Archive | July, 2016

Patient Safety in Dentistry

29 Jul

By Barry Kinshuck, Dental Adviser representing the British Dental Association

BDA Logo

My name is Barry Kinshuck and I have been asked to represent dentistry by the British Dental Association in the excellent project to be undertaken by the James Lind Alliance Primary Care Patient Safety Priority Setting Partnership.

As a dental practitioner in Wigan for nearly 40 years and a dental adviser in Wigan and now Greater Manchester I have seen continuous changes and improvements in patient safety in dentistry.

The dental profession is committed to providing safe dental care, which is necessary for ensuring good general health, and aims to minimise risks and establish an open culture of patient safety, in which practitioners can learn from their own and others’ experience.

Duty of Care

Responsibilities for health and safety are set out in the Health and Safety at Work Act 1974 (the Act) and associated regulations. The Act seeks to protect all those at work – employers, employees and the self-employed, as well as members of the public who may be affected by the work activities of these people.

Care Quality Commission inspects dental practices and wants to see evidence that a dental practice is:

  1. Safe
  2. Effective
  3. Caring
  4. Responsive to patients’ needs
  5. Well led

Safety is top of the list and dental practices should be able to demonstrate how they:

  • Manage risk
  • Prevent infection
  • Provide suitable premises and equipment
  • Manage  and maintain equipment
  • Manage medical devices
  • How lessons are learnt and improvements are made when something goes wrong
  • What systems, processes and practices are in place to keep people safe and safeguard them from abuse?

The General Dental Council

This is the organisation that regulates dental professionals and in their document Standards for the dental team makes several statements of relevance with respect to patient safety:

  • Principle one (put patient’s interests first) states in standard 1.5.4 ‘You must record all patient safety incidents and report them promptly to the appropriate national body’.
  • Principle eight (raise concerns of patients at risk) states in standard 8.1 ‘You must always put patients’ safety first’.

The James Lind Alliance Primary Care Patient Safety Priority Setting Partnership provides an opportunity for the British Dental Association to understand what areas of patient safety matter most to patients and healthcare professionals.

 

Controversial care.data programme closed: What did we learn?

12 Jul

by Rebecca Hays, Research Associate in Multimorbidity theme

careData

After a series of delays, the care.data programme has been closed for good. The decision to end this controversial project was announced following the publication of Dame Fiona Caldicott’s review of health and care data security, consent and opt outs.

The height of the controversy came in February 2014, when the programme was put on hold following NHS England’s highly criticised attempt to inform the public about care.data through a national leaflet drop. Issues with this mail out and the lack of clarity about the project became the subject of many news stories, and a popular topic on social media.

My colleague Gavin Daker-White and I were following the debate on Twitter, where a wide range of views and opinions were being expressed. Tweets highlighted the potential benefits of care.data, revealed worries, provided links to more information, and instructions to opt-out. To better understand the strengths and criticisms of the programme, we undertook a qualitative analysis of tweets containing the hashtag #caredata.

Those for and against the programme shared a range of concerns, including the issues reviewed by Dame Fiona Caldicott. Tweets also identified communication failures, confusion about care.data, and a lack of patient-centeredness. We found these concerns were eroding trust in the healthcare system, which, if ignored, could put patient safety at risk.

Many people will be relieved that the care.data programme has been closed but this is not the end of the story for data sharing in the NHS, and lessons need to be learned. Our work also identified the potential benefits of such projects, for patients and other stakeholders, and recommendations for their design and implementation.

For future programmes to be successful, they must actively engage and involve patients in discussions and decisions about who can access their data and how it can be used. People must also be fully informed about both the risks and benefits of data sharing. Thus, we strongly support Dame Fiona Caldicott’s view that “A key aspect of this work must be a dialogue with the public.”

Note:

Rebecca and Gavin’s paper, “The care.data consensus? A qualitative analysis of opinions expressed on Twitter” was published in BMC Public Health in 2015. A plain English summary [pdf] of this publication is available on our website.