Action On DTC Orthodontics - CQC Takes The Lead
- Details
- Published: Thursday, 01 July 2021 07:36
- Written by Chris Tapper
- Hits: 2294
The Care Quality Commission has effectively taken the lead in regulating Direct To Consumer Orthodontics, following the General Dental Council’s failure so far, to take any direct action on overseeing the growing industry.
The GDC disappointed many dental professionals in May, when it finally issued a statement on its position regarding DTC orthodontics.
The growing worldwide DTC business has caused many clinicians in the United Kingdom concern, since the vast majority of treatments are being planned without a direct clinical examination of patients being carried out in order to assess the suitability of the patient for orthodontic treatment.
‘Consultations’ are mainly carried out virtually, and patients either take their own impressions themselves, or are scanned in centres by operatives who are not generally qualified dentists or orthodontists.
One of the main criticisms of the DTC orthodontic business was that many patients were said to be unaware of the identity of their supervising dentists.
The GDC was under mounting pressure to act on regulating the activity of DTC companies. The British Orthodontic Society and the British Dental Association were both active in bringing concerns directly to the GDC.
In February 2020, the GDC “called for evidence” on the problems associated with DTC orthodontics and acknowledged that remote orthodontic work falls within the practice of dentistry.”
In May 2021, the GDC issued a statement on its position with regard to DTC orthodontic services.
The GDC said “These services fall within the legal definition of dentistry so can only be performed by dentists and dental care professionals who are registered with the GDC. All dental professionals must adhere to the GDC’s Standards for the Dental Team. Anybody practising dentistry while not registered with the GDC could be subject to prosecution for illegal practice.”
The GDC statement went on to say, “At present, there is no effective substitute for a physical, clinical examination as the foundation for that assessment.”
The GDC’s statement ended “Those who do not comply with the Standards for the Dental Team, indemnity requirements and authoritative clinical guidance put patient safety, and their registration, at risk.”
But the GDC’s stated position fell well short of expectations, according to the BDA and dental commentators.
On the BDA News website, the BDA wrote that “Newly published guidance for patients on the risks of direct-to-patient orthodontics is no substitute for meaningful regulation.”
The BDA said DTC orthodontics “Can lead to fundamental changes to a patient’s mouth that may be irreversible.”
CQC Acts
But yesterday, the Care Quality Commission published on its website, the CQC’s "Registration requirements for providers of ‘direct-to-consumer’ orthodontic treatment"
The CQC said “We consider orthodontic treatments provided to patients following an intra oral scan or when a patient has taken impressions themselves to be regulated activity."
“This is in the same way that treatment planning and diagnosis associated with aligners is also regulated activity.”
The CQC went on to explain that regulated activities are listed in the Health and Social Care Act 2006 and are encompassed in the regulated activities of Treatment of disease, disorder or injury and Diagnostic and screening procedures.
The CQC continued ‘Where a service is carrying on what the law describes as a regulated activity, that provider has to register with the CQC.”
“This enables us to work together to understand how the service operates and to protect people who use the service through our regulation.”
“To register with us, providers must assure us that they are able to provide safe and effective care in line with relevant legislation and guidance.”
The statement concluded “Providers cannot legally carry out regulated activities without registering with us. It is an offence under Section 10 of the Health and Social Care Act to provide regulated activities without being registered with CQC. We can use our regulatory powers to prosecute such offences.”
The publication of the CQC’s registration requirements came a few days after an orthodontist said “Knowing the name of the clinician who provides your orthodontic treatment should be a fundamental right.”
Dr Asif Chatoo, is an orthodontist who founded the first UK clinic to be dedicated to lingual orthodontics.
He made the comment after seeing a case study in the 2020 review of the Dental Complaints Service (DCS), which highlighted the “worrying growth” in DTC orthodontics.
“The patient did not know the full name of the clinician who wrote their treatment plan. This meant that they had no-one to turn to with their concerns or questions about their treatment.”
“The case study described how following treatment the patient complained to the company who provided the aligners because they could see no difference in their teeth. Initially the company would only offer another course of treatment involving a second finance plan.”
“Fortunately, the DCS intervened, and the company cancelled the finance agreement with the patient who declined a second course of "remote" orthodontic treatment.””
Dr Chatoo said "Several things about this case study concern me. I am shocked that the initially the company declined to share the name of the clinician who provided the treatment plan. Without the intervention of the DCS, the patient would not have had a refund and their credit rating might have been jeopardised due to the finance agreement not being cancelled.”
“This highlights the risk of an arrangement with an online company as opposed to with an individual clinician or practice."
Following the GDC’s statement in May, the British Orthodontic Society’s Director of External Relations Anjli Patel said, “As the voice of orthodontics in the UK, we still have reservations about how any wrongdoing by DIY orthodontic companies could be picked up by authorities and we don’t want patients falling through regulatory cracks.”
“Patients don’t know what they don’t know – we will endeavour to give them all the facts.”
GDPUK reported that a BOS members’ survey from April 2021 showed that 82% of members were concerned about more patients seeking DIY orthodontics during the pandemic, and 98.92% wanted to see the GDC take action.
Direct to Consumer Orthodontic concerns
I am pleased to see some public statements by both the CQC and GDC - however non of this really WARNS THE PUBLIC of the additional risks of bypassing currently safe, high-quality regulated dental care by their Dentist or Orthodontist !!What are they afraid of if protecting the public is their No.1 job ?!?
Are there some big companies with deep pockets who can intimidate and bypass those who regulate safety, thus providers unregistered with GDC/CQC bodies providing illegal services or leaving patients vulnerable?
The PUBLIC DO NOT KNOW THIS and assume as advertising widely on social media, TV, radio, sides of buses etc, they must all be fully safe and compliant, ERRONEOUSLY !!
Many thanks to those colleagues who were BRAVE and PUBLIC enough to warn everyone about the potential dangers in the Daily Telegraph back in 2020; it's long-time for 'bodies' to go very public even now!
https://www.telegraph.co.uk/news/2020/01/01/quest-perfect-smile-putting-instagram-generation-risk/
Tony.
You need to be logged in to leave comments.
Report