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relationship continuity of care, after adjustment for practice organisational and population factors. It found that deprivation scores from 2012 did not predict variations but there was an overall decline. Commenting on the study, Vice Chair of


the Royal College of GPs, Professor Kamila Hawthorne said: “Continuity of care is at the heart of general practice and is highly valued by both patients and GPs alike – in fact, 80 per cent of UK family doctors say it is one of the most essential components of general practice. “It’s disappointing but understandable to


read that, according to this paper, continuity of care is reducing, but GPs across the country are striving to provide continuity, even if not in the traditional sense.”


New duty of candour provisions


NEW duty of candour provisions in Scotland came into effect on 1 April. The provisions, as defined in the Health


(Tobacco, Nicotine etc. and Care) (Scotland) Act, set out a range of things that must happen when there has been an unexpected event or incident resulting in death or harm during health or social care. Principles of candour exist in many organisations and within professional codes of conduct but the Act introduces a statutory organisational duty of candour on health and social care services in Scotland.


Scottish government has


produced guidance on the new provisions including factsheets and an e-learning module to support organisations with implementation. For more information go to www.gov.scot/Publications/2018/03/1321.


No exemption on DPO requirement


THERE will be no exemption for dental practices in the requirement for all UK primary care providers to have a dedicated data protection officer (DPO). Government ministers rejected suggested amendments tabled by the Liberal Democrats following representations and lobbying by the BDA and other professional organisations when the Data Protection Bill was debated in Parliament on 9 May. The new General Data Protection


Regulation (GDPR) did not require dental practices to have a DPO, but the UK Government put this duty on NHS primary care providers by including them in its definition of “public authorities”. The suggested amendments would have


exempted dentists and other high street primary care providers from what the BDA calls a “huge and needless burden”. DPOs are now required to be in place and


practices should take steps to comply in order to avoid potential penalties.


Inequality gap in child tooth decay


NEW data in England has revealed an almost a 10-fold difference between some local authorities in the prevalence of child tooth decay.


The latest Child Oral Health Survey from Public Health England did find improvements in overall tooth decay levels but also wide regional inequalities, with 5.1 per cent of young children in Waverley in Surrey presenting with decay compared to 49.4 per cent in Pendle in Lancashire. Five-year- olds in Pendle had on average 2.3 decayed, missing or filled teeth compared to just 0.1 for those in Waverley. Dental advocates including the BDA have expressed concern that


authorities in England have failed to follow the lead set by


devolved governments to bring supervised brushing to schools and nurseries. They cite the Childsmile (Scotland) and Designed to Smile (Wales)


programmes which use targeted


interventions and have had success in reducing NHS treatment costs. The BDA points out that tooth decay is the number one reason for child hospital admissions in England. Each day 170 children and teenagers in England undergo tooth extractions under general anaesthesia in hospitals in England at a cost of £36 million per year. The number of operations has increased by 17 per cent since 2012. The BDA advocates a coherent and


appropriately funded strategy to bridge the inequalities gap and urges greater effort from both local and national government. Chair Mick Armstrong said: “It’s a tragedy that a child’s oral health is still determined by their postcode and their parents’ incomes. Sadly while cavities are almost wholly preventable, official indifference means this inequality gap shows little sign of narrowing.”


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MHRA ALERT ON VALPROATE USE VALPROATE medicines must no longer be used in women or girls of childbearing potential unless a Pregnancy Prevention Programme is in place, according to new guidance from the MHRA. Healthcare providers are urged to ensure all women and girls are fully informed of the risks with exposure to valproate, used primarily to treat epilepsy and bipolar disorder. For more information see the MHRA alert (tinyurl.com/ ycynqao3).


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UPDATED REVALIDATION GUIDANCE THE GMC has updated its guidance on revalidation to address concerns raised in a detailed review. Research from UK Medical Revalidation Collaboration (UMbRELLA) has shown that for some doctors the requirements remain unclear, particularly in regard to collating information necessary for appraisals and revalidation. Access the updated guidance at tinyurl.com/y7c7v9zf.


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NEW MANDATORY DATA TOOLKIT A NEW Data Security and Protection Toolkit has been launched by NHS Digital which all organisations in England with access to NHS patient data and systems must complete to help keep patient information safe. It replaces the previous Information Governance Toolkit and is an online self-assessment tool that enables health and social care organisations to measure and publish their performance against the National Data Guardian’s 10 data security standards and key elements of the GDPR.


MDDUS INSIGHT / 7


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