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Biting back X-ray excess...


with Arthur Dent S


ome of you will by now have received a letter from your NHS boards informing you that some practices in


your area are being selected for an inspection of your compliance with IR(ME)R regulations by Dr Arthur Johnston, a scientific officer from the Scottish Government. Indeed, some of you may even be


among the ‘lucky’ ones to receive an IR(ME)R inspection by Dr Johnston! And, like me, you might be thinking that our practice IR(ME)R compli- ance was already being checked as part of the regular triennial NHS board inspections… but the Scot- tish Government in its wisdom has decided that further inspections are needed and has instructed Dr Johnston to conduct these. If you visit www.scottishdental.


org you will find examples of all the paperwork required for strict IR(ME)R compliance. It’s not exactly light bedtime reading (unless you’re an insomniac), but it does have some rather entertaining sections, including “the process for patient identification”. It states: “Where possible, the operator must ask the patient to give the three


identifiers. The procedure must be positive and active i.e. What is your name? What is your address? What is your date of birth?” While these processes are


perfectly sensible in a larger clinic or hospital where radio- graphs are taken in a different department distant from the consultation room, in an average general practice they make no sense. The patient might be a regular attender at the practice and certainly will have been in consultation and been examined for some time before the dentist decides that radiographs are required. It hardly inspires confidence in


the patient if their dentist then asks such elementary questions of them when they have been in conver- sation for several minutes. This example demonstrates the folly of routinely imposing hospital proce- dures on general practice; in some circumstances these might apply, but very often they do not. Similar anomalies arise within


issues around decontamination, health and safety and many other areas. General dental practice is now suffering from regulatory over-


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“General dental practice is now suffering from regulatory overload“


Column


load. Regulation should help us manage risk to ourselves, our staff and patients. Risk assess- ment and risk management


is part of our role as healthcare professionals, but I’ve heard it said that NO risk is acceptable. This is nonsense – absolute risk avoidance is impossible and everything in life is a balance between risk and benefit. Statistically, the most dangerous things we do are to travel in a car or to cross a road,


but we all continue to do these things daily. Life is risky but by applying reasonable, balanced and sensible precautions, we can go about our daily lives and minimise the risks, but they can never be entirely eliminated. The wellbeing and safety of our


patients and staff is of great impor- tance, but many of these rules are less to do with safety and more to do with officialdom justifying its exist- ence. Time spent complying with these petty rules, recording our compliance then demonstrating it to yet another inspector means less time spent providing patient care... and isn’t patient care what dentistry is all about?


is published by


The copyright in all articles published in Scottish Dental magazine is reserved, and may not be reproduced without permission. Neither the publishers nor the editor necessarily agree with views expressed in the magazine.


ISSN 2042-9762


Studio 2001, Mile End, Paisley PA1 1JS Tel: 0141 561 0300 Fax: 0141 561 0400


www.scottishdentalmag.co.uk Scottish Dental magazine 5


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