Code of Practise

1.1    The Principals 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.

1.2    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.

1.3    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 Principals.

1.4    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”.

2.1 Treatment is provided under NHS Regulations. Patients are advised when making an appointment of the costs of NHS treatment.

2.2 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.

2.3 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.

2.4 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.

2.5 Patients are asked whether they want injections for pain control.

2.6 Record-keeping notations are discussed to ensure consistency and comprehension.

2.7 Regular checks of record-keeping are carried out by the Principal dentists and dentists to ensure that records are accurate and precise.

2.8 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.

2.9 Patients are referred to specialists and hospitals, where appropriate and after discussion and the referrals are checked daily by the dentists. NHS England is responsible for contracting referral services for this area. Our dentists are obliged by the contract imposed on us by the Department of Health to refer our patients through NHS England referral service. There are significant delays and errors, your dentist will do his best to follow up your referral with the referral centre but cannot refer you through other channels.

3.1 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.

3.2 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.

3.3 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.

3.4 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.

3.5 The practice keeps essential equipment for resuscitation and all staff undergo regular training in CPR annually.

3.6 The practice holds unannounced “crash” tests for all staff. Training follows any shortfall observed.

4.1 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.
4.2 The Principals are 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.
4.3 Changes to infection control procedures are noted on the minutes of the staff meeting to ensure consistency throughout the practice.

4.4 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 Principals may be asked questions.

4.5 Uniforms and protective equipment are provided.

4.6 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.

4.7 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.

5.1 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.

5.2 Minutes are written up and available to all staff.

5.3 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.

5.4 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.

6.1 This practice undertakes an anonymous patient survey twice a year. The first 100 patients in a random day are asked to complete a questionnaire.

6.2 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.

6.3 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.

6.4 We use a complaints procedure based on BDA advice and we usually write a complete and comprehensive reply to a complaint within 48 hours.

6.5 The Practice Manager is responsible for dealing with complaints about any aspect of our service. The Deputy Practice Manager will deputise in this matter. Reception complaints can also be handled in the first instance by the Head Receptionist.

6.6 All complaints are discussed at a meeting with the involved parties, including reception, ancillary, professional and nursing staff. Changes in systems or working practices will be discussed and incorporated in training and the current staff retrained.

6.7 These identified problems will be logged on our staff meeting agenda.

6.8 Patients are always informed that they have the right to complain to NHS England and the relevant address is on our complaints procedure. Complaints relating to private work should be addressed to the Dental Complaints Service.

7.1 All professional staff comply with the General Dental Council’s requirements for continued certification. The Practice Manager keeps the file.

7.2 Absence for training is co-ordinated with other professionals through the Practice Manager.

7.3 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.

7.4 All professionals keep in touch with current practice through peer review group and are encouraged to gain membership of a professional association.

7.5 Each professional reads professional journals and discussions are held between professionals on a regular basis to share findings.

8.1    References are taken up to establish that the individual is suitable for work within health care.

8.2    Everyone joining the practice receives induction training which includes training in the procedures described in this system. Specific training then follows the induction.

8.3    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.

8.4    The practice encourages all staff to belong to their relevant national association to keep them in touch with developments outside the practice.

8.5     All nursing staff have always been actively encouraged to take the national exam. Training will be sponsored by the practice for a reasonable commitment after qualification from the member of staff.

8.6     Between annual reviews, under performance will be pinpointed, discussed and training considered. Disciplinary action will be taken where necessary.

8.7    Crash tests will be undertaken without notice to the staff to ensure high standards.

8.8    Annual CPR training will take place at the practice’s expense for all staff. Professional staff will be invited to attend at their expense.

8.9    Where any failure in the system is identified, a review will take place to ensure a recurrence does not take place.

Complaints are taken seriously and we train our staff to deal with complaints courteously. We will expect patients to make their complaint without insults or threats. Our aim is to restore your faith in the practice and to ensure you are happy with the outcome of your complaint.

In the first instance, please call us to speak to the person responsible for complaints Mr Hom Gurung. He will try to find a solution to any concern you may have. If we are busy to take your phone call, do not hesitate to e-mail us a request for a call back, to info@nhsdentist.com. We will endeavour to call you back as soon as we can.

We try to handle complaints in house with a face to face meeting. Should your concern be a clinical matter, we often offer an appointment with another dentist or our principal dentist so you can discuss the matter with a third party or one of the most senior people at the practice. We find this frequently provides patients the information or reassurance that they need. Should we be unable to settle your complaint in this way, then you may want to put your complaint in writing to our complaints manager, Juan Mohamed, who will then follow the formal complaints procedure route.

We will try to establish what you expect as an outcome of your complaint and we will agree a plan of action. Your care and treatment will not be compromised because you have made a complaint. If at any stage you feel concerned about this, please let us know.

If the complaint is received from the outset in writing, we will acknowledge your letter within three working days.  We will endeavour to investigate the problem and write back to you within an agreed time frame, allowing for holiday periods and sickness. If the complaint takes longer to resolve, for any reason, we will keep you informed of progress to date and the reason for the delay. As mentioned above, we try and have a face to face meeting at the initial stage to establish the desired outcome of the complaint. We will contact you for such a meeting. In the event of you declining this, we will carry on according to the procedure without an initial meeting.

During the agreed period (or after the face to face meeting if appropriate), all parties involved in the complaint will be interviewed by the Complaints Manager. The notes, x-rays and any other information will be read and evaluated. The Complaints Manager will discuss the whole matter with any parties concerned and with the Principal dentist. You should be aware that we may need to disclose information about you to third parties in the event of a complaint e.g. solicitors, specialists, NHS England, medical indemnity organisation, etc.

Records are kept of any complaint. We monitor the reasons for complaints and we discuss them at staff meetings so we can learn from our mistakes. We also arrange training for any area of our work that we feel has been shown to need reinforcement following our regular complaints analysis e.g. understanding patient concerns.

Our complaints procedure is based on the National Health Service Complaints (England) Regulations 2009. Please follow our procedure in its entirety and if then you are dissatisfied with our response a complaint may be made to:-

• You can get help from PALS to make a complaint. www.pals.nhs.uk

• You can also engage with POhWER, who are an independent charity providing NHS Complaints advocacy www.pohwer.net

• NHS England Complaints Team, NHS England, Southside 4^th Floor, 105 Victoria Street, SW1E 6QT (if you chose not to give the practice the opportunity to resolve your complaint, as you cannot complain to both the practice and NHS England)

• Parliamentary and Health Services Ombudsman at Millbank Tower, Millbank. London, SW1P 4QP.

• You can write to the CQC at Finsbury Tower, 103-105 Bunhill Row, London EC1Y 8TG

All dentists, therapists, hygienists and qualified dental nurses are regulated by the General Dental Council.