MJDF Law Ethics and Professionalism 2

Question 1

What is the duty of candour in dental practice, and what does it require when a patient safety incident occurs?

Accepted Answer

The professional duty of candour (GDC) and statutory duty of candour (CQC Regulation 20) require dental professionals to be open and honest with patients when something goes wrong with their treatment, to apologise (apology is not an admission of liability under the Compensation Act 2006), explain what happened, offer appropriate remedy, and support the patient

Answer

The duty of candour has two components: the professional duty (GDC Standards — Principle 1.3.3: be open and honest with patients if something goes wrong) and the statutory duty (CQC Regulation 20: organisations must notify patients of 'notifiable safety incidents' where moderate or severe harm occurred). Requirements: tell the patient (or their representative) what happened as soon as possible, offer an apology (the Compensation Act 2006 section 2 confirms that an apology is not an admission of liability), explain the consequences, offer remedial treatment, and document the discussion. Failure to comply with the duty of candour can constitute a fitness to practise issue (GDC) or a regulatory breach (CQC).

Question 2

What are the legal requirements for dental record keeping in the UK?

Accepted Answer

Records must be contemporaneous, accurate, legible, and comprehensive, including patient identification, medical history, clinical findings, diagnosis, treatment plan (with consent discussion), treatment provided, materials used, prescriptions, radiographs taken with justification, and any complications; they must be retained for a minimum of 10 years (adults) or until the patient's 25th birthday (whichever is longer for children)

Answer

UK dental records must meet GDC, CQC, and medicolegal standards. Essential content: patient demographics, comprehensive medical history (updated at each visit), presenting complaint, clinical examination findings, diagnosis, treatment options discussed (including risks, benefits, alternatives), consent record, treatment provided (including materials, batch numbers for implants), local anaesthetic type/dose/batch, radiographs (with IRMER justification, report, and quality rating), referrals, and any complications/incidents. Records must be contemporaneous (made at the time of treatment), factual, legible, and in permanent form. Retention: NHS — 10 years from last entry or until age 25 (whichever is later); adults — 10 years; children — until age 25. In negligence claims, the patient must prove breach of duty, so adequate records are the clinician's best defence.

Question 3

What is the difference between negligence and an adverse outcome in dental treatment, and what must a patient prove to succeed in a negligence claim?

Accepted Answer

Negligence requires proof that the practitioner owed a duty of care (exists for all patients), breached the standard of care (the 'Bolam test' — fell below the standard of a reasonably competent practitioner, modified by the 'Bolitho test'), and this breach caused the patient's harm (causation); an adverse outcome alone does not constitute negligence if the treatment met the required standard

Answer

Dental negligence in UK law requires the patient (claimant) to prove three elements on the balance of probabilities: (1) Duty of care — automatically established in a dentist-patient relationship; (2) Breach of duty — the treatment fell below the standard expected of a reasonably competent practitioner in that field (Bolam v Friern Hospital 1957), AND the body of opinion supporting the practice must be reasonable and logically defensible (Bolitho v City and Hackney 1998); (3) Causation — the breach directly caused the harm suffered ('but for' test — but for the negligent act, the damage would not have occurred). A poor outcome despite competent treatment is not negligence — medicine involves inherent risks even with optimal care.

Question 4

What is the dental professional's responsibility regarding safeguarding children and vulnerable adults?

Accepted Answer

All dental professionals have a legal and professional duty to recognise signs of abuse or neglect (physical, emotional, sexual, neglect, domestic violence), report concerns to the local safeguarding team, follow the practice's safeguarding policy, maintain safeguarding training, and document any concerns; failure to act on safeguarding concerns may constitute a fitness to practise issue

Answer

All GDC registrants have a duty to safeguard children and vulnerable adults (GDC Standards Principle 8, Children Act 1989/2004, Care Act 2014). Dental professionals are well-placed to identify abuse: orofacial injuries (most common site of non-accidental injury in children), neglected dental disease, inconsistent explanations for injuries, behavioural changes, and signs of neglect. The threshold for reporting is concern/suspicion, NOT proof — it is not the dental professional's role to investigate, but to report to the local authority children's/adult services or the NSPCC. Practices must have a safeguarding lead, written policy, and all staff must complete appropriate training. Failure to raise concerns when abuse is suspected is a serious professional conduct issue.

Question 5

What are the CQC (Care Quality Commission) fundamental standards that dental practices in England must meet?

Accepted Answer

CQC regulates all dental practices providing NHS or private treatment in England against fundamental standards including: safe care and treatment (Regulation 12), good governance (Regulation 17), safeguarding (Regulation 13), staffing (Regulation 18), complaints (Regulation 16), consent (Regulation 11), and duty of candour (Regulation 20); practices are rated Outstanding, Good, Requires Improvement, or Inadequate

Answer

The CQC is the independent regulator of health and social care in England. All dental practices (NHS and private) must be registered with CQC and meet fundamental standards. Key regulations include: Regulation 12 (safe care and treatment — including infection control, medicines management, equipment maintenance), Regulation 17 (good governance — risk assessment, audit, policies), Regulation 13 (safeguarding), Regulation 18 (staffing — sufficient, qualified, trained), Regulation 16 (complaints), Regulation 11 (consent), Regulation 20 (duty of candour), and Regulation 15 (premises and equipment). Inspections assess five key questions: Is the service safe, effective, caring, responsive, and well-led? Rating outcomes can result in conditions, warning notices, or ultimately closure.

MJDF Part 1 Practice Test

MJDF Part 1 Practice Test

MJDF Law Ethics and Professionalism 2