Dental Nurse Insurance in the UK

Dental nurse liability insurance is not only required for General Dental Council registration, it can also help protect you, your career and your patients if you make a mistake. Even the most careful and well-trained dental nurse can make mistakes on the job, and indemnity insurance can help protect you financially if this happens to you. Here's what you need to know about dental nurse insurance to get the right cover.

What is Dental Nurse Insurance Cover?

The most common type of insurance for a dental nurse is indemnity insurance, which is required for GDC registration, but there are other types of insurance you might want or need to consider as well. Here is a brief summary of some popular types of insurance coverage for dental nurses, and what to look out for in a good policy.

Dental Nurse Indemnity Insurance

Indemnity insurance can protect dental nurses against negligence claims made by patients—or in other words, claims that the professional advice or service you gave caused the patient harm.

What does dental nurse indemnity insurance cover?

If you are sued by a patient, an indemnity insurance policy will pay for:

  • An expert opinion to support your case
  • Solicitor defence fees
  • Financial compensation to the patient if you're found liable

A comprehensive nurse insurance policy can provide a range of covers in additional to the GDC-required indemnity cover, but actual coverage can vary depending on the insurer. Here are some extended features to look for in a nurse indemnity insurance policy:

  • Indemnity cover for clinical negligence (details above)
  • Worldwide cover for Good Samaritans Acts
  • Professional indemnity cover for if you train or teach
  • Hiring a public relations firm to protect your professional reputation
  • Court attendance costs (with a daily court attendance allowance)
  • Legal defence costs to defend clinical negligence allegations
  • Legal defence costs related to clinical negligence GDC hearings

While some employers provide indemnity cover to their employees, it might not provide as many extra coverages as a specialist product that you buy yourself. It's worth asking for details about work-provided indemnity insurance to decide if it is sufficient for you—and if it's not, you can buy your own policy. For example, your employer's indemnity probably won't provide assistance if you're the subject of a GDC investigation, but your own liability cover should.

The GDC recognises three types of indemnity cover for dental nurses:

  • Dental defence organisation membership (indemnity provided through your employer's membership or your own membership)
  • Professional indemnity insurance held by you or your employer
  • Indemnity provided by NHS bodies

Occurrence-Based vs. Claims-Made Cover

According to a "Implementing Compulsory Indemnity: exploring the practical issues", a consultation response to Standards Committee of GDC, Dental Protection, 2005, fewer than 25% of all claims made against dentists happen within 12 months of treatment and a further 25% between one and two years. This means that more than 50% of claims against dentists are made more than two years after treatment.

If a dental patient doesn't discover or make a claim for an error you made until years after they had treatment, will your insurance cover you years later? It depends.

Occurrence-Based Cover

Dental nurse indemnity insurance can be sold on either a "claims-made" or "occurrence-based" cover. Occurrence-based cover provides perpetual indemnity for treatments that were provided during the period of insurance, which is normally 12 months long. So, as long as the treatment occurred while you were covered, you'll be covered forever (even if you cancel your policy or let it expire).

Occurrence-based indemnity insurance is typically more expensive because it provides longer-term protection.

Claims-Made Cover

On the other hand, claims-made cover means your policy will only protect you while you have an active insurance policy. If your policy expires or is cancelled, then your cover is terminated and you won't be covered even for an incident that occurred while your policy was active.

You need to be insured both at the time of the alleged incident and also when a patient makes a claim against you.

For example, if you had indemnity insurance that expired at the end of 2019 when you retired, then a claims-made policy would not cover a claim made in 2020 related to treatment you gave a patient in 2019 (even though when you gave the advice your indemnity policy was in force).

Claims-made insurance is more popular with commercial insurers and may be cheaper.

Run-off Coverage

A dental nurse with a claims-made policy who retires, takes a break, goes on maternity leave or changes professions should buy a "run-off" indemnity policy to protect against new claims made after your policy expires or is cancelled.

Retroactive Date

If you are renewing or switching insurers, a claims-made indemnity policy will have a "retroactive date" which is the first date from which you've held continuous PII cover. Even if you switch insurers, your retroactive date will remain the same, so long as you don't have a gap in cover between policies.

For example, say your first PII policy is with Insurer A from 13 July 2019 until 12 July 2020. You're unhappy with the renewal price in 2020 and decide to switch to Insurer B, buying a policy that runs from 13 July 2020 until 12 July 2021. The retroactive date on the second policy is 13 July 2019—the start date of your first policy with Insurer A. What does this mean? If you're sued in the second year for work done in your first year, your second insurer will actually cover you.

Business Use Vehicle Insurance

Locum dental nurses must ensure that their car insurance covers "business use", which is required for anyone driving between multiple work locations. Dental nurses who simply commute to and from a fixed place of work do not need "business use" (but they must declare their commuting to their insurer).

While car insurance that covers commuting and business use typically costs more, it is critical to declare your use properly—failing to do so can invalidate your insurance and essentially means you're an uninsured driver.

In addition, there are many other types of business insurance that you might need. Talk to a specialist insurer or broker if you are unsure of the coverage you need.

Legal Expenses Insurance

Some dental nurses also buy a business legal expenses policy, which provides access to an expert legal team and pays your legal defence costs in certain situations such as:

  • Employment disputes
  • HMRC tax enquiries
  • Contract disputes
  • Debt recovery
  • Identity theft
  • and more

These are the most common types of business insurance for a nurse.

Why Do Dental Nurses Need Insurance?

Dental nurses in the UK need professional indemnity insurance because it's required for GDC registration—plus it can protect you, your career and your patients if you make a mistake. In fact, dental professionals have always been required to hold indemnity insurance so patients entitled to compensation can make a claim. As of November 2015, however, the GDC has made declaring you're covered a requirement for registration.

