Policies at our Dental Practice

Liverpool Chiropractor

 

POLICY FOR HANDLING PATIENT COMPLAINTS

In this practice we take complaints very seriously indeed and try to ensure that all patients are pleased with their experience of our service. When patients complain, they are dealt with courteously and promptly so that the matter is resolved as quickly as possible. This procedure is based on these objectives.

Our aim is to react to complaints in the way in which we would want our complaint about a service to be handled. We learn from every mistake that we make and we respond to patients' concerns in a caring and sensitive way.

  1. The person responsible for dealing with any complaint about the service we provide is Ingrid Hughes (Practice Manager)
  2. If a patient complaints on the telephone or at the reception desk, we will listen to his or her complaint and offer to refer him or her to Practice Manager immediately.  If Practice Manager is not available at the time, then the patient will be told when he or she will be able to talk to the Practice Manager and arrangements will be made for this to happen. The member of staff will take brief details of the complaint and pass them on. If we cannot arrange this within a reasonable period or if the patient does not wish to wait to discuss the matter, arrangements will be made for someone else to deal with it.
  3. If the patient complains in writing the letter will be passed on immediately to: Ingrid Hughes (Practice Manager).
  4. If a complaint is about any aspect of clinical care or associated charges it will normally be referred to the dentist, unless the patient does not want this to happen.
  5. We will acknowledge the patient's complaint in writing and enclose a copy of this code of practice as soon as possible, normally within two working days. We will seek to investigate the complaint within ten working days of the complaint being received to give an explanation of the circumstances which led to the complaint. If the patient does not wish to meet us, then we will attempt to talk to him or her on the telephone. If we are unable to investigate the complaint within ten working days we will notify the patient, giving reasons for the delay and a likely period within which the investigation will be completed.
  6. We will confirm the decision about the complaint in writing to the patient immediately after completing our investigation.
  7. Proper and comprehensive reports are kept of any complaint received.

If patients are not satisfied with the result of our procedure then a complaint may be made to:

NHS England, Customer Service Dept, Po Box 16738, Redditch, B97 9PT, Tel No: 03003112233(NHS England- Complaints)

Denplan Patients Only, Denplan Complaints Handling and Risk Management Dept, Tel No   0800 169 7220

Private PAYG Patients Only, Dental Complaints Service, Stephenson House, 2 Cherry Orchard Road, Croyden, CR06BA ,               

Tel No: 08456120540, Email: info@dentalcomplaints.org.uk

Care Quality Commission, Healthcare Team, Citygate - Gallowgate, Newcastle upon Tyne - NE1 4PA, Email:  info@cqc.org.uk Website: www.cqc.org.ukTelephone: 03000 616161

 

PROTECTING YOUR HEALTH

The practice uses a medical history sheet which includes lifestyle questions (to help identify patients in an oral cancer risk group) and questions to identify patients for whom special infection control precautions are needed (against transmissible spongiform encephalopathies)

New patients complete a medical history sheet. Patients check medical information on file at each routine examination. Our private practice carries out regular checks of medical history-taking

The medical history sheet complies with periodic recommendations from the British Dental Association

The practice is in contact with local medical practices so that further checks on patients’ medical status can be quickly made, if necessary.  We will not share your data with anyone else.

The practice keeps drugs for use with common medical emergencies in dentistry as recommended periodically by the PCT

The practice keeps essential equipment for resuscitation and all staff undergo annual training in CPR

Antibiotic prophylaxis follows guidelines from the faculty of General Dental Practitioners (uk) published  April 2000, unless a patients specialist gives specific alternative instructions

 

CONSISTENT PRACTICE QUALITY

Our Dental Practice in South Liverpool aims to provide dental care of a consistent quality, for all patients. We have management systems to help us and which define each practice member’s responsibilities when looking after you.

