MyGDCUnderstanding your personal Scope of Practice
Supporting Material shows ways in which the Principles, Professional Guidance, the Expectations and the relevant legislation can be applied within different contexts, and they may signpost to relevant resources. They do not introduce new principles or guidance and will not be used as a basis of an allegation of impaired fitness to practise. |
Take a look at this case study to see how professional judgment can be applied within your scope of practice:
Pravleen’s story
Pravleen is a dentist with 15 years of experience in NHS dentistry. Pravleen has been trained to do multi-root endodontic treatments, and used to routinely undertake this procedure, however he no longer practises this procedure and has not for more than four years. Pravleen will still regularly provide single-root endodontic treatment and does so effectively.
A patient has presented to Pravleen with a history of pain in an upper first permanent molar (26) that has now subsided. After undertaking a careful examination of this tooth, including cold tests and radiographs, Pravleen has made a differential diagnosis of chronic pulpitis. He provides this information to his patient
Pravleen explains his findings to his patient and provides him with his treatment options (including the option to do nothing), ensuring to carefully explain the possible outcomes of each treatment choice. Pravleen’s patient decides that he would like to pursue endodontic treatment.
Pravleen uses his professional judgment to consider how best to provide for his patient…
When considering his Scope of Practice, Pravleen should reflect on three key areas: his training, his competence, and the coverage provided by his indemnity insurance. Multi-root endodontic treatment was included in Pravleen’s dental training, and his indemnity insurance provides coverage for performing this type of procedure. The remaining consideration, therefore, is a reflection on his own competence and confidence in carrying out this treatment safely and effectively.
Pravleen’s recent continuing professional development (CPD) activities have been focused on emergency care and paediatrics, with little to no development in endodontics, which, when he considers this alongside four-year gap since last performing the treatment, he decides that multi-root endodontic is no longer in his personal scope of practice and refer his patient appropriately.
Discussion points
- What could Pravleen do to reincorporate more complex endodontic procedures back into his practice?
- What are the risks that come from practising outside of your personal scope of practice?
- How can dental professionals effectively communicate their scope of practice limitations to patients while maintaining trust and professionalism?
Providing safe and ethical care within the boundaries of your professional scope
Carmen's story
Carmen is a dental hygienist with over 20 years of experience, she sees most of her patients directly but will liaise with the dentist to ensure her patients are receiving the most appropriate care.
A patient presents to Carmen for her first oral health visit in two years, she reports that she has lost a filling and, as a result, is getting food stuck in the area. She points to the lower left side. A clinical examination and radiographs confirm the patients concerns and identify dental caries on the adjacent tooth, both requiring restorative treatment.
Carmen develops a treatment plan for her patient…
Carmen has identified that these teeth require restorative treatment, along with other care needed to support the patient's overall oral health. Carmen develops a treatment plan that ensures she can support her patient, whilst remaining within her professional Scope of Practice. She is confident in her decision making because she is familiar with GDC resources such as Scope of Practice Guidance and the Safe Practitioner framework.
Carmen will work alongside the patient to improve their oral health, before referring to her practice’s dentist to complete the restorative treatment.
This professional relationship benefits the patient significantly. The dentist can feel confident that any restorative treatment will have a better outcome due to the patient’s improved oral health. Carmen can be reassured she is providing the safest possible care, and the patient can maintain trust in the dental profession.
Discussion points
- What could Carmen do, if the patient needed these carious lesions attended to on the same day, without compromising her professional scope?
- How can Carmen explain her Scope of Practice and the professional relationship with her patient, in a way that maintains the patient’s confidence in her abilities?