A recent report from Healthwatch England made for particularly grim reading regarding how vulnerable patients don’t always get the help they need when they come into contact with the healthcare system. Their report sought to bring to light “the human consequences of getting discharge wrong and to outline some of the key reasons this is happening.” Caring for vulnerable patients is not just the domain of patients presenting to their GP or A&E with mental health issues. It is vital that all members of the team offering care can be able to pinpoint, diagnose and help vulnerable patients.
The NHS and Department of Health, as well as the regulatory bodies, have begun to advise healthcare professionals to take the appropriate steps in these cases early. Their duty of care compels them to be able to take strong action in these situations, designed to help potentially vulnerable people and give them the special care they need. Healthwatch England’s report detailed some of the tragic cases where vulnerable patients did not receive the appropriate care, suffering fatal consequences as a result.
One particularly sad case concerned a man called John, whose wife Anne had taken him to hospital where he was voluntarily admitted. As the report states: “A few days later, Anne received a text telling her to collect John from the hospital. She was told John would be leaving with medication and she would need to provide him with additional support. John was agitated and did not want to return home, but the hospital rejected his request to stay. He asked if he would be able to return if he felt unable to cope at home but the hospital said no and discharged him with an appointment for further assessment a week later.
“One evening the following week John said he was going to visit a friend and did not return home. Anne contacted the police who told her that he had committed suicide.”
Although critical of the discharge process, in particular, in this case it nevertheless highlights how action could have been taken to potentially save a life. Furthermore, it reinforces the need for all members of the healthcare team to be aware of these issues and be able to take action to ensure vulnerable people are given the care they need in these situations.
Luckily, healthcare bodies have begun to take the appropriate steps and, in the dental profession, the industry has begun to step up. Safeguarding Children and Adults became recommended CPD by the General Dental Council earlier this year. Scotland recently announced extra funding for training for dental professionals to recognise the signs of domestic abuse and violence.
It may seem innocuous, given the short amount of time that individual patients spend in a dental practice, but the responsibility, and more: the opportunity, is there for dental professionals to be able to spot signs of potentially vulnerable patients and do everything in their remit to provide care for that patient.
The GDC’s guidance states: “As a dental professional, you are likely to notice injuries to the head, eyes, ears, neck, face, mouth and teeth, as well as other welfare concerns. Bruising, burns, bite marks and eye injuries could suggest that a concern should be raised.”
While signs of physical abuse may be easy to identify, the problem of mental health issues certainly problematizes the issue. It was certainly high on the agenda in the run up to the election, and has gained even more traction since then. This week, alone, Jeremy Corbyn, following the creation of a shadow post specifically for mental health, identified it in his key note speech at the Labour Conference as a vital issue. To achieve parity in terms of the services offered for mental and physical health, equipping all healthcare professionals with the ability to identify those affected by mental health problems is an important stepping stone to achieving this parity.
As it is now recommended CPD, it has become a way for dental professionals to learn these essential skills while also fulfilling their required CPD in the process. Emphasising that CPD is a worthwhile undertaking and not simply a requirement to remain on the register, Safeguarding Vulnerable Adults and Patients is the way for dental professionals to ensure they can protect their patients, especially those most vulnerable in society: children, the elderly, etc.
The dental team can make their patients have a great smile. Being able to effectively treat vulnerable patients gives those people a reason to smile, too.