The needs and individual situations of patients seen in different workplaces can vary enormously, but one common theme faced by dental professionals is the requirement to try and manage the expectations of those patients.

Although this has always been important, the current difficulties with providing care during the pandemic have highlighted the importance of taking a team-based approach to this fundamental aspect of a patient's experience of their treatment.

Good communication

Good communications are a crucial component of making sure patients and anyone who attends with them know what to expect before, during and after an appointment. This has become especially important over the last couple of years as the systems and procedures in all workplaces have needed to change a number of times.

Clear, concise and consistent information is an essential starting point when considering how to try and manage the expectations of all patients, so think carefully about all aspects of your communication.

Remember, first impressions count, so look at any publicity or information material that is provided. Make sure it is up to date, relevant and does not set you up to fail. Unfortunately, some 'promises' are unachievable. Look at the aspirations that are set and think if you can meet them for every single patient who attends.

Here are some examples of phrases that are very subjective, and might lead to difficulty.

• "Pain free dentistry!"
• "We provide a friendly, relaxed and calm environment."
• "Satisfaction guaranteed..."

Consider the timelines indicated. If the service you provide incudes any mention of the likely time it will take to achieve the outcome, no amount of small print will take away from the expectation that care will be completed by that date.

You should also be careful about making any sort of claims of expertise or specialism. The GDC have provided advice on ethical advertising, and it's important you follow this.

Getting the message across

Make sure that anyone who communicates information to any patient is fully up to date with the latest requirements and knows what to say to all patients. If changes need to made to any existing appointments, make every effort to check that the information has been received.

Don't forget to make a note about any postoperative advice that is given. If you're supplementing oral advice with written information, double-check it's up to date so there are no contradictions between what's written down and what you said.

It's also helpful if everyone in the workplace is consistent with the messaging given. It can be both confusing and frustrating for the patient if they're told by the treating clinician that they need to return urgently, only to be told when booking the appointment that there is nothing available for more than a month.

If you're speaking to a patient, keep notes of the conversation. It is important these are consistently recorded in the same place so everyone who needs to access them knows how to do so.

If sending out the information another way - whether it's email, an instant messaging service or letter - you need to be aware of the requirement to keep any information about a patient confidential, so check you have permission from the patient to use that method of communication and keep your records up to date.

For example, it's a good idea to have a system for regularly checking that you have the preferred email address or telephone number for patients, as well as their preferred method of communication.

Managing yourself

Making sure patients have a realistic expectation of their treatment isn't just about their considerations. Your own are important too, and again, you need to be clear about what can be delivered.

Have you thought about the number of appointments needed? The length of those appointments? When you'll be available to deliver the care? A patient may not appreciate these demands on your time or ability and will rely on you to tell them. Not doing so could lead them into have unrealistic expectations about what you can do to help them.

If you're providing extensive treatment plans, build in time to reassess the patient's expectations. It's not uncommon for expectations to change over time, but it is very disappointing to be told by a patient at the end of a lengthy course of treatment that they are unhappy with the outcome. Regular reviews of what the patient is expecting can help detect any divergence from what was agreed originally to what the patient would like to achieve now.

Remember, it is a GDC requirement (Standards 2.3.8) to update any treatment plans and cost estimates in writing as well as verbally. When updating the time treatment is likely to take, it can be helpful not only to make a note in the records but also update the patient in writing.

Good communication is a team effort so it is helpful for everyone if it is included as part of the initial and ongoing training of the whole team. If you manage or lead a team, think about how you can build this into any induction training for new staff and how best to incorporate it into the ongoing training that is provided for the team.

Remember, the DDU can provide training on a wide range of dento-legal topics with practice presentations, as part of GROUPCARE membership.

If things go wrong

No-one wants to have an unhappy patient, but while it is impossible to please all the people all the time, many issues or concerns can be nipped in the bud with a suitable apology, explanation and correction.

To be able to do this it is important that patients think they will be listened to if they express dissatisfaction. Working in an environment where patients feel valued can help. If they don't, a general expression of dissatisfaction could become a formal complaint, made either to the practice or to someone else.

If a patient is unhappy, they might generally have one of three options:

• let you know
• not let you know and not return
• not let you know but continue with the treatment.

The first of these might seem uncomfortable at the time, but because you are given the opportunity to address the issue of concern, it is the best situation.

The last option is the most difficult to deal with because you're unaware the patient is unhappy, so anything else that happens might be the 'straw that breaks the camel's back'. A seemingly trivial matter might result in a lengthy complaint about all previous care provided by everyone.

Team working

Everyone in the practice should be trained in how to handle complaints. As with communication, it is ideal for this to be included in both the induction training and ongoing training programmes.

It is helpful to have a zero-tolerance policy on aggressive and abusive behaviour. It is important that patients are aware of this policy so include a notice at reception or on the website. Hopefully it will never need to be used, but if you do not have it in place, you cannot invoke it.

In conclusion, sticking to the basics is most often a good starting point. Ensure there is good communication with all patients, try to create an environment where people feel listened to, and think carefully about the expectations you are setting.