December 2024 Newsletter

Message from the President

It seems like just yesterday I was welcoming you to the final edition of the 2023 newsletter … and here we are again, one year later. Time really does fly!

2024 has been another busy year in the regulatory space. While the Council saw an increase in the overall number of complaints received, the majority continue to be discontinued or result in no regulatory action being taken. This is because the Council will only take regulatory action where there is an identified risk to public safety or where it is in the public interest to take such action.

In order to find out more about the work of the Councils, including the Dental Council, I recommend that you review the Joint Health Professional Councils’ Annual Report for FY2023/24. Additional information regarding the annual report is included further on in this newsletter.

Complaints review project

In November 2022, as one of the Council’s Professional Officers at the time, I completed a project where I reviewed complaints received between FY2019/20 and FY2020/21. This project focused on more serious complaints that resulted in Council Inquiries; Performance Assessments; Performance Review Panels, and s.150 (immediate action) referrals to the Health Care Complaints Commission for investigation and/or prosecution before the NSW Civil and Administrative Tribunal.

As a result of this project, a number of themes/issues/risks were identified. Some of these continue to be seen in the complaints received in more recent years. Further on in this newsletter, we have included some of the information and analysis from this project highlighting the main issues that we still continue to see in the complaints received by the Council. 

We hope that this will assist you in better understanding recurrent themes/risks identified in complaints and that, in turn, it will also help your practice to reduce the likelihood of you receiving a complaint in future.

We recognise that it isn’t pleasant receiving an email from the regulator advising you that a complaint has been received. Regardless of whether you feel the complaint is warranted, the Council has an obligation to assess the complaint, and you are provided the opportunity to respond to the complaint with any additional information that you feel will assist the Council in assessing the complaint.

We are more than aware of the stress that this situation can cause, and we aim to resolve complaints as quickly as possible. Sometimes practitioners fail to respond promptly, and this means it can drag on. It is really important that you seek advice from your Associations or Insurers so that you can fulfil the professional requirements included in Section 8 of our Code of Conduct; ignoring complaints does not make them go away. If you do find yourself the subject of a complaint, support networks are really important.

It is pleasing to report that, throughout the year, a number of practitioners, who have been the subject of a complaint, have acknowledged that, although it is confronting when a complaint is received, they have found the Council’s process to be fair and that the experience has assisted with their future practice.

Dental Practitioner Support is available

I also acknowledge that we have had another challenging year overall and that you may have been affected by events outside of your control, both here at home and/or overseas. It is important to note that there are well-being support services that you can contact, and this includes Dental Practitioner Support. This is a free and confidential support service - details are provided further in this edition of the newsletter.

Ask the regulator

The Council also recognises that there are a number of organisations involved in the regulation space in NSW and the individual responsibilities of each is sometimes difficult to understand. To assist you, we have included an Ask the regulator item further on in this edition of the newsletter in which we provide an overview of the role of each body.

I would like to take this opportunity to thank everyone who has contributed to the regulatory work of the Council during the year. This includes my fellow Council members; Professional Officers; Authorised Persons; hearing/panel members; assessors; members of the Assessment Committee and the staff of the HPCA, in particular, Colin Borg and the Dental Council Team. The Council could not fulfil its mandate of public protection without the involvement of all these dedicated people.

If you are celebrating over the festive season, happy holidays! I hope everyone gets a break and enjoys time with family and friends.

Wishing you all the best for 2025!

Kind regards

Deb

Adjunct Professor Deborah Cockrell AM

President

Annual Report - FY2023/24

The Joint Health Professional Councils’ Annual Report for FY2023/24, which includes information relating to the work of the Dental Council, is available on the Council’s website.

The highlights for the Dental Council’s complaints:

• 21% increase in complaints received compared to previous year
• 69% of complaints were made by patients
• 62% of complaints related to clinical care
• 509 complaints were closed during the year
• 78% of the closed complaints resulted in no regulatory action being taken
• 29% reduction in assessments and hearings held compared to previous year.

Joint Position on Family Violence by regulators of health practitioners

Australia’s health practitioner regulators have issued a joint position statement about family violence. 

Health practitioners have a vital role in detecting family violence, supporting those impacted, and ensuring their own professions and communities are safe.

As often the first point of contact for people who have experienced or are experiencing family violence, health practitioners can prevent further harm and encourage victim-survivors to seek help.

Health practitioners are also reminded that their conduct, as well as that of their colleagues, must reflect the trust and confidence the public have in them for safe and effective healthcare. As a health practitioner, the way you behave impacts your role in providing trusted and appropriate care to victim-survivors.

