.8 - Offer apology and practical solution if patient makes a complaint

Question 6

Candour mean?

Answer 6

However Candour means being open and honest with all patients whether they made complaint or not.

Question 7

Duty of Candour ?

Answer 7

• Being open and honest with patient Before tx
• An important part of being open and honest with patients is having a thorough discussion before tx starts
• it is important that patients understand their options for tx including benefits and risks.
• you must give information in a way they can understand that they understand decision they are being made
• Make sure you give enough time to make decision

Question 8

Delivering Apology

Answer 8

• as soon as Tell the patient and and we question fully and honestly.
• Apologise in meaningful way rather than being general expression.
• Offer an appropriate remedy or support to put matter right if possible.
• Explain fully short and long term effects of what has happened.

Question 9

What if patient does not want to know details?

Answer 9

• Respect their decision
• let them know if they change their mind in future , can provide further information
• Record you discussion with patient including their decision not to have further information.

Question 10

Is apologising to the pt is not the same as admitting legal liability for what happened?

Answer 10

NO

Question 11

Notifiable Patient Safety Incident

Answer 11

• It applies to incident where something unintended or unexpected has occurred in the care of patient.

Notifiable safety incident is a specific term defined in the duty of Candour regulation.

Do not get confuse with other legislation

Question 12

Example of Notifiable patient safety incident

Answer 12

• child with UNKNOWN allergy to latex went for dental check up. Dentist wore latex gloves and child had anaphylactic attack. Child made full recovery

Question 13

Checklist of Notifiable safety Incident.

Answer 13

1- Did something unintended or unexpected happen during care or tx

2- Did it occur during provision of regulated activity

3- has it resulted in death or severe or moderate harm?

Question 14

Never Event in dentistry

Answer 14

Serious incidents that are wholly preventable because of guidance or safety recommendations that provide strong systemic protective barriers are available at national level and should be implemented by all healthcare providers

Question 15

Never event in dentistry

Answer 15

The extraction of wrong tooth had been classified as one of the Never events in dentistry but removed from list of never event and classified as PATIENT SAFETY INCIDENT

Question 16

General Dental Council
Standards for Dental Professionals

Answer 16

• Standards for Dental Professionals
• Principle of Dental Team working
• Principle of Patient Confidentiality
• Principle of Patient consent
• Principle of Complaints Handling
• Principle of Raising Concerns

Question 17

Putting patient interest first and acting to protect them

Answer 17

• Put patient interest before anyone
• Work within your knowledge and competence. ( Refer for second opinion or further tx when necessary
• Keep full and accurate records including MH
• Deal appropriately with patient complaint
• Do not put patient at risk because of your health or behaviour or of colleague . Seek advice when necessary.
• Do not accept any gift or payment which may appear to affect your personal judgment.
• Do not make misleading claims

Question 18

Work within your knowledge and competence

Answer 18

-Only work under your scope of practice
- Update CPD/ life long learning
- Post grads courses
- Journal and articles
- Professional meeting
- Research/ awareness of current best , Practice / law and guidelines
- Refresher/ back to work courses

Question 19

Keep Full and accurate records

Answer 19

• Dated
• Contemporaneous
• Medical history updated
• Nothing option given / pt choices decisions
• Any treatment provided and advice given
• Material used e.g type of anaesthetic
• Any problem encountered
• Further treatment discussed, appt recommended, referral

Question 20

Respect patient dignity and choices

Answer 20

• Treat patient with respect and dignity
• Always seek patient consent
• Treat all patients fairly - do not discriminate
• Listen to patients and provide them with the information they need to make an informed decision
  -Maintain appropriate relationships with patient

Question 21

Protect confidential of patient information

Answer 21

• All patient information is confidential and only to be used for purpose it’s given
• Keep patients information secure
• In certain cases it is justifiable to disclose pt information without consent. You should get advice before doing this.

Question 22

Co -Operate with other members of the dental team

Answer 22

• Treat all team members and colleagues fairly - do not discriminate
• Communicate effectively, share your knowledge and skills with other team members.

Question 23

Maintain your Professional knowledge and competence

Answer 23

• Life long learning
• Identify your limits as well as your strengths
• Find out about current best practice and evidence based guidance
• Follow the law and regulations which affect your work equipement and business

Question 24

Be trust worthy

Answer 24

• Justify the trust that your pt, public, your colleagues have in you by always acting honestly and fairly
• Apply these principles to professional business and educational activities
• Maintain appropriate standards of personal and professional behaviour

Question 25

If patient come in emergency you don’t have orthodontist . You can do this

Answer 25

Removal of wire causing trauma

Question 26

Consent forms

Answer 26

• Implied
  -verbal
  -written
• informed

Question 27

Best of consent would be ?

Answer 27

Written

Question 28

Principle of consent

Answer 28

• Voluntary - they making decision
• Valid
• Informed consent - understand full information
• Capacity - pt has ability to make an informed decision.

Question 29

Consent

Answer 29

• Is a process not always a one off event
• Discussions should continue through out treatment
• Decision may change or second opinion may be requested at any time

Question 30

Confidentiality Breach

Answer 30

-If confidentiality breached , dentist/ therapist/ hygienist faces investigation by GDC
- Possible erasure from registration.
- legal action by patient for damages for breach of 1988 data protection act.

Question 31

When disclosure is in public interest

Answer 31

• Where Expressly the patient has given consent to the disclosure
• Where disclosure is necessary for purposes of enabling someone else to provide health care to pt and patient consented to this sharing information
• where disclosure is required by Statute or ordered by court of law

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