Viewpoint: Joint statement on dental complaints
Janet Collins, the General Dental Council's Head of Standards explains why it is important to make sure that complaints about dental care are dealt with consistently and why they joined Healthwatch England to lead a project to do just that.
For the last 18 months, the GDC has been working with other organisations which have a role in commissioning, managing and regulating dental care in England – NHS England, the Department of Health and the CQC. We came together as the Regulation of Dental Services Programme Board (RDSPB) to look at how regulation in dentistry might be made more coherent and effective while still providing the protection that patients rightly expect.
We identified several areas for improvement, one of which was around complaints about dental services. The Board recognised that:
- there was confusion about which bodies handle complaints and what the various processes are;
- there could be overlap between organisations potentially responsible for different aspects of the same complaint;
- there was a lack of consistency, with different organisations covering different nations of the UK and working to different timeframes; and
- patients who initially approached the ‘wrong’ body could then get lost in the system.
In addition to the range of bodies, complaints in dentistry are further complicated by the mixture of NHS treatment free at the point of delivery, NHS treatment which patients pay for, private dental treatment paid for individually and private treatment paid for via insurance plans. There is also a considerable range in severity, from issues which could be better categorised as feedback for the practice about their service to those which are so serious that they call into question the dental professional’s right to practise.
The GDC took joint leadership of the work with Healthwatch, whose detailed knowledge of the various complaints systems and patients’ experiences of them was hugely valuable. We spoke to various stakeholders, many of whom are frustrated by the current system, but we recognised that wholesale reform is unlikely at the moment. A single complaints system would be a very long-term project and even a single portal, while more achievable, poses difficult questions around ownership and where the costs would fall. However, one thing that would be helpful to patients, beneficial to the various organisations and is achievable in the short term is much clearer signposting. We therefore agreed to produce a single, public-facing statement on dental complaints which we could all adopt.
The statement is designed for providers and relevant bodies to use when publishing their own material for patients, to ensure that information from a range of sources is consistent. It encourages patients to resolve issues at the most local level possible, not because we want to discourage patients from making complaints to regulators but because that is the best way to preserve relationships and to reduce the stress for both parties. While enforcement – in the form of fitness to practise processes – remains an essential part of patient protection and a core function of regulators, it should be deployed to manage serious risk to patients or to public confidence in dentistry and is not always appropriate.
The statement provides information that will guide patients to the best organisation to help them achieve the outcome that they want. The various organisations, including ourselves, are now reviewing our patient-facing materials and we will be encouraging registrants to do the same as part of trying to create a more open culture in which feedback, even in the form of a complaint, is valued and acted upon. Crucially, the RDSPB partners have also put in place clearer information for staff about the kinds of issues each of us should be dealing with, supported by information-sharing agreements to allow us to route complaints to the most appropriate place.