Dental professionals have an existing ethical and legal duty to act if they believe a patient is being abused, but in this highly sensitive area it helps to be aware of relevant guidance and available support.
Now Public Health England has issued Safeguarding in general dental practice, which provides an overview on the roles and responsibilities of everyone in the dental team in relation to vulnerable adults and children.
As well as setting out the steps to follow in cases of suspected abuse, the guidance defines common terminology and different categories of abuse, 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 proper safeguarding arrangements in place.
- Have a practice safeguarding policy that sets out the practice's commitment to protect children and vulnerable patients which should then be regularly reviewed. The guidance includes a sample policy (appendix 4).
- 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. The guidance sets out the relevant competencies for safeguarding children and adults in appendices 7 and 8, respectively, and links to free training resources in appendix 9.
- Have a safeguarding reporting system in place that is known to staff.
- Ensure all members of staff know how to access the NHS Safeguarding app for local safeguarding contact details.
- Incorporate 'Safeguarding in general dental practice' 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 consent
A section of the guidance is devoted to confidentiality, consent and information-sharing in safeguarding cases - a subject that sometimes prompts calls to the DDU advice line. It makes clear that dental professionals' duty of patient confidentiality is, 'not intended to prevent exchange of information between different professionals and staff who have a responsibility for ensuring the protection of children, young people and adults at risk'.
If you're not sure whether safeguarding concerns justify the disclosure of confidential information, the guidance recommends getting advice from the relevant local safeguarding contact. The DDU is also a good source of support and advice for members.
In the absence of consent, practices should get advice from their local safeguarding contact or the DDU. Sharing information with the appropriate agencies without consent may be justified if the disclosure is in the patient's best interests or is necessary to protect others from a risk of serious harm. The DDU recommends that members keep a record of their decision and the reasons for it - whether it is to share information or not, what information has been shared, with whom and for what purpose.
More broadly, the guidance emphasises that, 'accurate record keeping is an essential part of the accountability for safeguarding' and calls on dental professionals to document all causes for concern about a child or vulnerable adult, including injuries observed, interactions with parents or carers, missed appointments and non-compliance.
Read the guidance here.