DCPs (dental nurses, dental hygienists, dental therapists, orthodontic therapists, dental technicians and clinical dental technicians) declare that they have indemnity cover (or that they will by the time they start working) during their annual renewal period in June/July; dentists make this declaration during their annual renewal period in November/December.

Even if indemnity insurance wasn't required, it is critical for a dental nurse. Consider that even if a claim is unfounded and you have done nothing wrong, if a patient sues you'll still need to pay for legal advice and defence. And legal costs can quickly run into the thousands of pounds.

How to Buy Dental Nurse Insurance

A dental nurse can obtain indemnity insurance:

  • Through membership of a mutual defence union or protection society
  • From a commercial insurance indemnifier

Mutual Indemnifiers offer discretionary cover

A mutual indemnifier is a not-for-profit organisation and the assets and liabilities of member dentists are included in the collective mutual fund. As a result, indemnity insurance from a mutual indemnifier is usually cheaper, but when making decisions about defending claims keep in mine that they balance the wider interests of the membership against the individual interests of a single member. In other words, mutual members have a right to seek assistance with a claim but the organisation is not obliged provide it (this is called "discretionary cover").

Commercial insurers offer contractual insurance

On the other hand, when you buy dental nurse insurance form a commercial insurer, they have a legal obligation to accept qualifying claims and make resulting payments (subject to the terms of the policy, of course).

How Much is Indemnity Insurance for Dental Nurses?

A dental nurse will pay in the region of £65 to £105 a year for liability insurance. The cost of nurse liability insurance ultimately depends on a number of factors, such as the coverages you need, the cover limits, your previous claims history, the scope of your work (e.g., basic duties or extended duties), how much you work (e.g., full time or part time) and even where you work. Below are lists of basic and extended duties from the General Dental Council's Scope of Practice guide:

List of Basic Duties

  • Prepare and maintain the clinical environment, including equipment
  • Carry out infection prevention and control to prevent physical, chemical and microbiological contamination
  • Record dental charting and oral tissue assessment
  • Prepare, mix and handle dental bio-materials
  • Provide chairside support to the operator during treatment
  • Keep full, accurate and contemporaneous patient records
  • Prepare equipment, materials and patients for dental radiography
  • Process dental radiographs
  • Monitor, support and reassure patients
  • Give appropriate patient advice
  • Support patient and colleagues if there is a medical emergency
  • Make appropriate referrals to other health professionals

List of Extended Duties

  • Further skills in oral health education and oral health promotion
  • Assist in the treatment of patients under conscious sedation
  • Further skills in assisting in the treatment of patients with special needs
  • Further skills in assisting in the treatment of orthodontic patients
  • Intra and extra-oral photography
  • Pouring, casting and trimming study models
  • Shade taking
  • Tracing cephalographs

List of Extended Duties Carried out on Prescription

  • Take radiographs
  • Place rubber dam
  • Measure and recording plaque indices
  • Remove sutures after the wound has been checked by a dentist
  • Construct occlusal registration rims and special trays
  • Repair the acrylic component of removable appliances
  • Apply topical anaesthetic to the prescription of a dentist
  • Construct mouthguards and bleaching trays to the prescription of a dentist
  • Construct vacuum formed retainers to the prescription of a dentist
  • Take impressions to the prescription

FAQs

Yes, dental nurses are required to have indemnity insurance. In fact, dental nurses must provide a declaration of indemnity insurance (either that you have it or that you will before you start working) in order to register or renew with the General Dentist Council (GDC).

No, trainee or student dental nurses do not need indemnity insurance, since they are not yet registered with the GDC. That said, the trainee's employer or supervising registrant must have indemnity insurance, because they are responsible for the student's work. In addition, the employer or supervising registrant's policy must specifically cover them to train or supervise staff working towards a qualification.

At a minimum, a dental nurse needs indemnity insurance (which is required for registration with the BDA). A dental nurse may also want or need additional coverages such as legal expenses (e.g., to cover contract disputes) or business use coverage for their car if they work in multiple locations.

If a dental nurse is sued for negligence by a patient, indemnity insurance for dental nurses covers expert advice, legal defence costs and financial compensation for a patient if the nurse if found liable.

NHS employees and contractors ordinarily get indemnity cover provided by the NHS, as will some private dental nurses, but this may not be sufficient—in fact the BDA advice document on professional indemnity insurance states that NHS or Crown indemnity does not preclude the need for personal indemnity. In fact, all forms of Crown indemnity are discretionary, only covering claims related to work carried out under the terms of your employment, not private work nor GDC cases.

For example, your employer's liability cover might not cover fitness to practise allegations or a GDC disciplinary action. If you have indemnity insurance through your employer, it's best to ask for written confirmation of what is covered and excluded so you can decide if you need additional cover.

All dental nurses need indemnity insurance, whether you work in a general private practice, an NHS practice, a specialist referral practice, a local NHS dental service, prisons, the MOD or a hospital.

The professional indemnity insurance offered by many insurers only covers financial loss of a client—not bodily injury or illness. A nurse needs a special "medical" type of indemnity insurance to cover injuries related to their professional work.

Dental Nurse Employment and Earnings Statistics

According to the latest Annual Survey of Hours and Earnings (ASHE), the average pay for a dental nurse in the UK is £15,098 a year; but dental nurses working full time earn an average of £18,791. Here are some official statistics on dental nursing employment in the UK:

Dental Nurse Employment Statistics UK
Number of Jobs37,000
UK Average pay (full time)£18,791
UK Average pay (part time)£10,827
UK Average pay£15,098

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