at the heart of the trusted doctor-patient relationship. However, confidentiality cannot be absolute and there are situations where a doctor may have to disclose confidential information in order to protect the public interest, even when consent has been refused by the patient.” Access the new guidance at www.gmc-uk.


org and contact MDDUS for any specific advice on fitness to drive issues.


Dental phobia linked to poor oral health


PEOPLE with dental phobia are more likely to have decayed or missing teeth, according to a new study. Those who fear dental treatment also reported a poorer oral-health-related quality of life than non-phobics. The research conducted by King’s College London (KCL), and published in the British Dental Journal, analysed data from almost 11,000 participants of the Adult Dental Health Survey (2009), of whom 1,357 were identified as phobic. Of these, the vast majority were women (1,023) compared to just 344 men. The results showed that dental phobic people were more likely to have caries compared to non- phobic respondents, and were likely to have one or more missing teeth. The report argued that this poorer oral health could be caused by phobics avoiding regular dental visits to address oral conditions that are preventable and chronic in nature. Professor Tim Newton, of the KCL Dental


Institute said: “The correlation between those with missing teeth and dental phobia could be the result of treatment decisions made when the individual with dental phobia finally seeks treatment. Both patient and practitioners may favour extraction of the tooth rather than booking a number of appointments to complete a restoration.” KCL’s Dr Ellie Heidari, lead author of the study, added: “Other research has shown that individuals with dental phobia express negative feelings such as sadness, tiredness, discouragement and general anxiety, less vitality and more exhaustion.”


New complaints procedure in Scotland


A NEW complaints handling procedure for the NHS in Scotland came into effect in April of this year.


The new NHS Scotland Model Complaints


Handling Procedure (CHP) is intended to be used by all NHS service providers, including GPs, dentists, opticians, pharmacists, as well as other contractors such as cleaning or catering providers. The CHP is designed as templates for NHS bodies and primary care service providers to adapt and adopt – and there is also an implementation guide available. The revised two-stage procedure is intended to support a consistent person- centred approach to complaints handling across NHS Scotland, and bring it into line with other public service sectors. Stage 1 allows five days for early local resolution of a complaint. Should a complainant remain dissatisfied this can be escalated to a 20-working-day Stage 2, providing for a more “thorough and robust” investigation. Complex complaints where an early outcome is unlikely can be handled directly at Stage 2 of the procedure.


NHS Scotland says that the model CHP has


been structured with as much flexibility as possible, while still providing standardisation across NHS service providers. Details on how to make a complaint should be widely publicised, simple and clear for all service users. Access at tinyurl.com/ke3yrr3


Treat severe sepsis within one hour


PATIENTS showing symptoms of severe sepsis should be treated within one hour, according to a new draft quality standard from NICE. The quality standard highlights areas from NICE’s 2016 sepsis guideline and stresses that staff in any setting, from GPs to paramedics, should check patients for specific signs that will show if their symptoms are life- threatening. This includes


temperature and heart rate, and checking for


rashes or skin discolouration. NICE says that high- risk sepsis patients should get antibiotics and IV fluid treatment


within the hour. If it will take more than an hour to get someone to hospital, GPs or ambulance staff can also administer antibiotics. Professor Gillian Leng, NICE deputy chief


executive, said: “Severe symptoms can develop in sepsis very quickly. If high-risk patients are not identified and treated promptly, people can be left with debilitating problems. In the worst cases, they may die. This quality standard highlights priorities in the continued fight to improve sepsis care.” The new quality standard is due for publication in August.


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ALCOHOL ADMISSIONS HIGHEST EVER ALCOHOL-RELATED hospital admissions in England have increased by 64 per cent over the last decade with 1.1 million admissions in 2015/16 – this despite data showing that the proportion of adults drinking is at its lowest level since 2005 (though 7.8 million people admit to binge drinking). The Royal College of Physicians and alcohol health experts are calling on government for more action to tackle the harm done by alcohol.


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EXPANDED EMPLOYMENT OF IN-SURGERY PHARMACISTS NHS England plans to introduce new, surgery- based clinical pharmacists to over 700 more practices in order to help free up GP time. NHS England has pledged over £100m of investment to support an extra 1,500 clinical pharmacists to work in general practice by 2020/21. This is in addition to over 490 clinical pharmacists already working across 650 practices as part of a pilot, launched in July 2015.


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PRESCRIPTION HISTORY AID TO CANCER DIAGNOSIS LOOKING for patterns in medication given to patients before they are identified with cancer could improve early diagnosis. Research to be funded by Cancer Research UK will analyse an anonymous dataset of nearly all NHS primary care prescription data – approximately 80 million medications being prescribed each month – alongside cancer statistics to identify trends that could help guide GP referrals.


MDDUS INSIGHT / 7


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