With the summer holidays getting underway many parents are considering fun and safe activities to keep the kids busy. But for medical professionals, patient safety and safeguarding are on their minds all year. A new NHS dentistry and oral health update echoes this sentiment by focusing on safeguarding.

The update opens with Sara Hurley, chief dental officer for England and Kenny Gibson MBE deputy director of NHS safeguarding explaining the importance of safeguarding in the current social climate, “The past few months have seen notable cases regarding the safeguarding of children reach the news once more. Whilst our first thoughts of safeguarding might be about protecting children or supporting vulnerable adults who have a lack of capacity, safeguarding principles are equally applicable to evacuees, refugees and asylum seekers. We should all be confident in using our judgement to help protect people from neglect, abuse, exploitation and violence; this special bulletin pulls together a range of resources to assist you and your staff in fulfilling your safeguarding responsibilities.”

Safeguarding in the dental setting

Dental teams will encounter adults and children at risk. The update explains “The General Dental Council Standards for the dental team requires registrants to raise concerns for those at risk of abuse or neglect and the Care Quality Commission Safeguarding Statement specifically seeks assurance of the dental team’s competence in safeguarding them.”

To make the process seamless the update advises, “Safeguarding processes should also be integrated into existing dental practice systems when delivering care in order to reduce the risk for those who are vulnerable.”

Medical professionals are in a unique position to identify signs of abuse, neglect or harm. Dental professionals are no exception. The update advises team members to speak up on behalf of these individuals to protect them from further harm and refer their concerns to “your local multi-agency safeguarding hubs (MASH).”

The update went on to explain, “The revised NHS Safeguarding accountability and assurance framework states that robust information-sharing is at the heart of safe and effective safeguarding practice and is covered by legislation, principally the General Data Protection Act 2018 (GDPR) and the Data Protection Act 2018.”

In most case reviews, a lack of information regarding safeguarding concerns is standard. Therefore, the report advises staff to view the framework as a mechanism to ensure that personal information is “shared appropriately.”

Key guidance and resources for safeguarding children

For children, there are several ways to access safeguarding assistance. The update advises staff to, “search for your local Safeguarding Children Partnership’s website using the NHS Safeguarding app. There you will find telephone numbers and instructions for referring a safeguarding concern to Children’s Social Care, or for referring a family for Early Help”.

Alternatively, you can consult specific advice for dental professionals including ‘Child protection and the dental team: an introduction to safeguarding children in dental practice’ available via the British Dental Association (BDA).

By consulting the advice from the BDA you will also receive:

  • “an illustrated reference manual – covering Responsibility, Recognising, Responding, Reorganising and Resources
  • “a fast response tool – with an interactive summary flow chart
  • “a training resource – with 3 hours of CPD available free-of-charge to all UK-registered dental professionals, whether BDA members or not.”

Missed appointments can be cause for concern. Considering the child’s perspective there is a decisive difference between “was not brought” and “did not attend”. To evaluate missed appointments the Sheffield Community & Special Care Dentistry service has developed standardised pathways to identify if there is a safeguarding issue. A guide to these procedures featuring top tips, flowcharts, and templates is available for through the BDA Safeguarding website.

Key guidance and resources for safeguarding adults

Following the pandemic, the NHS has seen an “increased vulnerability to abuse and neglect” of at-risk individuals. The effect of self-isolating, shielding and social distancing has disproportionately affected vulnerable populations including: “older people; people with learning disabilities or autism; those with underlying health conditions; and minority communities.”

Domestic abuse and mental health illnesses have also risen sharply since the pandemic, due to decreased social contact. The authors point out “Facial and dental injuries with sometimes inconsistent histories can be a sign of physical abuse of which dental teams should be mindful.”

Relationships between dental teams and patients are vastly different to other medical professionals. Dental teams typically see patients over an extended period of time, therefore they may see indications of behaviour changes or self-neglect that call for support.

Recommendations

“The Public Health England Toolkit recommends that every dental practice should:

  • “have a named Safeguarding Practice Lead
  • “ensure all members of staff know how to access the NHS Safeguarding app for local safeguarding contact details
  • “ensure all members of staff (clinical and non-clinical) undertake the appropriate level of safeguarding training
  • “have a robust safeguarding reporting system in place, and ensure staff are familiar with this system.”

The bulletin closed by reflecting on trauma-informed practice. An approach which seeks to understand the impact of trauma on people’s lives. The section particularly pertains to interactions with domestic abuse or violence survivors as their situations must be treated with respect and confidentiality.

Advice and support for domestic abuse or violence survivors is available by seeking an appointment with Independent Domestic Abuse Advisor (IDVA).

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