In proposing treatment we will take account of our own wishes. We will explain options, were appropriate, and costs, so that our patients can make an informed choice. We will always explain what we are doing

We will do all we can to look after your general health. We will ask you about your health and any medication you are taking. You will be asked to complete a medical History form on a yearly basis. This helps us to treat you safely. We keep all information about you confidential.

Contamination control is also essential to the safety of our patients. Every practice member receives training in practice systems for contamination control

We screen all our patients for mouth cancer at routine check ups. We ask patients about tobacco and alcohol use because they increase your oral cancer risk.

Practice working methods are reviewed regularly at practice meetings for all staff. We encourage all the team to make suggestions for improving the care we give patients

We regularly ask patients for their views on our services. We have systems for dealing promptly with patient complaints and for ensuring that lessons are learnt from any mistakes that we make

All the dental team take part in continual professional education, meeting the General Dental Council’s requirements. We aim to keep up to date with current thinking on all aspects of general dentistry, including preventive care which reduces your need for treatment

All staff joining the practice are given training in practice procedures. Once a year there is an individual review of training needs for everyone in the practice.

All members of the practice know of the need to ensure that dentists are working safely. In the unlikely event that a dentist in this practice becomes unfit to practice, we have systems to ensure that concerns are investigated and, if necessary, acted upon.

 

FEES AT OUR DENTAL PRACTICE

It is the policy of this practice to give patients full information about the cost of their dental care before any treatment is undertaken. A list of common treatment charges is available at Reception for treatments provided under NHS regulations or privately we will ensure that all patients:

Are advised of what they have to pay, when they should pay and how they can pay (e.g. cheque, cash, card, direct transfer)

Know what they will receive for their payment (i.e. what treatment or care)

Understand whether their treatment is provided privately or under NHS contract or a mixture (in which case we will identify clearly what is proposed)

Are given a written estimate and treatment plan on request or where treatment involves more than routine preventive examination and hygiene care

Understand their own responsibilities in terms of payment terms and how to avoid any penalty for overdue fees (missed appointment charges, late payment etc)

Are not pressured into signing agreements or paying fees

Obtain a receipt for any payments they make and can review their account details

Can talk to a staff member who can explain clearly what payments are due and what they are for

Can discuss with staff what treatment options and costs are available

Are given an estimate where a precise cost cannot be determined in advance (e.g. laboratory work) and will receive timely advice of any additional costs where appropriate.

We try to make payment as straightforward as possible.

Our normal policy is that patients are asked to pay a proportion at each visit or patients are asked to pay a deposit of 50% prior to the commencement of treatment costing over £100.00 and the balance on completion or patients are asked to pay on the day of completion of treatment.

Denplan patients are advised at the time of registration what their plan includes, what is excluded and what costs are involved

Denplan Care Patients will receive 20% off cosmetic treatment. Denplan essential patients receive 10% discount. Denplan Membership patients receive 15% discount off their check ups only.

 

INFORMED PATIENT CONSENT

At The Aigburth Dental Practice we aim to treat our patients with respect and politeness, to give them sufficient information to allow them to make an informed decision on their treatment and to recognise their needs and wishes.

Informed Consent

We discuss with all our patients their treatment needs and provide them with the different options available, even if we cannot offer them in the practice. We make sure they understand the risks and benefits of all treatment options and will also say what we feel is appropriate for them.

We will inform them whether the treatment is to be provided by: NHS, Denplan, or privately. They will be provided with a written estimate of treatment and costs after they have attended for initial consultation or after an examination appointment if it is found treatment is required.

We make sure that our staff are trained to explain estimates honestly to patients or will refer the patient back to the dentist or practice manager if there are any queries or questions.

If the treatment needs to be changed once started we will inform the patient of this and confirm that they consent to the changes.

Voluntary Decision Making

We make sure that the patient is allowed to make their decision without any time restraints or pressure. We respect that patients can withdraw their consent at any time and that we will then discuss with them their reasons and alternatives. We understand that the patient has the right to refuse treatment.

