3: Law and Ethics

CHAPTER 3 Law and Ethics

3.1 Regulation of dental nursing in the UK, scope of practice, training and qualifications


The Regulatory Bodies

In the UK, all healthcare professionals are accountable to a regulating body. There are in total nine regulating bodies:

Each regulator maintains ‘registers’, which contain names and other details of healthcare professionals who are considered fit to practise in the UK. The regulators’ functions include:

The General Dental Council

The GDC is the organisation that regulates all dental professionals training and working in the UK. Dental professionals include dentists and all dental care professionals. The dental care professionals are:

The aims of the GDC are to:

The GDC achieves these aims by setting the standards and principles for ethical dental practice in the UK. These are covered in detail in Subchapter 3.2.

The GDC itself is regulated by the Council for Healthcare Regulatory Excellence (CHRE).

The Care Quality Commission and the Care Commission

Another, independent, regulatory body that dental nurses need to be aware about is called the Care Quality Commission (CQC) in England and the Care Commission in Scotland. The aim of the CQC is ‘to ensure better care for everyone in hospital, in a care home and at home’. Thus the CQC ensures the safety and quality of the care provided to patients through various assessment, monitoring and inspection procedures, and this includes dental professionals.

In April 2010, CQC introduced a registration system for all providers of health and social care which was introduced gradually across the care sector with the aim of incorporating primary care services that provide dentistry (NHS and private sector) by 1 April 2011. Thus, in addition to standards set by GDC, it is mandatory for dental practices to register with CQC and comply with its Essential Standards of Quality and Safety (standards that outline the ideal outcome patients should experience when using a service). Each practice will need to be able to demonstrate compliance with the regulations in the following areas:

The national health service (NHS)

The NHS is the name commonly used to refer to the UK’s publicly funded healthcare system, which was set up in 1948. It is now called by different names in different parts of the UK:

However, a person who lives in one part of the UK can receive treatment under the relevant NHS in another UK country without being discriminated against.

Structure of the NHS

The NHS is divided into two sections: primary and secondary care.

The strategic health authorities (SHAs) oversee the work of PCTs and other NHS trusts in a particular region and provide the link between the Department of Health and the NHS at the local level.

Several healthcare-related government agencies (e.g. National Institute for Health and Clinical Excellence (NICE) and the National Patient Safety Agency (NPSA)) also come under the umbrella of the NHS.

Dental nurses’ scope of practice

The material in this section is largely adapted from the GDC’s ‘Scope of Practice’ publication, which states that:

GDC Guidance on the Various Areas of Dental Nurse Roles in ‘Scope of Practice’

Additional Skills that a Dental Nurse Could Develop during Their Career

With additional training, dental nurses may also be involved in expanded duties such as:

Dental nurse training and qualifications

Several different routes lead to a qualification in dental nursing. This is because a route that may be suitable for some may be less suitable for others. Dental nurse training providers in England, Wales and Northern Ireland are listed in Table 3.1.1. For details about the Scottish Vocational Qualification (SVQ) in Oral Healthcare: Dental Nursing Level 3, contact the Scottish Qualifications Authority (see p. 78 for contact details).

TABLE 3.1.1 Accessing Dental Nurse Training (England, Wales and Northern Ireland)

Qualification Awarding Body Details of Study and Examinations Available from
The National Certificate – Dental Nursing National Examining Board for Dental Nurses (NEBDN) NEBDN (www.nebdn.org/)
The City & Guilds Level 3 NVQ in Dental Nursing (England and Wales) NEBDN/City & Guilds Care, Health & Community NEBDN
City & Guilds (www.cityandguilds.com/uk-home.html)
The City & Guilds Level 3 Award in Dental Nursing (VRQ) (England and Wales) NEBDN/City & Guilds Care, Health & Community NEBDN
City & Guilds
The Certificate of Higher Education in Dental Nursing Cardiff University* School of Postgraduate Medical and Dental Education (see p. 78 for contact details)School of Professionals Complementary to Dentistry
  Portsmouth Dental Academy (scl.admissions@port.ac.uk) School of Professionals Complementary to Dentistry
Foundation Degree in Dental Nursing University of Northampton (study@northampton.ac.uk)  

* This programme has received provisional approval from the GDC Education Committee. Full GDC approval of new programmes is not granted until the first batch of students has completed their studies and examinations or assessments and the programme has been inspected by the GDC. Potential applicants should contact the provider for further information about the programme.

Pre-registration Certificates

Appropriate pre-registration certificates are offered by:

The national examination board for dental nurses

The National Certificate of the NEBDN (see p. 78 for contact details) provides a mix of theoretical learning and practical teaching and experience. It can be undertaken at a dental hospital or at a college of further education.

The NEBDN stipulates that 24 months of verified chairside assisting (assisting a dentist or other clinician during treatment of a patient) is necessary before the qualification can be awarded. However, the national examination can be taken before these 24 months are completed.

The NEBDN syllabus has 15 sections. In addition to theoretical study, you need to complete a ‘Record of Experience’ in the workplace. This provides a measure of your application of skills during routine dental procedures as outlined in the syllabus. The procedures are divided into five units. For each unit, you must demonstrate competence in a prescribed number of clinical activities and provide additional evidence recorded on a ‘Practical Record Sheet’, which is signed and dated by a witness who holds a GDC-registerable dental qualification. You must also complete a report (case study) of no fewer than 1000 words and no more than 1500 words on one treatment session which involves provision of a fixed or removable appliance or a surgical or restorative procedure.

The national examination is held twice each year – on the third Saturday in May and November – and comprises:

The city & guilds of london institute

Vocational qualifications reflect the skills, knowledge and understanding an individual possesses in relation to a specific area of work. National Vocational Qualifications (NVQs) and Vocationally Related Qualifications (VRQs) are workplace-based. The NEBDN provides the dental expertise whereas City & Guilds is the awarding body.

The ‘City & Guilds’ is the main UK examining and accreditation body for vocational training. Dental nursing is also recognised as a vocational qualification.

Dental Nursing NVQ (No 3231)

You can undertake NVQs at dental hospitals and at further colleges of education. NVQs are made up of different units of competence. A portfolio of evidence is completed in the workplace, which is assessed and verified before you sit an independent assessment. The Dental Nursing NVQ (No 3231) is a Level 3 qualification and is aimed at dental nurses working in general dental practices, community dental services, dental and general hospitals, armed services, who are providing direct chairside work, patient care and support during a range of dental treatments.

To gain the full NVQ, you must complete a total of 11 mandatory units as follows:

Dental nurse registration

Continued Professional Development

The GDC states that:

Compulsory CPD means that dental nurses must complete and record 150 hours of CPD every five years, of which a third (50 hours) should be verifiable (Box 3.1.1). Most providers of CPD will issue a certificate for proof of attendance at the verifiable CPD event, but it is wise to check there will be CPD credits before deciding to participate in the CPD. Some CPD must be on mandatory (essential) core subjects, which are the same as for clinicians:

Jan 8, 2015 | Posted by in Dental Nursing and Assisting | Comments Off on 3: Law and Ethics
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