It seems that there is very different advice and very different requests being asked for by each Trust. Some are closed, running casualty services only and some are still open, running a reduced or selective service.

Despite not being front line, orthodontic patients still do need advice and backup to ensure their care is progressing safely. There will always be exceptional cases that require unexpected actions and we must try to work to the principle of “first not doing harm”.

  • We have to remember four things:
    • We are employees of our Trusts and as such we are obliged to undertake the tasks that the Trust management asks of us
    • We are independent practitioners regulated by the GDC and should not be doing anything that is outside our competencies
    • We each have our own conscience and moral framework to refer to
    • We have professional indemnity that should support us in our decision making

We therefore need to keep a dialogue with our hospital managers and support the efforts of our hospitals to deal with the coming difficulties. We need to be prepared to be flexible and take on roles that are required in the Trusts as the need for ITU admissions increases. Having said that, we must look after ourselves and our professional integrity and refer to the GDC scope of practice to ensure that we are acting within our competencies until such time as these are centrally revised as might happen by the GDC in an extreme situation. We should refer to our colleagues, protection societies, BDA and GDC to check that we are not working inappropriately.

Clinical Governance Directorate

British Orthodontic Society

March 2020