The Care Quality Commission (CQC) has released a signposting statement
setting out their initial thoughts on a new regulatory model for primary dental
care practices. Their aim is to make changes quickly but without compromising
their commitment to co-production and quality. The plan is to actively engage
dental providers, patients and other stakeholders to ensure a regulatory model
that reflects the key characteristics, risks and quality issues of the sector
is developed, and is seen as fair, transparent and effective in helping to
improve services for those who use them.
The regulation of dental care is extremely
important as good dental care plays an important role in people’s health and
wellbeing. Having poor oral health has been shown to be linked with many other
health diseases such as stroke, diabetes and heart disease. It can also have a
negative effect on a person’s quality of life, such as not sleeping or eating
properly.
Inspections of primary care dental services by the CQC, including NHS
and private dental services, in the last two years have identified that,
compared with the other sectors that are regulated by them; dental services
present a lower risk to patients’ safety.
However,
there are already a number of organisations involved in monitoring the
quality and safety of dental services and dental care professionals; The
General Dental Council (the professional regulator), the Care Quality Commission
(the systems regulator) and NHS England (the commissioner of NHS dental care
services, which also holds a list of suitable performers) have a mutual
interest in ensuring that patients receive high-quality, safe dental services
from professionals and organisations that are competent and meet national
standards, and that services improve. Where concerns about the safety of dental
care emerge, these three organisations between them have the legal powers to
intervene to mitigate risks to patients and the public. Currently, the
potential for significant overlap within this structure, as well as the
opportunity for regulatory gaps to emerge is significant. Therefore, the CQC, the
General Dental Council and NHS England, along with NHS Business Services
Authority, have established a Tripartite Programme Board to review the approach
to dental regulation and inspection across England, assess current arrangements
and determine an effective model for regulation for the future.
The principles and key elements of CQC’s operating model will be
adopted, but some of the details will be different. The CQC will explore with
their partners how they use data and share information. They will also explore
how Experts by Experience are used in their new approach, and whether or not a
specialist adviser is required on every inspection.
Approximately 10% of providers will be inspected, starting from
April 2015. The general model of inspection includes the ability to rate care
providers on their quality of care. It is not intended to rate primary care dental
services when the new approach commences in 2015/16; however, as part of this
new approach the CQC is seeking feedback on whether ratings should be carried
out in the future. Although the CQC receives few complaints from the public in
relation to primary care dental services, they are committed to working with
the public and other stakeholders to gain a better understanding of the risks
within the primary care dental sector and, in particular, understand whether
there is a link between the number of complaints and the actual risk to patient
safety.
There have been significant changes to the contract monitoring and
quality assurance arrangements of NHS-funded primary care dental services and
all of these have an impact on how the CQC regulates primary care dental
sectors.
Primary care dental practices have varying characteristics that will
inform the changes needed to be made to the way the CQC monitor, regulate and
inspect providers. These include the:
-
Complexity and range of services offered and the size
of the dental team.
-
Oral health needs of the population, including the
variation of oral health in our society (oral health inequalities).
-
Type of services offered, for example out-of-hours
care, general dental care, sedation, NHS-funded care, private dental care,
domiciliary dental care.
-
Level of risk to patient safety and the quality of
dental care.
The CQC have identified four main priorities as part of this
statement.
Priority 1: Working with partners to develop a shared view of
risk, agree roles and responsibilities, and identify gaps.
Priority 2: Improving their registration processes and ensuring
that they adapt their model to meet forthcoming changes to regulations and
their new enforcement powers.
Priority 3: Developing an approach to inspection that protects the
public from unsafe care.
Priority 4: Adopting a thematic approach.
For more information on the proposed changes to how the CQC
regulates primary care dental services visit www.cqc.org.uk
Source: www.cqc.org.uk
Image: Liz West, Flickr