Ability to give consent - Adults

We respect that every adult has a right to make his or her own decisions and must be assumed to have capacity to give consent unless proved otherwise. In cases where we are concerned whether the patient fully understands we would endeavour to explain to the patient in a way in which they could understand and also try to involve carers and family. We would refer to the Mental Health Act 2007 practices in England and Wales  to make sure that we adhere to the principles of the act.

Ability to give consent - Children

We respect that the age of consent for children is 16. We understand that although at 16 and 17 they may consent to their own treatment, they do not have an absolute right to refuse treatment. We appreciate however that this can only be overridden by the court and always act with the patient’s best interest. We understand that children under 16 must either be Gillick competent or that whoever has parental responsibility gives permission for treatment.

At all times we will act in the patient’s best interest and if we have any concerns we would consult our defence organisation.

 

DENTAL EMERGENCIES

The Practice sets time aside for emergency patients in acute pain on a daily basis. We understand that Patients prefer to see the Dentist they are registered with, whenever possible we will try our best to arrange this for you. However our objective is to get you out of pain, therefore if your dentist is not available it may be necessary to arrange an appointment with a colleague.

Out of hours

This is for emergencies only.

NHS Patients must call NHS direct on 08454647

Denplan and PAYG Patients

The practice has an in house emergency service for Denplan and PAYG Patients.

Denplan Patients are covered by their policy. Private Pay as You Go patients will be charged £200 for calling the dentist out (this will include treatment provided at the emergency call out appointment)

You must call 0151 727 3012 and listen for the emergency number.

It changes each week depending on who is on call.

The On call dentist will provide the care he/she feels necessary.

We have a number of dentists on the emergency rota and so you may see a Denplan registered dentist at their own Practice.

The Practice on the Rota:

 

Thomas, Powell and Wilkinson

Aigburth Dental practice

310 Aigburth Road,

 Liverpool L17 9PW

Chris Mercier

45 Rodney Street

Liverpool L1 9EW

Lubna Hussain

75 Church Road

Liverpool L25 6DA

 

Jeff Lamb

252 Brodie Ave

Liverpool L19 7NG

Tim Melia

99 Aigburth Road

Liverpool L17

Mr Sharma and Assoc

Menlove Ave Dental Surgery.

1 Menlove Ave

Liverpool L18 1LS

 

CONFIDENTIALITY AT OUR PRACTICE

At this practice, the need for the strict confidentiality of personal information about patients is taken very seriously. This document sets out our policy for maintaining confidentiality and all members of the practice team must comply with these safeguards as part of their contract of employment/contract for services with the practice.

The importance of confidentiality

The relationship between dentist and patient is based on the understanding that any information revealed by the patient to the dentist will not be divulged without the patient’s consent.  Patients have the right to privacy and it is vital that they give the dentist full information on their state of health to ensure that treatment is carried out safely.  The intensely personal nature of health information means that many patients would be reluctant to provide the dentist with information if they were not sure that it would not be passed on.  If confidentiality is breached, the dentist/dental hygienist/dental therapist/dental nurse faces investigation by the General Dental Council and possible erasure from the Dentists or DCP Register; and may also face legal action by the patient for damages and, for dentists, prosecution for breach of the 1998 Data Protection Act.

General Dental Council

All staff must follow the General Dental Council’s rules for maintaining patient confidentiality contained in Standards for dental professionals and Principles of patient confidentiality.

“The dentist/patient relationship is founded on trust and a dentist should not disclose to a third party, information about a patient acquired in a professional capacity without the permission of the patient. To do so may lead to a charge of serious professional misconduct. A dentist should be aware that the duty of confidentiality extends to other members of the dental team....There may, however, be circumstances in which the public interest outweighs a dentist's duty of confidentiality and in which disclosure would be justified

Communications with patients should not compromise patient confidentiality. In the interests of security and confidentiality, for example, it is advisable that all postal communications to patients are sent in sealed envelopes”

If confidentiality is breached, each registered dental professional involved is responsible to the Council for their individual conduct.

