The Blog

All that's new in the world of dentistry

DDU reassured by Court of Appeal ruling that Ombudsman's decisions must be fair and just

DDU reassured by Court of Appeal ruling that Ombudsman's decisions must be fair and just


A recent Court of Appeal judgment has criticised the fairness and scope of the former Parliamentary and Health Service Ombudsman’s procedure for investigating clinical complaints against healthcare professionals. The GPs in the case were jointly represented by the MDU and another medical defence organisation but the judgment will also have positive implications for dental professionals.

The court considered exactly how the Ombudsman applied her discretion to investigate a complaint. It found an investigation should not begin where a complainant has another legal remedy open to them (other than complaining to the Ombudsman) unless the Ombudsman “is satisfied” that it was not reasonable to expect the complainant to use the alternative legal remedy. The Ombudsman must obtain and analyse information related to the complainant’s particular circumstances and not simply refer to general criteria. 

The court also provided welcome clarity on the standard applied by the Ombudsman to determine whether or not the exercise of clinical judgement was reasonable.

The judge commented:

The standard chosen by the Ombudsman is beguilingly simple but incoherent. It cannot provide clarity or consistency of application to the facts of different cases. There is no yardstick of reasonable or responsible practice, but rather a counsel of perfection that can be arbitrary. It runs the risk of being a lottery dependent on the professional opinion of the advisor that is chosen. It is unreasonable and irrational and accordingly, unlawful.”

John Makin, Head of the DDU said: “This judgment will have positive implications for dental professionals. When their clinical judgement is criticised, the Ombudsman can investigate what happened, reach conclusions and make recommendations if service failure is found. It is essential that the standards used by the Ombudsman to judge the clinical care provided to a patient are appropriate. Dental professionals should not be held to unreasonably high standards. It is also important that the Ombudsman stays within its legal powers and does not investigate exactly the same facts as a court would consider as this could present double jeopardy for dental professionals.  

“Those facing an investigation into their clinical practice should have reassurance that the processes being followed by the Ombudsman are fair and just. This judgment is good for healthcare professionals, and will also benefit patients who can be assured that the investigation was properly and fairly carried out.”


The DDU, the specialist dental division of the MDU, is a not-for-profit organisation wholly dedicated to our members’ interests. Our team is led and staffed by dentists with real-life experience of the pressures and challenges faced in practice.


We offer our members expert guidance, personal support and robust defence in addressing dento-legal issues, complaints and claims. Our customised services range from legal assistance to indemnity to appropriate CPD.

  2014 Hits
2014 Hits

Government working party should tackle runaway legal costs, says DDU

Government working party should tackle runaway legal costs, says DDU


The Dental Defence Union (DDU) said today the establishment of a Civil Justice Council working group to consider fixed legal costs in clinical negligence claims is a positive step in tackling runaway legal costs.

John Makin, head of the DDU, said:

“The announcement of a Civil Justice Council working group to examine excessive legal costs in clinical negligence claims is a delayed but still welcome first step. Proposals to make claimants’ lawyers costs more proportionate to the compensation their clients receive were first mooted back in 2015. We hope that things will move ahead faster now.

“Even with dental claims, which are generally lower in value than medical awards, the fees charged by claimant lawyers are still, on average, above the level of compensation awarded and that cannot be right. For example in one settled claim, the claimant’s costs were more than quadruple the settlement figure received by the patient.

“Patients who believe they have been negligently harmed must have access to justice, but fixed costs are fairer and will help to establish some much needed balance to the system.

“We will be happy to take part in the working party to represent our members’ views. However, disproportionately high costs charged by claimants’ lawyers are only part of the problem. The cost of litigation is becoming unaffordable for the dental profession and the NHS. The Government needs to take more decisive action. We urgently need more radical legal reform to restore balance to the system for clinical negligence claims.”


The DDU, the specialist dental division of the MDU, is a not-for-profit organisation wholly dedicated to our members’ interests. Our team is led and staffed by dentists with real-life experience of the pressures and challenges faced in practice.

We offer our members expert guidance, personal support and robust defence in addressing dento-legal issues, complaints and claims. Our customised services range from legal assistance to indemnity to appropriate CPD.

  2288 Hits
2288 Hits

The Tipping Point

The Tipping Point

It has been a little while since I last wrote this blog. Various things have taken over as they tend to do in life, and the blog unfortunately was something that seemed to never quite get done. However, I’ve now found myself back in the writing frame of mind, and I still seem to have opinions that some will agree with and no doubt others will disagree with, so here we go with some more ramblings of a Yorkshireman.