Australia’s health practitioner regulators are united in their view that family violence is unacceptable. Family violence can also be a serious crime and a violation of human rights. It is a gross departure from the ethical standards expected of health practitioners that are fundamental to providing safe healthcare. Perpetrators of family violence could face suspension, cancellation, the imposition of conditions, or refusal of registration.

As regulators we are committed to minimising the risk of adding to victim-survivors’ trauma or exposing them to further risk of harm, therefore we seek to respond to their complaints in a trauma-informed way.

This means prioritising the safety and dignity of victim-survivors and sensitively supporting them through the health complaint management process.

We work to ensure health practitioners are safe, ethical and professional for the protection of the public.

The full joint statement can be accessed here.

The importance of making timely entries in health records

In previous newsletters, the Council has highlighted the obligations that are placed on all of us when it comes to maintaining our patients’ health records. Ahpra and the Dental Board of Australia’s shared Code of conduct outlines these responsibilities.

After reviewing recent complaints, the Council has identified situations where, for whatever reason, practitioners have not maintained up-to-date health records. Not only does this pose a risk to your patients and their ongoing care, but it may also be detrimental to you, should you receive a complaint. 

Most complaints the Council receives relate to clinical care - a clear and accurate health record will help you in responding to any allegation made by a patient about their care.

We acknowledge that in general, life is getting busier and busier - a day in the life of a dental practitioner is no different. At one time or another you may have said, or thought, “I’ll complete that record later”. Depending on your day, this may seem the best option at the time, however in the long run it may be disadvantageous.

We recommend that you set aside sufficient time with or just following each patient to update their record before moving onto your next patient or task. This is essential for continuing good care of patients and will make life easier when you need to review a patient’s case in the future.

Changes to Council education and research grants – next round opens on 1 February 2025

As you may be aware, the Council has advertised the availability of its education and research grants in its newsletters and has in the past, called for applications twice a year.

During 2024, the Council reviewed its guidelines for applicants to ensure that they meet the needs of the current academic/research environment.

As a result of this review, a number of changes were made including:

• an increase in the total funding allowable for each research grant from $10,000 to $20,000, with a maximum of two years’ duration - smaller Grants of shorter duration are still encouraged
   
• clarification about the costs/budget items that can be considered as part of a grant application
   
• the timing of calls for applications which was previously twice a year – will now move to once a year.

Applications will now open on 1 February and close on 1 May each year.

Expressions of interest may from time-to-time, be advertised by the Council for specific projects outside of the annual grant round.

What are the criteria to be eligible for a grant?

The Council will consider providing funding for research and education that relates to the health, performance and conduct of registered dental practitioners and students.

Grants are available to applicants who are registered dental practitioners (all divisions) and whose principal place of practice is in NSW, or registered students (all divisions) training in NSW. Grants may be awarded to individuals, groups or institutions.

Where an application is from a group, the Chief Investigator must be registered with a principal place of practice in NSW. Co-investigators do not need to meet this criteria, and may be unregistered health practitioners, including from professions other than dentistry/oral health. Individual chief investigators cannot hold more than one Council Grant at any one time. The research/education project should be conducted in NSW and must be of benefit to practitioners/students in NSW.

For further information and to access the guidelines and application form, please visit the Council’s website.

Please place a reminder in your calendar that applications open on 1 February 2025 and will close on 1 May 2025

Meeting your professional obligations when using Artificial Intelligence in healthcare

As you may be aware, Artificial Intelligence (AI) technology is rapidly becoming integrated into many areas of healthcare.

As an emerging issue, the Council reiterates the importance of you being aware of your existing responsibilities under the Code of conduct and how they apply to the use of AI in your practice.

Ahpra and the National Boards have now issued guidance to practitioners to assist them in meeting their obligations. The guidance will also be regularly updated to reflect new developments in AI.

Review of complaints received and recurrent themes

The Council acknowledges that the following information relates to a project commissioned by the Council in 2022 and is based on data from FY2019/20 to FY2020/21. This review remains pertinent as many of the themes/issues/risks identified as part of this project continue to be seen in complaints received and are therefore of relevance to current dental practice. 

For the period FY2019/20 – FY2020/21, a total of 939 complaints were received by the Council. Of these, 73 cases were reviewed as part of this project.

The project focused on more serious complaints that led to Council Inquiries; Performance Assessments; Performance Review Panels, and s.150 (immediate action) referrals being made to the Health Care Complaints Commission (HCCC) for investigation and/or prosecution before the NSW Civil and Administrative Tribunal (NCAT).

The vast majority of the complaints related to clinical care and were made by patients of the practitioners.

Recurrent themes raised by complainants

The initial complaints usually included multiple elements however a number of recurrent themes were identified.

In our next newsletter we will summarise the findings following investigation of these complaints, and we will provide a link to this summary in that newsletter. It is interesting to reflect on our own performance and approaches to clinical care in light of these complaints.

