A common discussion that I am having while out and about visiting my customers is how to prepare and adapt to the recent CQC changes. There is no doubt that there will be fewer inspections in 2015/16, but for those who do get inspected, they should be prepared for a considerably more challenging experience than previously.
As always, preparation will be key, as will ensuring that the whole team understands what they need to do and is fully involved in the practice’s protocols.
With this in mind, we asked Apolline to summarise the key aspects of two important new CQC documents entitled ‘Primary Care Dental Services: Provider Handbook’ and ‘What to expect when we inspect: for dentists’. Below are some key changes for the whole team to be aware of:
The inspections and standards
- The CQC’s ‘essential standards of quality and safety’ ceased to exist on 1 April 2015 and have been replaced by new ‘fundamental standards’ which are clearer standards below which the level of care must not fall
- There are two types of inspection – ‘comprehensive’ and ‘focused’: ‘Comprehensive’ inspections will seek to establish whether the practice provides care that is safe, effective, caring and responsive, and well led. Practices will usually be given two weeks’ notice prior to inspection. ‘Focused’ inspections will concentrate only on areas indicated by the particular information that triggered the inspection and can be announced or unannounced depending on why it is taking place
- 10% of practices will have comprehensive inspections in 2015/16 – selected either randomly or on a risk-based basis
- Focused inspections will be in addition to these and in response to concerns. If an inspection identifies significant concerns, it may trigger a comprehensive inspection
- Key lines of enquiry (KLOEs) will be used for consistency from inspectors. The new Dental Providers Handbook – Appendix A, focuses on KLOEs and provides examples of questions that may be asked and evidence expected
- Comprehensive inspections will take one day and will be undertaken by a CQC inspector with support from a specialist advisor (often a dentist)
- Inspectors will speak to dental nurses, dentists, practice managers and receptionists
- They will review policies and protocols and will expect these to be tailored to the individual practice.
Some useful ‘need to knows’
- Each practice will now have a member of the CQC’s inspection staff as their ‘relationship manager’
- Practices will be asked for information before their inspection and have five days to respond
- Information will be shared with and feedback encouraged/requested from NHS area teams, the GDC and local Healthwatch organisations
- Strong focus areas of inspection:
- Gathering feedback, including asking for results of the FFT
- Complaints and compliments
- Consent and an understanding of the Mental Capacity Act
- Patient records will continue to be scrutinised
- At their inspection, practices will be asked to share any concerns they have identified themselves in their ability to meet the requirements of the regulations (including the new fundamental standards) and what they are doing about it. They will also be asked to provide examples of any areas of ‘notable’ practice in which they are exceeding the regulations
- When an inspection is taking place, the lead inspector will review any emerging findings in real-time, and will enable the dental team to refocus the inspection if necessary
- Feedback will be provided to the practice at the end of the inspection ahead of the draft report.
Five handy hints to turn compliance into a business benefit
Here are a few hints to get you thinking. Ensure you:
- Involve your whole team
- Customise all your policies and protocols, keeping them up-to-date, understood and ‘lived’ by the whole team
- Are organised – keep full, accurate and up-to-date contemporaneous patient records to support and demonstrate delivery of excellent treatment
- Measure your compliance against the fundamental standards to understand your specific strengths and weaknesses. Make plans to address your weaknesses
- Act on any feedback from your patients, tracking any complaints in a way that you can show the actions you took. Feedback is a requirement and your practice will never be as successful as it could be if you don’t know what your patients are thinking.
The lists above are not intended to be exhaustive, therefore practice teams are encouraged to familiarise themselves with all the latest information published by the CQC. Remember that well organised and compliant practices are more likely to have happy patients, teams and healthy finances and if you need support, then help is available from a number of sources.
If you do have any questions in relation to the changes or this guidance, please contact Apolline on 0800 193 1033 or by email at [email protected], who will be happy to help. Practice Plan customers are entitled to a 10% discount on usual fees.