What is personal information?

In a dental context, personal information held by a dentist about a patient includes:

  • the patient’s name, current and previous addresses, bank account/credit card details, telephone number/e-mail address and other means of personal identification such as physical description information that the individual is or has been a patient of the practice or attended,
  • cancelled or failed to attend an appointment on a certain day
  • information concerning the patient’s physical, mental or oral health or condition
  • information about the treatment that is planned, is being or has been provided
  • information about family members and personal circumstances supplied by the patient to others
  • the amount that was paid for treatment, the amount owing or the fact that the patient is a debtor to the practice.

Principles of confidentiality   

This practice has adopted the following three principles of confidentiality:

Personal information about a patient:

  • is confidential in respect of that patient and to those providing the patient with health care
  • should only be disclosed to those who would be unable to provide effective care and treatment without that information (the need-to-know concept) and
  • such information should not be disclosed to third parties without the consent of the patient except in certain specific circumstances described in this policy.

Disclosures to third parties

There are certain restricted circumstances in which a dentist may decide to disclose information to a third party or may be required to disclose by law.  Responsibility for disclosure rests with the patient’s dentist and under no circumstances can any other member of staff make a decision to disclose.  A brief summary of the circumstances is given below.

When disclosure is in the public interest

There are certain circumstances where the wider public interest outweighs the rights of the patient to confidentiality.  This might include cases where disclosure would prevent a serious future risk to the public or assist in the prevention or prosecution of serious crime.

When disclosure can be made

There are circumstances when personal information can be disclosed:

  • where expressly the patient has given consent to the disclosure
  • where disclosure is necessary for the purpose of enabling someone else to provide health care to the patient and the patient has consented to this sharing of information
  • where disclosure is required by statute or is ordered by a court of law
  • where disclosure is necessary for a dentist to pursue a bona-fide legal claim against a patient, when disclosure to a solicitor, court or debt collecting agency may be necessary.

Disclosure of information necessary in order to provide care and for the functioning of the NHS

Information may need to be disclosed to third party organisations to ensure the provision of care and the proper functioning of the NHS. In practical terms this type of disclosure means:

  • transmission of claims/information to payment authorities such as the DPD/SDPD/CSA
  • in more limited circumstances, disclosure of information to the PCT/HB
  • referral of the patient to another dentist or health care provider such as a hospital.

Data protection code of practice

The Practice’s Data protection code of practice provides the required procedures to ensure that we comply with the 1998 Data Protection Act.  It is a condition of engagement that everyone at the practice complies with the code of practice.

Access to records

Patients have the right of access to their health records held on paper or on computer.  A request from a patient to see records or for a copy must be referred to the patient’s dentist.  The patient should be given the opportunity of coming into the practice to discuss the records and will then be given a photocopy.  Care should be taken to ensure that the individual seeking access is the patient in question and where necessary the practice will seek information from the patient to confirm identity.  The copy of the record must be supplied within forty days of payment of the fee and receipt of identifying information if this is requested.

Access may be obtained by making a request in writing and the payment of a fee for access of up to £10 (for records held on computer) or £50 (for those held manually or for computer-held records with non-computer radiographs). We will provide a copy of the record within 40 days of the request and fee (where payable) and an explanation of your record should you require it.

The fact that patients have the right of access to their records makes it essential that information is properly recorded. Records must be:

  • contemporaneous and dated
  • accurate and comprehensive
  • signed by the dentist
  • neat, legible and written in ink
  • strictly necessary for the purpose
  • not derogatory
  • such that disclosure to the patient would be unproblematic.

