GDC CHECK THE REGISTER


BACKGROUND A dental nurse working for Dr P is signed- off by her GP for three weeks after having a minor operation. Temporary cover is arranged through an employment agency that the practice has used on numerous occasions over the last few years. A replacement dental nurse – Ms T –


starts work on the Monday providing routine chairside duties including preparing treatment materials and ensuring that proper equipment is available, as well as cleaning and sterilising used instruments. She carries out these tasks efficiently and with little need for instruction. Dr P, in working with Ms T, learns that she


studied part-time at college and recently completed her national diploma in dental nursing with hopes to further her career in some specialist aspect of oral care. Three weeks later the practice’s regular dental nurse returns to work. Six months later a letter from the GDC


arrives at the practice concerning the employment of an unregistered nurse. It alleges that this action has put patients at unnecessary risk. The letter states that a GDC caseworker will be investigating whether this information could raise a question of Dr P’s fitness to practise.


ANALYSIS/OUTCOME Dr P contacts MDDUS and a dental adviser provides guidance on the process and assistance in gathering the necessary details required by the case worker. A subsequent letter from the GDC informs Dr P that the case will be further assessed by case examiners and she is invited to provide her “observations” on the allegations. Dr P requests assistance from MDDUS in preparing a response to the case examiners. This is actioned by a dental adviser with supporting documentation being disclosed.


In regard to the allegation that Dr P


allowed an unregistered dental nurse to work at the practice – she admits it is her responsibility to ensure that nurses are employed in accordance with GDC requirements but she seeks to assure the case examiners that this was the result of a genuine error. It was her clear understanding that all the candidates –


KEY POINTS ●Ensure the practice has a fool-proof system to ensure staff are adequately qualified and registered as required by law. ●Do not rely on guarantees from temporary employment agencies: carry out your own checks.


including Ms T – supplied by the employment agency were fully qualified and registered with the GDC. She has now subsequently introduced a new system of validating the qualifications and registration status of all nurses and other DCPs working at her practice, whether on a temporary or permanent basis. Dr P also acknowledges that GDC


registration is essential to ensure patients are properly protected but she points out that there was never any question of Ms T’s experience and apparent competence. In responding the case examiners


determine that the allegations do not merit consideration by a full practice committee, but the regulator does issue Dr P with a written warning that is also published on the GDC website. The dentist accepts that this is a fair result.


ADVICE SOUL AND CONSCIENCE


BACKGROUND Ms G has severe cerebral palsy with hearing loss and difficulty speaking and communicates mainly through her carer. She has some cognitive impairment but


KEY POINTS ●Ensure that any judgement made on a patient’s fitness to testify in court is strictly on medical grounds. ●A letter stating that a patient is not fit to attend should include detailed reasoning behind that judgement.


there is no question of mental incapacity. Ms G has been called to testify in a


criminal court and wishes to be exempt on medical grounds. Her GP – Dr J – contacts MDDUS for advice in regard to a soul and conscience letter stating that the patient is medically unfit to appear as a witness. Is her condition sufficient grounds for an exemption?


ANALYSIS/OUTCOME An MDDUS adviser first consults with in-house legal colleagues and then responds to the query. It’s clear that Ms G’s ability to give evidence is difficult to assess as communication is mainly via her


long-term carer. It is presumably possible that, with the correct level of assistance, she may be able to provide evidence to the court. However, the court needs to understand the issues at hand. As such, the adviser suggests that


rather than setting out that the patient is ‘medically unfit’ to act as a witness, the GP should provide a factual account of her medical problems and why her ability to testify is difficult to assess. It would then be for the court to consider whether any steps are available to assist her in giving evidence. In this way it is a legal consideration for the court rather than a medical issue.


MDDUS INSIGHT / 19


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