I have still been keenly observing what has been going on with regards to the profession over the last few months, and there still seem to be the same old problems surfaces that always have. I shall be writing about all of these issues in the near future.

The GDC seems to still be a problem to many, and personally whilst it seems to be to have become more aware of its previous problems, I don’t think it can truly move on whilst the current chair is still at the helm. It is time for a registrant to be in charge again, and for Dr Moyes to be moved to some other Quango where he can’t oversee damage to the morale of an entire profession.

Social media is also still a hot topic, and the GDC have now issued a case study on this. Some of the profession are obviously of the opinion that social media is the real world, and seemingly lack the ability to see it in its true context. There is a lack of humility in the profession where social media is concerned, and huge damage can occur to people when they believe that all they see on their iPhone is the unadulterated truth. It isn’t.

The lack of a new NHS contract, or anything really concrete is also concerning. However, I have a fairly simple view on this. We must be deluded as a profession if we think for one moment that there is suddenly going to be a fantastic new contract that will give the patients and us everything we ask for. I will guarantee that any new contract will primarily be worded to the benefit of the DoH so that the dentists can be held responsible for whatever goes wrong with it.

I’ll write more on these subjects in the coming weeks. But for this blog I though I would concentrate on something that has seemed to be brewing for quite a time, and might actually be reaching a tipping point.



Now, I can remember when my indemnity was about £1200 a year, and didn’t particularly change by much annually. But now, as a principal dentist working full time, it is £5800. This increase is over the period of about 10 years. We have seen an increase in both the activity of the GDC and especially negligence solicitors in this time, which it is claimed to account for the increase in our costs.

Indemnity is a little bit like car insurance in that you hope you will never need it, but it is a necessary evil to have. With the costs of legal representation being what they are, and the increase in the amount of cases being brought, it is not really surprising that costs rise year on year.

But how do we know how these costs are calculated individually? If you are a young driver with a fast car (which you will no doubt be flaunting on Facebook!) then you are likely to be a higher risk than an older person in a more sedate family saloon. This doesn’t necessarily translate to your dental indemnity though. It seems that the longer you are in the profession, the more likelihood you are to be sued and thus have higher premiums. Perhaps the reason for this is that when these practitioners retire, often the patients are found to have large amounts of remedial dentistry to be done. This may be the case, and I am aware of some dentists who have built up a good practice on rectifying this type of problem, especially when they perhaps encourage the patient to take some form of action against the previous dentist.

I’m not saying a wrong shouldn’t be corrected in that situation, but there do seem to be some dentists who are quite happy to throw colleagues under the bus in order to ensure they get the benefit of the patient charges to rectify the problems. Perhaps ‘There but for the grace of god go I’ would be an apt phrase to remind those considering this course of action. In addition, they will also find that their indemnity is going to increase also when this happens.

Because that’s how this kind of indemnity really works; the current members are paying for the claims that are currently being made and are going to be made in the future. In much the same way as the state pension works.  We can’t have an indemnity company suddenly have empty coffers, so they have a duty to ensure they assess the needs of the society to actively have the funds to cover their expenses. All of this is paid for by the membership.

However, this is where I spot a problem. There are some dentists who for what ever reason have higher indemnity costs. Whilst it always seems unclear why this is (as there is no apparent transparency in the fee structure when applied to an individual member), it is not unreasonable to consider that there might be an increased risk identified by the indemnifier. So they are basically saying there may be claims likely to be made against this person in the future. I have no problem with that in principle, but the issue comes when this person then leaves the society because the costs of indemnity have risen so high it is fundamentally unaffordable for them to keep paying.

What happens then? The costs of these future claims will be potentially met by the rest of the members who are maybe NOT doing the same sort of high risk dentistry as the member who has left. One can argue that this is a socially responsible and indeed professional manner in which a wronged patient can claim recompense. The problem occurs when there are more of the lower risk members paying for the expenses of the higher risk. Add into this situation that the societies offer ‘discretionary cover’, meaning that your claim only has the right to be considered by the society (and not actually guaranteed to be supported), then some people feel that they are paying an increasing amount of money for less than guaranteed and continued support in their time of need.