Practical rules

The principles of confidentiality give rise to a number of practice rules that everyone in the practice must observe:

  • records must be kept secure and in a location where it is not possible for other patients or individuals to read them
  • identifiable information about patients should not be discussed with anyone outside of the practice including relatives or friends
  • a school should not be given information about whether a child attended for an appointment on a particular day.  It should be suggested that the child is asked to obtain the dentist’s signature on his or her appointment card to signify attendance
  • demonstrations of the practice’s administrative/computer systems should not involve actual patient information
  • when talking to a patient on the telephone or in person in a public area care should be taken  that sensitive information is not overheard by other patients
  • Before making an appointment or disclosing information to the patient ask the pt to give their D.O.B and postcode to you
  • do not provide information about a patient’s appointment record to a patient’s employer
  • messages about a patient’s care should not be left with third parties or left on answering machines.  A message to call the practice is all that can be left
  • recall cards and other personal information must be sent in an envelope
  • disclosure of appointment books, record cards or other information should not be made to police officers or Inland Revenue officials unless upon the instructions of the dentist
  • patients should not be able to see information contained in appointment books, day sheets or computer screens
  • discussions about patients should not take place in the practice’s public areas.

Disciplinary action

If, after investigation, a member of staff is found to have breached patient confidentiality or this policy, he or she shall be liable to summary dismissal in accordance with the practice’s disciplinary policy. Employees are reminded that all personal data processed at the practice must by law remain confidential after your employment has terminated.  It is an offence under section 55(1) of the Data Protection Act 1998, knowingly or recklessly, without the consent of the data controller (insert name), to obtain or disclose personal data.  If the practice suspects that you have committed such an offence, it will contact the Office of the Information Commissioner and you may be prosecuted by the Commissioner or by or with the consent of the Director of Public Prosecutions. 

Queries

Queries about confidentiality should be addressed to The Practice Manager at our South Liverpool Dental Practice.  More information is contained in BDA Advice Sheet B1 Ethics in Dentistry and B2 Data protection which are available for reference in the BDA  advice sheets folder in the attic cabinet

 

CLINICAL DECISION MAKING

Treatment terms are discussed with patients and agreed. Where patients attend the practice for the first time, terms for the initial appointment are discussed when the appointment is made

Written cost estimates are given for treatment proposed under private contract, and for treatment proposed under NHS arrangements in accordance with NHS Regulations
    
We share clinical decision-making with the patient, based on clear explanations of the condition and the treatment options available
    
Dentists share professional judgements on types of risks to be identified to patients, when explaining treatment options
    
Patients are asked about their preferred form of pain control
    
Record-keeping notations are discussed to ensure comprehensibility to other clinicians
    
Regular checks of record-keeping are carried out to ensure that records properly document the decision-making and care process
    
The practice has discussed and formally adopted ‘Selection criteria for dental radiography’ as a guide to the use of radiographs. Regular checks of the quality of radiographs are carried out
    
Patients are referred to specialists, where appropriate, and referral systems are checked regularly
    
Check findings are discussed at practice meetings and checking is rotated amongst dentists to ensure an effective exchange of views.

 

CHAPERONE POLICY

It can be distressing or embarrassing undergoing dental treatment. Chaperones are people who are there through the examination to make it less embarrassing. Chaperones are also used sometimes for medico-legal reasons – for example to provide protection to healthcare professionals against unfounded allegations of improper behaviour. 

Aigburth Dental Practice is committed to providing a safe, comfortable environment where patients and staff can be confident that we adhere to the British Dental Association guidelines in Infection Control are being followed at all times and the safety of everyone is of paramount importance.

All patients are entitled to have a chaperone present for any consultation, examination or procedure where they feel one is required. This chaperone may be a family member or friend. On occasions you may prefer a formal chaperone to be present, i.e. a trained member of staff.

Wherever possible we would ask you to make this request at the time of booking appointment so that arrangements can be made and your appointment is not delayed in any way. Where this is not possible we will endeavour to provide a formal chaperone at the time of request. However occasionally it may be necessary to reschedule your appointment.

If you have any questions or comments regarding this please contact the Practice Manager, Lorna Slade