Ask the Regulator … Who’s who in NSW Regulation?

So many acronyms but who are our regulators? It is very clear that a lot, maybe even the majority, of dental practitioners have not been exposed to detail around who is who in regulation. We have tried to briefly summarise the various roles but have also provided links to the various websites for full details.

Health Care Complaints Commission (HCCC)

The HCCC is an independent body that investigates and manages complaints about health practitioners and health service providers in NSW. The HCCC consults with the Council on all complaints to determine how the complaints will be managed. The HCCC investigates and prosecutes more serious complaints. Less serious complaints about the health, conduct or performance of dental practitioners will be referred to the Council for management.

Generally, upon the lodgement of a complaint, a practitioner will receive advice from the HCCC with an initial request for a response to the complaint. Following consultation with the Council, if the complaint is not referred to the Council for management – for example it is discontinued - contact with the practitioner is maintained by the HCCC.

Dental Council of NSW

The Council manages complaints about the health, conduct and performance of dental practitioners and students in NSW where, following consultation with the HCCC, the complaint is referred for management.  In these circumstances, practitioners will receive ongoing communication from the Council regarding the progress of the complaint.

In some cases, upon receipt of a complaint, the Council may make contact with a practitioner prior to the HCCC in circumstances where serious concerns are raised in the complaint.  This occurs as part of the Council’s risk assessment process.

The Council also monitors conditions placed on practitioners’ registration in NSW, where the conditions relate to health, conduct or performance.

Health Professional Councils Authority (HPCA)

The HPCA is the administrative body providing executive/administrative support to the 15 health professional Councils in NSW including the Dental Council. HPCA employees support the Council, in its complaint and/or monitoring functions.

The HPCA work together with Council to protect the public by regulating health practitioners in NSW.

The HPCA also works closely with the NSW Health Care Complaints Commission (HCCC) and National Boards/Ahpra at a national level. As co-regulators, the HCCC, HPCA and Councils decide the best way to manage complaints about health practitioners and students.

Dental Board of Australia

Dental practitioners in all jurisdictions throughout Australia are registered with the Board. 

The Board publishes regulatory standards, codes and guidelines, updates and other resources for dental practitioners, employers, students and the public. It also approves programs of study.

The Board also manages complaints/notifications relating to dental practitioners in all other jurisdictions throughout Australia (excluding NSW). Conditions placed on practitioners’ registration in jurisdictions other than NSW, are monitored by the Board.

Australian Health Practitioner Regulatory Agency (Ahpra)

Ahpra works in partnership with the National Boards, including the Dental Board of Australia. It supports the Boards functions, including the administrative processing of new applications for registration and renewals of registration, and audits of compliance with registration standards. Ahpra also manages complaints about advertising and holding out offences.

Mandatory notifications are also made to Ahpra. For dental practitioners practising in NSW, any mandatory notification made to Ahpra will be referred to the HCCC/Council for consideration/management.

Ahpra also publishes the online register of health practitioners registered in Australia.

NSW Civil and Administrative Tribunal (NCAT)

NCAT’s Administrative and Equal Opportunity Division reviews administrative decisions made by government agencies. Where applicable, dental practitioners apply to NCAT for reviews and appeals of Council decisions.

The HCCC also prosecutes complaints before NCAT. NCAT has the power to cancel or suspend registration and/or place conditions on registration.

Health and wellbeing support service for dental practitioners

As we all know, maintaining our own health and wellbeing is of utmost importance. We also appreciate that individual personal and/or professional circumstances may result in us requiring extra support at certain times in our lives.

This may include when a complaint has been made about you. We acknowledge that this can be a very stressful time, regardless of whether you feel you have done anything wrong. 

The Dental Board of Australia has funded a nationwide health and wellbeing support service for dental practitioners.

Dental Practitioner Support is the first national 24/7 telephone and online service for all dental practitioners. The service also offers support to dental students, educators, employers, Australian Dental Council exam candidates and concerned family members.

An experienced team of counsellors will provide confidential and immediate support, advice and referral on a wide range of health and wellbeing related issues. The service runs independently of the Board. Anyone calling the service does not have to give their name.

Access Dental Practitioner Support:

• 1800 377 700
• dpsupport.org.au

If you are experiencing difficulties, the Council strongly recommends you access this free and anonymous service.

Health Professional Councils Authority (HPCA) office closure

The HPCA office will be closed from Monday 23 December 2024 to Friday 3 January 2025.

The HPCA will continue to process urgent complaints during this period. Less urgent matters may not be dealt with until the week beginning Monday 6 January 2025. If you have any queries, please contact the HPCA/Dental Council team prior to the office closure at hpca-dentalcouncil@health.nsw.gov.au