It seems to me that many of the members of the traditional membership societies are becoming increasingly worried about the inexorable rise in costs, and the discretionary nature of the support offered. I am aware of much conversation about the pros and cons of moving between the societies, and I’m also aware of the increase in membership of the Insurance based companies as a result of the concerns about this. One of the advantages of insurance based cover is the presence of a written contract, and the ability to make a complaint to the Insurance Ombudsman, which doesn’t exist with the discretionary membership. In addition, the insurance companies are also heavily regulated by the likes of the Financial Services Authority; the traditional indemnifiers however seem to have no regulator at all. The counter to this argument is that with discretionary cover the traditional indemnifiers can cover those who are not indeed members at the time of a claim, and for the benefit of the profession. I can recall this publically happening at some point in the past, and if I am not mistaken it was a human rights issue that became clarified as a result. However, just how many times has the discretionary cover been used in that manner, and not just to refuse cover?

The way I see it, we will reach a tipping point if something is not done soon to clarify more robustly the stance of the traditional indemnifiers, especially where their discretionary powers are concerned. I want to know that I have the support of the indemnifier in assisting me in my time of need, and not that at some point they decide to pull the plug due to a disagreement or just because it is easier and cheaper to settle (despite it being morally, ethically, and clinically wrong to do so). Does writing a blog of this nature give them grounds to refuse cover? Your guess is as good as mine since there is no real published criteria to know where you actually stand.

I can see there becoming a tipping point at some time in the future where all the good clients of the protection societies are no longer willing to put up with the uncertainty and the lack of transparency about the decisions made about any individuals’ costs and especially the discretionary element of support. These clients will leave, and since it is a requirement to have appropriate indemnity, there will be no shortage of new style companies happy to disrupt the market place and offer an alternative.

For example, what if the indemnifier needed a million pounds to cover its expenses and it had 10,000 clients? The cost per client is obviously £100 per client. But what if this indemnifier then starts to haemorrhage clients until it only has 1000? The cost per client is then £1000. These remaining clients are not necessarily going to be the high risk ones either, as it’s probably the case that those higher risk clients will have changed society much sooner in order to keep their costs down.

This is probably a gross oversimplification, and I’d actually welcome someone putting me right over this, especially from any of the defence societies. However, fundamentally what I see is an ever increasing demand on the resources of these societies, with a potentially decreasing number of members footing the bill, and those members not actually knowing if they will be fully supported by the society due to the discretionary nature of the membership. This is a prime situation for a tipping point to occur that changes significantly the whole model this operates under. This might be practitioners leaving, or it might be a re-evaluation of the business model to take things into account. However it is not something that can remain the unchanged as it appears to me unsustainable in the long term.

Before anyone says this couldn’t happen as the societies are so big and have so many customers, all I have to remind you of is Kodak not identifying the digital camera revolution, Encyclopaedia Britannica not recognising the  threat of the internet, and finally the inexorable rise of Uber in its disruption of how we utilise taxis.

All indemnifiers are also reliant on the need for legal cases to continue. By this I mean there is a symbiotic relationship between the defence and prosecution of dental cases, as without one side the other cant really exist the in the same way. Once a case is begun, then costs accumulate on both sides, and the legal profession feeds from this accordingly. These adversarial sides become dependent on one another, and in particular the defence side of negligence does not necessarily work under a no-win, no-fee basis in my experience and gets paid regardless of winning or losing (by our indemnifiers). Cynically, one would say it is therefore in the financial interests of those in the legal profession to have the current highly litigious situation in dentistry to continue, because there appears to be no shortage of work for them. The practice of dentistry becomes the raison d’etre for the existence of both the societies and those legal firms feeding it until we do something to stop it.

There may be protests from the indemnifiers of the tome of this blog; certainly I have taken no account of some of the truly awful issues that result in harm befalling patients by some practitioners. I am definitely of the opinion that we as a profession most certainly still need to put our house in order, and there is probably no room within it for some of the practices that some of our colleagues routinely feel are acceptable. However, unless you are part of the solution, then you are actually part of the problem, and I feel that there should be much more clarity evident in the world of indemnity, so that the profession can practice with the confidence that our patients need us to have when caring from them.

Otherwise, what’s the point in us continuing to serve our patients? That may well create a further tipping point…..of no one in the profession left to care.

Image credit - Guiseppe Milo under CC licence - not modified.

