WELSH HEALTH CIRCULAR

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Laureen Cole
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WHC (2006) 052 WELSH HEALTH CIRCULAR Parc Cathays Caerdydd CF10 3NQ Cathays Park Cardiff CF10 3NQ Issue Date: 10 August 2006 Status: Guidance Title: Consent for school dental inspections and dental

1 WHC (2006) 052 WELSH HEALTH CIRCULAR Parc Cathays Caerdydd CF10 3NQ Cathays Park Cardiff CF10 3NQ Issue Date: 10 August 2006 Status: Guidance Title: Consent for school dental inspections and dental epidemiological surveys For Action by: s of Local Health Boards Action required See paragraph(s) : For Information to: See attached list Sender: Wendy Chatham, of Quality, Standards and Safety Improvement ate, Department of Health and Social Services, Welsh Assembly Government, Cathays Park, Cardiff, CF10 3NQ. Tel: (029) National Assembly contact(s): Carl Eley, Head of Healthcare Standards, Quality, Standards and Safety Improvement ate, Department for Health and Social Services, Welsh Assembly Government, Cathays Park, Cardiff, CF10 3NQ. Tel: (029) , Fax: (029) , carl.eley@wales.gsi.gov.uk Enclosure(s): None

2 CONSENT FOR SCHOOL DENTAL INSPECTIONS AND DENTAL EPIDEMIOLOGICAL SURVEYS Dear Colleague Purpose 1. To provide revised guidance on the issue of consent for both school dental inspections and dental epidemiological surveys. Background 2. We have recently become aware that the Department of Health in England has revised its guidance on negative consent for dental surveys. The previous guidance had implied that it was acceptable to rely on negative consent, but lawyers at the Department of Health and the Welsh Assembly Government are now advising that this guidance should no longer be followed. Advice 3. The functions of Local Health Boards (Dental Public Health) (Wales) Regulations 2006 provide that a local health board will have the function of dental inspections of pupils in attendance at schools maintained by Local Education Authorities. As dental inspections and dental epidemiological surveys will inevitably involve physical contact between a dentist and a child, it is necessary to obtain consent from the child (if he/she is competent to give consent) or from a person with parental responsibility for the child, in accordance with the Guidance on Consent to Examination and Treatment (issued with WHC (2002)42). Whilst the risk of any proceedings being brought against a dentist or Local Health Board in relation to a school dental inspection or epidemiological survey might be considered low, in the event that there was, a dentist may not be able to prove that consent had been obtained simply on the basis that a letter had been sent out to parents and no objection had been received. 4. We are aware of concerns about the impact that obtaining positive consent might have on the NHS oral health epidemiology programmes within England and Wales. Where programmes are surveying older children eg year olds it is likely that a child of this age would be competent to consent to the dental examination, provided it is explained to them what the process involves, for what purpose the information obtained will be used, and that they can refuse to take part if they wish. If the competent year old child consents, this will be sufficient. 5. In relation to younger children, along with the Department of Health, we are exploring whether positive consent to dental inspections/surveys obtained from the child s parent (or relevant person with parental responsibility) when their child begins school would be sufficient proof of consent. 6. The Welsh Assembly Government considers that a dentist performing these inspections and surveys might be able to rely on such consent, as long as sufficient information is provided to the parent at the time that consent is obtained to enable their consent to be fully informed. It would be good practice to inform parents how many times the procedures would take place and in which school years, and that they may withdraw their consent at any time. It would also be good practice to write to parents to inform them when examinations/surveys are about to be carried out and reminding them that they may withdraw consent if they wish. 2

3 7. As this will be additional information that would need to be obtained from parents at the time their child starts school, we will need to discuss with Assembly education colleagues and Local Health Boards how this might be best achieved prior to issuing further formal guidance. Yours sincerely Wendy Chatham of Quality, Standards and Safety Improvement ate Department of Health and Social Services 3

4 DISTRIBUTION LIST s Medical s s Medical s Secretary Postgraduate Dean information services Secretary Regional Head of Health Board Secretary Welsh Council Representative Wales Secretary Regional Secretary General Secretary Assistant Officer for Wales IR Officer Regional Secretary Board Secretary for Wales Welsh Executive Information Officer Business manager Librarian Secretariat Regional s Librarian Children s Commissioner Head of International Regulation Commissioner for Wales Head of Welsh Affairs person Local Health Boards Local Health Boards NHS Trusts NHS Trusts NHS Confederation Welsh NHS Confederation Board of Community Health Councils in Wales Welsh Local Government Association Commission for Racial Equality British Dental Association in Wales University of Wales College of Medicine University of Wales College of Medicine British Medical Association (Wales) UNISON Royal College of Nursing (Wales) British Dietetic Association British Orthoptic Society The GMB Community Pharmacy Wales Royal College of General Practitioners Wales TUC Chartered Society of Physiotherapists Society of Radiographers Society of Chiropodists and Podiatrists Union of Construction Allied Trades and Technicians Royal College of Midwives Royal Pharmaceutical Society of Great Britain Wales Council for Voluntary Action Institute of Health Care Management Welsh Division Association of Optometrists British College of Optometrists Statutory Committees NHS Wales Regional Offices Health Commission Wales (Specialist Services) National Public Health Service Welsh Language Board / Bwrdd yr Iaith Gymraeg Healthcare Inspectorate Wales Children s Commissioner for Wales Children in Wales Council for Healthcare Regulatory Excellence Disability Rights Commission Wales Disability Wales General Medical Council Wales Healthcare Commission Health and Personal Social Services Regulation and Improvement Authority Interim Health Information & Quality Authority Mental Health Act Commission National Leadership & Innovation Agency for Healthcare 4

5 Manager Manager Auditor General for Wales Chief Inspector man of Wales Regional Manager Policy Officer Wales Secretary to the Welsh Board of Operational Policy Specialist Pharmacist, Quality Assurance and Control Wales National Institute for Health & Clinical Excellence National Patient Safety Agency Welsh Health Estates Postgraduate Medical Education and Training Board Welsh Risk Pool Health & Safety Executive The Parliamentary & Health Service Ombudsman Public Services Ombudsman for Wales NHS Centre for Equality & Human Rights NHS Quality Improvement Scotland Wales Audit Office Wales Centre for Health Care Standards Inspectorate for Wales Social Services Inspectorate for Wales The Academy of Medical Royal Colleges Academy of Royal Colleges in Wales Royal College of Speech & Language Therapists Association of the British Pharmaceutical Industry Wales British Psychological Society MENCAP Cymru College of Occupational Therapists MIND (National Association for Mental Health) Cymru Royal College of Midwives WIHF (Wales Independent Healthcare Forum) Welsh Pharmaceutical Quality Assurance 5

WELSH HEALTH CIRCULAR

WELSH HEALTH CIRCULAR WHC (2008) 051 Parc Cathays Caerdydd CF10 3NQ Cathays Park Cardiff CF10 3NQ Issue Date: 11 June 2008 Status: Action Title: Priority Treatment and Healthcare for Veterans For Action