Thursday, 25 September 2014

Proposed changes to how the CQC plan to regulate and inspect primary care dental services

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


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