  7591 Hits
7591 Hits

Cyber Attacks – No Longer the Threat of Tomorrow



For the last 18 months’ we have been writing articles about the threat of cyber-attacks to the healthcare industry. This is indeed one of the most targeted sectors in the UK and the risk to your dental practice is significant. This has further been highlighted by the events of the last few days where the NHS has suffered its biggest attack of this kind.

What is the risk to you?

No business is completely safe from the threat of cybercrime, no matter how many firewalls you have or virus scanners, it only reduces your risk by a small fraction. Over the last few years we have seen major companies and organisations such as Talk Talk and MI5 affected, organisations who invest heavily in the reliability of their IT systems are just as vulnerable and you and me.

So how does it work? Often, we see businesses that have their IT systems or software encrypted by the criminals. This means that the hackers take control of your systems and lock you out. They usually request payment in the form of Bitcoins in exchange for releasing your data back to you. In the past when this has happened clients have still had major problems with their software afterwards and have had to get professional companies in to reinstate the corrupted data. If you decide not to pay the ransom, then the cybercriminals will often look to sell the data on the black-market and then it is lost forever.

What is your most valuable data?  

For any medical practice the value is in the patient medical records and appointment logs. This is the lifeblood of your business and without access to this the practice would struggle to continue, at least in the short term.

In the event that your patient records were sold on the black-market and got into the hands of other cybercriminals your patients could be at significant risk. Your patients can sue you for compensation if their medical records became accessible to others. You could face a claim by every single person affected by the data breach and furthermore, you would become liable for their legal costs as well as your own if you required representation or defending from such claims. The Information Commissioners Office (ICO) can also get involved too. They are the statutory regulator when it comes to data security and they will investigate a breach of data to see if there are grounds for imposing statutory fines against you! These fines can start from tens of thousands of pounds and there is no real upper limit.

So what is the solution?    

It is very difficult to guarantee your business will not be affected by cybercrime although I would recommend that you review your IT security arrangements anyway and make upgrades where possible. Something that is within our control however, is what measures we have in place to protect our businesses should something catastrophic happen.

To do this, it is advisable to have Cyber Liability Insurance cover in place. As a basic cover, this will protect you against the claims that could be made against you, including legal costs and statutory fines. However, there is further cover that can be included within a policy such as:


·         Damage to Hardware

·         Data Corruption & Reinstatement

·         Financial Crime i.e. money being fraudulently taken from your bank account

·         Data-Breach Expenses including reputation protection

·         Loss of Business Income


How much does a policy cost?


It all depends on a few variables:


·         How many patient records do you hold?

·         What is your gross annual revenue?

·         What limit of indemnity do you require?


The last question above will be an area that your insurance adviser can guide you on. The larger the practice and the more records held the greater the exposure to claims and statutory fines. Prices typically start from around £500 per year although we are usually able to save our clients’ money on their main Practice Insurance policy if a Cyber Liability policy is taken out.


Enquire with All Med Pro today by calling us on 0203 757 6950 or emailing us at This email address is being protected from spambots. You need JavaScript enabled to view it.. Further details can also be found on our website at

  3530 Hits
3530 Hits

Why Cyber Insurance Is Vital for 2017

Why Cyber Insurance Is Vital for 2017



It may come as a shock to you to understand that the healthcare sector is the primary target sector for Cyber attacks. With sensitive information on patient's medical history and general health, Cyber criminals know that if they obtain this type of data then it will be highly profitable for them. 

Attacks of this nature in the healthcare industry are becoming more regular, and more severe, than any other market sector.

We all hear about Cyber attacks of the largest scale when the make the headline news, however, even small, family run businesses are at risk. These proficient hackers are not selective about who they target as such; if there is an opportunity on any scale, they are likely going to take it.

If you have protection technology and software then it's a starting point, although don't think that this will be enough to protect your practice data and systems. 

It is now essential that you also protect your practice and business, financially, if something on this nature does occur. 

What are the true consequences of a Cyber attack?

If criminals obtain your patient data, there are a couple of things they may do with the data. 

Firstly, they can sell the data on the black market, which means your patients suffer a breach of confidentially, 

Or, secondly, they may request a ransom for keeping the data confidential, which means your business needs to honour their demands at great expense. 

Cyber attacks often result in the following for practice owners:

1. Redundant hardware and software, which needs to be replaced

2. Hefty litigation and legal costs in dealing with the matter in hand

3. Compensation requests from your patients, for the breach

4. Loss of revenue, whilst you get back up and running

5. Often it is combination of all the above

This is the cost element, but also there could be a direct impact on the reputation of your practice. 

