Circuit 2, station 3

Prioritising Patient Interests and Safety (GDC Standard 1): The foremost concern should always be safeguarding patients from any potential harm arising from the involvement of an inebriated colleague. Furthermore, in certain circumstances, it may necessitate the cancellation of the colleague’s clinical appointments.

Effective Patient Communication (GDC Standard 2): Ensuring clear and thoughtful communication with patients is imperative, particularly when conveying information about any clinic delays or cancellations. Patients have a right to be informed promptly and comprehensively.

Compliance with Complaints Procedures (GDC Standard 5): It is imperative to acknowledge that patient complaints may arise as a consequence of clinic cancellations. Therefore, it becomes essential to navigate these procedures diligently and transparently.

Collaborative Teamwork (GDC Standard 6): In managing such situations effectively for the benefit of both patients and staff, meticulous organisational efforts and cooperative teamwork are indispensable. A harmonious interplay among team members can lead to more efficient resolutions.

Sustaining and Enhancing Professional Competence (GDC Standard 7): Facing a novel situation, one that may not have been encountered previously, underscores the necessity of maintaining, enhancing, and operating within one’s professional competencies and knowledge base.

Reporting Concerns (GDC Standard 8): In circumstances where patients may be exposed to harm due to a colleague’s condition, the responsibility to raise concerns becomes paramount. Timely and appropriate reporting mechanisms should be employed to address potential risks.

Preserving Trust in the Dental Profession (GDC Standard 9): Central to the ethical framework is the imperative to uphold the trust and confidence that patients place in the dental profession. Actions taken in response to the situation should not compromise this essential foundation.

Addressing General Professionalism and Fitness to Practise: In addition to the specific GDC standards outlined, this situation also encompasses broader aspects of general professionalism and the individual’s fitness to practise within the dental field. These facets warrant due consideration and adherence to established professional norms and ethical principles.

In the context of short-term management, the primary objective is to effectively address the situation involving the colleague while minimising disruptions for patients. The following steps are recommended:

1. Initiate a conversation with the Colleague: Prior to making any judgments, it is essential to engage in a dialogue with the colleague to understand the context and circumstances. This initial conversation should aim to ascertain whether the colleague is indeed under the influence of alcohol and whether they are cognisant of the unsafe and unacceptable nature of their condition.
2. Consult with a supervisor: In instances where you may feel uncomfortable handling the situation independently or require additional support, it is advisable to consult with your supervisor. Their guidance and input can be instrumental in resolving the matter effectively.
3. Arrange for safe departure: Given the colleague’s impaired state, it is imperative to arrange for their safe departure from the workplace. This may involve arranging for a taxi service or requesting assistance from another colleague. It is unequivocally unsafe for the colleague to operate a vehicle or remain at work in this condition, and their safety in transit must be ensured.
4. Manage the colleague’s clinic list: Considering that appointments may have been scheduled in the colleague’s clinic, collaborative efforts are crucial to addressing this situation. Several options are available, including:
   • Cancelling the entire clinic and promptly notifying patients with offers to reschedule, accompanied by apologies for the unavailability of the dentist.
   • Attending to those few patients who may have already arrived while cancelling appointments for the remaining patients.
   • Distributing the patient load among the team members to minimise delays, with appropriate apologies for the dentist’s unavailability.
   • Exploring the possibility of securing a locum dentist on short notice to cover for the absent colleague.
   • Considering nearby dental practices that may provide emergency care if needed.
5. Reference the complaints procedure: Recognising that patients may express dissatisfaction with the situation, it is essential to be prepared to direct them to the established complaints procedure. Resolving any complaints within the practice framework is the preferred course of action.
6. Consult with indemnity provider: Seeking guidance and support from your professional indemnity provider is advisable in situations where complex legal or liability issues may arise as a result of the incident.
7. Maintain comprehensive documentation: In situations involving complaints or critical incidents, thorough and meticulous documentation is of paramount importance. This documentation should be complete, concise, clear, and contemporaneous, ensuring that all pertinent details are recorded accurately for future reference and legal purposes.

Longer term management:

Engage in a Discussion with the Colleague (or involve a supervisor): In order to comprehensively address the situation, it is essential to initiate a discussion with the colleague to gain further insights into the circumstances that led to their inebriation. This conversation should aim to elicit information regarding any underlying personal challenges or stressors that may have contributed to their condition. If it becomes evident that the colleague is undergoing a difficult period in their life and requires additional support, it is imperative to refer or provide appropriate guidance. Moreover, it is crucial to determine whether the colleague acknowledges the inappropriateness and lack of professionalism in their actions. In cases where the colleague appears to lack awareness of the implications of their behaviour or perceives no wrongdoing, there may be justifiable grounds for further escalation. Ultimately, this could lead to the involvement of the General Dental Council (GDC) with the potential for a fitness-to-practice case.

Arrange suitable clinic cover: In anticipation of the colleague’s potential absence from work, it becomes imperative to make arrangements for appropriate clinic coverage. This may involve identifying suitable colleagues or practitioners to take over their clinical responsibilities, or in certain instances, it may necessitate the cancellation of scheduled clinics.

Address complaints in accordance with established policies: Handling any complaints that may arise should be conducted in strict accordance with both practice-specific and General Dental Council (GDC) policies and guidelines. If necessary, it may be prudent to engage indemnity providers for guidance and support in navigating any legal or liability issues associated with the complaints.

Engage in reflective practice and portfolio development: Following the resolution of the situation, it is prudent to engage in reflective practice to contemplate and evaluate one’s approach to the incident. This process involves introspection regarding the management of the situation and considering whether alternative actions could have been taken. Such reflections contribute to professional growth and may inform future responses to similar circumstances. Moreover, documenting this incident within one’s professional portfolio can serve as a valuable learning experience and a record of one’s professional development.

Continual Professional Development (CPD): To enhance the practice’s overall preparedness for situations of this nature, it may be beneficial to explore general Continuing Professional Development (CPD) opportunities related to topics such as complaints handling, ethics, and professional conduct.

Conduct team meetings: Convening team meetings provides an ideal forum to not only discuss the handling of complaints but also to coordinate the arrangement of clinic cover for the colleague. It fosters collaborative decision-making and ensures that all team members are aligned.