There continues to be much discussion in the profession about the best way to ensure that your practice becomes and remains compliant with regulatory requirements. The CQC is now one year into its new and much more robust approach to regulation and inspection.
CQC inspections are now either ‘comprehensive’ or ‘focused’ (in response to a concern), and for 2016/7 they will continue to undertake comprehensive inspections for 10% of all practices.
Comprehensive inspections are undertaken by a trained CQC assessor and he or she is regularly accompanied by a specialist adviser who is usually a dentist or a dental care professional.
These inspections seek to establish if:
- A practice is providing care for patients that is safe
- The care they are providing is effective
- They are caring
- They are responsive to their patients’ needs and
- The practice is well-led.
Patients put their trust in us as a profession to do all these things and they assume that we do. In my view any practice that does not provide care that is safe, effective, caring and responsive and is not well-led should not be allowed to look after patients.
Hopefully most dental practices do provide care that fulfils these five requirements so they should have little fear from a CQC inspection. Or is there still something to fear? The answer to this question is ‘maybe’, because in 2016 it is not enough just to think you are doing all these things, you need to be able to demonstrate that you are.
How do you do that? You need to measure your compliance – simple! And how do you do that? Well in a clinical and in a business context, the answer to all questions that begin with ‘how do you measure…?’ is always audit!
So that’s much clearer now…isn’t it? And therein lies one of the problems; it’s not clear at all!
The way to think about how best to demonstrate your compliance is to think about what you need to audit, measure or do in order to demonstrate that your practice provides care that is safe, effective, caring and responsive and that it is well-led.
The starting point for your compliance ‘journey’ should be to have a practice meeting and agree, as a team, what the component parts are of a practice that provides care as described above and then to measure or audit these parameters.
Examples of what you need to put into each category are listed below and, in time-honoured fashion, I must first point out that this list is not exhaustive and you and your team will have ideas to add to this.
- Infection control, including legionella
- Radiation protection
- RIDDOR compliance
- Fire safety
- Medical histories
- Emergency drugs, equipment and training
- Electrical safety
- All risks
- Adverse and significant incident recording
- Safeguarding – training and understanding.
- Completeness of patient records
- Evidence that patients presenting complaints or comments have been recorded
- Evidence that all treatment alternatives have been explained
- Evidence of valid consent
- Compliance with FGDP(UK) guidance in ‘Selection Criteria for Dental Radiography’
- Preventive care delivered
- Team understanding of the Mental Capacity Act.
- Patient surveys with questions designed to demonstrate a caring attitude
- Comments boxes, capture of ad hoc comments and all other feedback
- Audit of handling dental emergencies.
- Actions taken as a result of patient and staff feedback
- Complaints received and actions taken
- Complaints tracker.
Plus evidence that appointment times are convenient to the patient population and that waiting times and cancellations are minimal.
- Staff satisfaction survey and evidence that actions have been followed up
- Regular practice meetings with minutes and actions delegated and followed up
- Evidence that all audits and risk assessments have dated actions and evidence that tasks have been completed
- Regular staff appraisals with personal development plans
- Induction training
- Regular and comprehensive ongoing internal training.
The unhelpful ‘negative mind set’
Many practices continue to complain about the imposition of a regulator they don’t think is necessary or desirable. This negative mind set is not helpful or productive and anyway the CQC is here to stay so we might as well turn all the negative energy into a positive force and just get on with it.
At Apolline we encourage and support our clients to become and remain compliant because it’s the best way to run an efficient and profitable practice.
A study from all the practices we have worked with at Apolline shows that those that are compliant invariably have much higher levels of both patient and staff satisfaction. The converse is also true, in that we find practices that are very non-compliant usually have an unhappy workforce and higher levels of complaints and patient dissatisfaction.
‘Why does that matter?’ I hear some doubters ask…it matters enormously.
Research shows that unhappy or dissatisfied patients tend to tell a significant number of their friends, family and colleagues about their views on whatever it is that has caused them to be dissatisfied. There is also evidence that the more dissatisfied someone is, the more people they tell about it. The danger is also that if something better comes along they are at risk of leaving. This is very bad for business and for profitability.
Unhappy staff who have had insufficient training or who don’t feel valued, motivated or empowered are unlikely to be willing to ‘go the extra mile’ and give great customer service. If staff don’t feel valued and end up leaving then that has the effect of lowering morale. This can lead to a higher staff turnover and then, before you know it, you’ve got no one in the practice who knows how things are done. Again – very bad for business and profitability.
If doing all this by yourself sounds too difficult, tools specifically designed to support you to become and remain compliant are available. For example, our automated audit measures compliance, our task manager automatically schedules compliance and important business tasks and our patient and staff satisfaction surveys provide invaluable real-time information on what is working and what needs to improve or change, all to make compliance easier in your practice.
A positive mind set to all this ‘stuff’ is crucial to moving forward to a happier, more profitable practice.
At Apolline we say that just as dogs aren’t just for Christmas, compliance is not just for your CQC inspection; it’s for life, and over time it should become the way in which you run your practice.
Apolline is just one of DPAS Dental Plans’ Business Bites partners and their services are available to DPAS client practices. For more information visit www.dpas.co.uk, call 01747 870910 or email [email protected].