After all, bad news spreads fast and it could certainly deter existing patients and new patients from choosing you over one of your competitors. 

Does your Practice Insurance sufficiently cover you? 

So you may be thinking that your Practice Liability Insurance covers you against such crimes. Here, it is essential to read the Terms & Conditions in detail, as most policies only offer an introductory level of cover. 

Specific Cyber Liability Insurance covers your practice, comprehensively, in the event that this nightmare materialises. 


Cyber Insurance policies vary, however many include:

·         Compensation payments to your patients

·         Your patient’s legal fees

·         Statutory fines

·         Hardware replacement costs

·         Data Corruption & Reinstatement Costs

·         Liability Cover for Affected Third Parties – e.g. patients

·         Cyber Financial crime

·         Data – Breach Expenses

·         Loss of Gross Revenue


As we are now part of a very digital working environment, it is your responsibility as a business owner to protect the data you hold in the form of patient records. 

In 2017, it is essential to not turn a blind eye, or be ignorant to what could happen, hoping that it won't happen to you.

For further information please get in touch with All Med Pro - 0203 757 6950 -

  2908 Hits
2908 Hits

Get on the bus with All Med Pro at the Dental Showcase 2016

Get on the bus with All Med Pro at the Dental Showcase 2016



Back in April this year All Med Pro teamed up with Hiscox Insurance to provide indemnity cover for Dental Professionals across the UK.

With indemnity costs on the rise and the well-publicised issues around discretionary indemnity and in particular the payment of claims we believe our offering provides a true alternative to the medical defence organisations. 

We are exhibiting at this year’s BDIA Dental Showcase at the London Excel on the 6-8 October. We will be located at stand C70 in a red route master bus. Our aim together with Hiscox Insurance is to offer support to Dental Professionals throughout their career and we invite you to join us and discuss your indemnity requirements.

Just one of the ways we have assisted our clients is by partnering up with a specialist provider of verifiable CPD - for dentists by dentists. This provides online CPD, resource library and access to training courses.

For Dentists who are claim free premiums start at £1,642.00* including insurance premium tax. We can also assist those who may have had claims, refused cover or GDC enquiries. The policy with Hiscox includes the following:


·        Up to £10,000,000 limit of indemnity

·        Run-off cover

·        Reputation protection

·        Good Samaritan acts

·        Data protection cover 

·        Loss of documents cover

·        Contract certainty 

·        12 month interest free direct debit for the medical negligence cover


We can also provide indemnity cover for hygienists, therapists, technicians and dental nurses.



For further information click here -


*This does not include the cost of medico legal expenses and CPD. 

  2748 Hits
2748 Hits

Summary of Products & Services Available from All Med Pro

Summary of Products & Services Available from All Med Pro


Did you know that AllMedPro can assist you with any of the following products and services?

  • Medical Indemnity Insurance (individuals and vicarious entity cover)
  • Practice Insurance (buildings, contents, public & employers liability)
  • Practice Overheads / Locum Cover
  • Online Dental CPD & Document Resource Library
  • Pressure Vessel Inspection Cover
  • Property Owners Insurance (buy-to-let, holiday home, unoccupied)
  • Home Insurance
  • Hands & Eyes Insurance
  • Directors & Officers Liability Insurance
  • Dental Laboratories (including products liability)
  • Aesthetics Medical Indemnity Insurance
  • Private Medical Insurance
  • Travel Insurance

We can also refer you to one of our specialist partner firms for:

  • Financial Advice
  • Legal Services
  • Accountancy Services
  • Practice Sales
  • Patient Payment Plans


Just pick up the phone and give us a call to discuss any other insurance requirements you may have on 01793 820100

or email us on This email address is being protected from spambots. You need JavaScript enabled to view it..


T. 01793 820100   E: This email address is being protected from spambots. You need JavaScript enabled to view it.  W:
All Med Pro is a trading style of All Medical Professionals Limited who are authorised and regulated by the Financial
Conduct Authority Number: 309853. All Medical Professionals Limited registered in England number 04468555.
Registered office: 59B Thornhill, South Marston, Swindon, SN3 4TA
  4160 Hits
4160 Hits

Please do not re-register if you have forgotten your details,
follow the links above to recover your password &/or username.
If you cannot access your email account, please contact us.