The BDA's 'Was Not Brought' (WNB) toolkit has been extended to help dental teams safeguard adults at risk of harm (AAR) if they miss dental appointments.

Following trial periods in several clinical settings, the purple pathway (WNB-ARR) is now to download.

The pathway extends the scope of the BDA’s existing safeguarding pathways and joins the green, pink and blue pathways for children and young people who miss appointments. The purple pathway follows the familiar style of the existing pathways to promote a patient centred approach to the safeguarding of adults at risk of harm and encourages early intervention and communication with relevant professionals.

The BDA has worked with James Bird, NIHR in-practice fellow and senior dental officer and Jenny Harris, consultant in paediatric dentistry to update the ‘Implementation Guide’. The downloadable flowchart is accompanied by template letters and template notes to make the implementation of the pathway straightforward.

The original innovative green children’s and young people pathway (WNB-CYP) was developed and evaluated in the community dental service in Sheffield by Jen Kirby and Jenny Harris, consultants in paediatric dentistry at Sheffield Teaching Hospitals NHS Foundation Trust. They later added pathways for children who were looked after or who were the subject of a child protection plan (pink) and for orthodontic patients (blue).

These pathways, along with an accompanying implementation guide, template letters, and notes, provide an easy-to-follow way of consistently responding when children and adults at risk are not brought to appointments. This helps promote timely reappointment and clarifies when to consider sharing information with other health and social care professionals.

James Bird said, “The WNB purple pathway provides a useful prompt in reminding all dental professionals that liaising with other health and social care professionals can be beneficial, and could be crucial, in protecting vulnerable members of our local communities from harm.”

Jo Adlington, specialist in special care dentistry at Sheffield Community & Special Care Dentistry, said, “These letters have been in use for adults from vulnerable groups in Sheffield for some time now, and they have proved useful in encouraging carers, particularly in residential and nursing homes, to engage with us regarding attendance. They also provide clear evidence, if required, to support our colleagues in adult safeguarding in protecting adults at risk of harm.”

Giten Dabhi, chair of the BDA’s England Community Dental Services Committee, said, “Many vulnerable adults are unable to come to dental appointments without support.

“We are putting a vital framework in place to provide the right support and safeguarding where the term ‘did not attend’ is frankly inappropriate.

“For both children and adults, we’ve set out to ensure a safety net is in place, so no patients fall through the cracks.”