Managing Dental Complaints

I hope you have managed to get some new routine with university during these very strange times!

Another week- another Dental Situational Judgement Test (Dental SJT) revision topic.

This week we discuss Complaints in primary care- again if you find this useful please share on social media to all your dental friends.

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Unfortunately as I am sure you will all be aware, dental practitioners can, at some point in their career receive a complaint about some aspect of the treatment or the service they have provided. Obviously trying to provide the best clinical care, communication and time management will help to prevent this, but some patients can surprise you and complain about something unexpected.

Question- What is a complaint?

Answer- 'an expression of dissatisfaction that requires a response' (DDU, 2018).

 

Question- how is this different to feedback?

Answer- feedback is an opinion, whether invited or spontaneous, that can be positive, negative or neutral.

 

Question- What does the GDC recommend for managing complaints?

Answer- Well, in 2019 the GDC came together with 28 organisations, (see list below), to agree six universal principals for handling complaints about dental professionals. (GDC, 2019).

 

What are the six principals?

  1. All of your feedback is important to us.
  2. We want to make it easy for you to raise a concern or complain, if you need to.
  3. We follow a complaints procedure and keep you informed.
  4. We will try to answer all your questions and any concerns you raise.
  5. We want you to have a positive experience of making a complaint.
  6. Your feedback helps us to improve our service.

We think that these principals are an easy, clear way of trying to manage complaints, which can help to de-escalate the situation and ensure the patient and you, the clinician, get to the best conclusion.

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Question- If you get a complaint during your foundation training, is there a protocol you should follow?
Answer- Yes, your practice will have an individual complaints procedure and in your first week or 2 ideally ask your trainer or practice manager for a copy of this so that you have read it prior to receiving any complaints to ensure that patients are not further dissatisfied with the complaint handling process as well as their initial concern.

Question- What happens when it is not resolved at a local level?
Answer- Dealing with issues at a local level is great as it will get a fast result, however unfortunately come complaints can be deemed so serious, (the professional is possibly considered not fit to work in their role), that they can be referred to the General Dental Council.

Question- What other organisations were involved agreeing these principals?
Answer- The principles of good feedback and complaints handling for dental patients were developed by the following organisations:

  • Association of Dental Administrators and Managers
  • Association of Dental Groups
  • British Association of Dental Nurses
  • British Association of Dental Therapists
  • British Dental Association
  • British Orthodontic Society
  • British Society of Dental Hygiene and Therapy
  • Bupa Dental Care
  • Care Quality Commission
  • CFC Underwriting
  • CODE
  • Dental Complaints Service
  • DDU
  • Dental Protection
  • Dental Technologists Association
  • Department of Health and Social Care
  • General Dental Council
  • Health Education England
  • LDC Confederation
  • MDDUS
  • MyDentist
  • NHS Digital
  • NHS England
  • Orthodontic National Group
  • Orthodontic Technicians Association
  • Parliamentary and Health Service Ombudsman
  • Simplyhealth
  • Society of British Dental Nurses

Question- Who can you ask for advice?
Answer- lots of people, especially during your Dental Foundation Training. Remember the purpose of this year is for you to become a confident dentist, so usually the first person to consider asking for advice will be your Dental Foundation Trainer.

So- who else can you ask for help?

  • Training Programme Director (TPD)
  • Other Dental Foundation Trainees (DFTs) that are in your scheme
  • Other Dental Foundation Trainees (DFTs) that qualified in your year from dental school, but work in a different scheme
  • Other dental professionals working in practice with you
  • Your dental indemnity organisation

Question- Is there a difference between a Private vs NHS complaint?
Answer- at a local level probably not, but you should check with your practice complaints policy! If the complaint is not resolved at a local level it will progress depending on whether it is private or NHS.

Regarding NHS complaints, the patient can contact the local NHS dental services office. After this, if they are still not happy with the way in which their formal complaint was handled (either by the dental practice or the NHS) they can contact the local Ombudsman. The Ombudsman makes the final decision on complaints that have not been resolved by the practice or NHS.

Private treatment complaints, if not resolved at a local level, can be dealt by the Dental Complaints Service (DCS). They are a team of trained advisors who aim to help private dental patients and professionals settle complaints fairly and efficiently. The DCS is funded by the GDC in order to provide free and impartial service to mediate between patient and professional.

 

Question- How should you respond to a complaint?
Answer- Remembering that the aim of responding is to hopefully resolve the complaint for all parties involved. You should follow your local policy, discuss with your ES and consider contacting your indemnity. It is important that you contemplate why the patient is complaining, what their ultimate goal will be and what you could possibly say. Sometimes you will need more information to ascertain this (DDU, 2018).

 The following are a list of possible methods to resolve the complaint (and you could in fact do a combination of these):

  1. Apologise to the patient, and express genuine empathy.
  2. Explain to the patient how you will make sure the situation does not happen again for them or other patients.
  3. Give the patients the clinical facts and access to their records to assist with the patient understanding and remembering the situation clearly. Explain to the patient, avoiding any jargon, what happened and how you suggest to fix the situation
  4. Offer a face to face consultation to have a discussion and explain things again.
  5. Propose to see the patient in order to re-treat the clinical needs.
  6. Refer the patient to a colleague within the practice to complete the treatment.
  7. Refer the patient to a consultant for a second opinion.
  8. Finally, the financial consideration could be to offer a refund of either all or part of the monies and/or complete the remedial treatment free-of-charge, as a gesture of goodwill- as this demonstrates you are being reasonable and trying everything to resolve the complaint.

 

 

Our final top tips:

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  1. Ideally try to fix any concerns as soon as possible. If a patient or colleague raises something to your attention, do something within the first 24 hours. This gets the ball rolling, and most of the time the person will be so surprised that you have prioritised their concern so that it can be dealt with at a practice level.
  2. Don’t be afraid to ask for advice! See our list above on who we think you should ask for help and the order of this list may change depending on the situation.
  3. Consider- is the complaint about your treatment or actually about communication? Sometimes clinicians are so focused on getting the filling perfect, they can lose sight of the fact the patient has been in the dental chair for over an hour. Make sure you explain what you are doing at each stage and why, so the patient feels involved and in charge of their healthcare.
  4. Discuss lesions learnt with your DFT trainer, reflect on the e-portfolio system, discuss with colleagues and try to put procedures in place to avoid the complaint in the future.
  5. Managing complaints is a very common ethical dilemma, so make sure you read the two references below prior to completing your Dental Situational Judgement Test (Dental SJT).

What did you think of the question and answer format of this week’s blog post? Let us know on Instagram or send us a DM if you have any specific requests!

 

 

Will

Co-Founder: DentalSJT.com

PS. Did you see our blog post last week about social media? If not- check out the link here: 
https://www.dentalsjt.com/social-media

 

References:

  1. GDC. 2019. Link: https://www.gdc-uk.org/DownloadHelper.aspx?docID=6220e6b7-0553-4e06-a8b8-27ef4d7df244
  2. DDU. 2018. Link: https://ddujournal.theddu.com/issue-archive/summer-2018/dealing-with-dental-complaints

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