Although urban myths around dentists over powering their patients to deliver unwelcome and painful procedures are firmly embedded in the public psyche, they are of course far removed from the truth.
The law (CQC Regulation 11, Need for Consent) and dental regulations (GDC and Standard 3- Gain Valid Consent) place patient’s informed consent squarely at the core of the patient- carer relationship. In fact the CQC has the power to prosecute for breaches of Regulation 11.
Every dental registrant is expected to include Continuing Professional Development (CPD) content on consent in their Personal and Professional Development Plan and to keep up- to-date on wide ranging expectations of the public, the profession and the law.
Practice Policy
The practice’s Consent to Treatment Policy and Procedure is just the first step to ensuring every opportunity to educate and inform patients is consistently recognised and followed, so that patients are informed before any care, or treatment is provided. This consent must pay due regard to the patients capacity to consent. So dental professionals must know how to react if:
- The capacity to consent under terms covered in the Mental Capacity Act 2005 is in question;
- The lack of the availability of accurate, unbiased information for patients to base their decisions could bring the validity of consent in to question;
- If a patient withdraws their consent after a procedure has been started.
The Procedures
Practices need to develop and communicate their procedures with direct reference to the regulations, by identifying the specified end results and developing practical steps to secure the outcomes. For example Regulation 11(1) specified seven points of guidance starting with:
- “When a person is asked for their consent, information about the proposed care and treatment must be provided in a way that they understand. This should include information about the risks, complications, and any alternatives. A person with the necessary knowledge and understanding of the care and treatment should provide this information so that they can answer any questions about it to help the person to consent to it”.
The regulations should be used as the basis for discussion in team meetings, to determine how the team will meet the specific requirement to provide every patient and/or their ‘relevant person’ with information that they can understand. The team needs to determine the content and format of information provided, how it will be delivered and by whom. In a busy practice it is all too easy for the best intentions of the team to become eroded so that over time the practice falls short on its compliance.
Involving the Team
The regulations are clear that each member of the team must follow the practice procedures for consent gathering and state that:
- “Policies and procedures for obtaining consent to care must reflect current legislations and Guidance , and staff must follow them at all times”.
It is important that the regulations are known and understood by the whole team. Involving the clinical and administrative teams in decision making about practice procedures ensures that they are aware of the requirements and can contribute to ongoing development processes, based on reflective review in team meetings of day-to-day practice events.
