Taking a team approach to CQC

Taking a team approach to CQC

Your practice has registered with CQC – hooray! But wait – that’s only the tip of the iceberg – now comes the actual proof of compliance! 

Until the government decided that dentistry should be included under the realms of the Health and Social Care Act, we were very much a self-audited profession. The only statutory inspections were those of the PCTs for practices providing NHS care for patients. Each PCT had their specific criteria for assessment and there was no centralised system of monitoring performance.  The audit was generally aimed at identifying poor performance and obvious breaches of regulation. Ultimately, it was only the individuals failing in their duty of patient care who came under GDC scrutiny.

A standardised system

For private practices, there was no requirement to be audited by a dental authority, and unless there was cause for patient complaint, private practitioners were generally, relatively free from inspection. But, there has been a growing trend of practices wanting to demonstrate quality. Initiatives, which invited external audit, such as Investor in People, BDA Good Practice Scheme and Denplan Excel, have been used for many years to demonstrate a commitment to higher standards and to provide a benchmarking against other practices. Although these have been very useful, one of the disadvantages is that there is also no standardised system.

So, the government has decided that all organisations providing health care or social care should comply with a national set of essential standards – and now is the turn of dentistry. We have no choice in the matter, and denial, kicking, screaming, anger or protest, are not going to change the fact that we have to play the game – which has changed dramatically. 

The CQC will inspect all types of practices, and, having given us a list of the 16 outcomes it regards as relevant to dentistry, there will be no excuse for not complying. The requirements at first glance seem overwhelming and petty, and will definitely require a significant amount of effort to implement them within our practices, which will result in a major change in the way in which our practices are run. Over the last few years, we have had compulsory registration which means a better qualified group of professionals in practice. It’s no longer enough to just have a beautiful practice, the latest equipment or attend lots of CPD courses. 

CQC compliance will mean that all team members now have a responsibility to work together to provide evidence that the whole practice is complying with the six key areas and 16 outcomes of patient care. 

The six key areas are:

1. Involvement and information

2. Personalised care, treatment and support

3. Safeguarding and safety

4. Suitability of staffing

5. Quality and management

6. Suitability of management.

Although we don’t know exactly how these inspections will take place, there are lots of things we can be do together to get ready in advance. If you have a practice manager, they will be responsible for much of the paperwork, but everyone will have to be involved.

How to make life easier for your practice team

Play the game together

Life is always more fun if people work together – by volunteering to document how you each do your jobs (procedure), you will create a bespoke practice manual. It’s easier to train new people and you will appreciate how hard everyone works together. Lots of procedures make a process and these make systems, for example, those needed for HTM 01-05, patient record administration or x-rays. An auditor will be impressed by a cohesive team that is communicating and working together. Patients also like to have a well-trained team working for them and will comment on this.

Know the rules

The BDA has given excellent guidelines on the six key areas and 16 outcomes of Essential Standards of Quality and Safety – the rules of the game. Work through each guideline as a team and see just how much you already do to comply. An auditor will like to see that you understand the outcomes and that you can show how you contribute personally. 

Plan your strategy

There are lots of things for everyone to do. By agreeing how you will manage this and who is responsible for each small section, you will feel in control of the process and will know exactly what needs to be done and the priorities.

We are all busy in our own jobs, so a bit of time spent in planning your strategy will make you more efficient in reaching compliance. The assessor will be able to see that you are progressing in areas that require more work. 

Get the evidence together

There is bound to be a lot more paperwork for everything concerned with CQC. Write it down and file it in a way that is easily retrievable by anyone. 

An assessor will be much happier when you can produce the necessary documents immediately. If you can’t find them, it’s difficult to prove that they exist. This particularly applies to statutory information, for example, contracts, registration and indemnity certificates, CPD logs and equipment certificates.

Watch the clock

Much of the information for CQC compliance needs to be revisited regularly, so make up a calendar of events for the whole practice. This could include appraisals, x-ray audit dates, review of procedures, equipment certification, etc. This supports the timing of the planning phase, gives realistic time scales, and can include individual responsibilities. Showing this can give an assessor an idea of how the cycle of information leads to outcomes.

Get your patients on your team

CQC compliance is all about patient outcomes and so get those questionnaires out. Ask something easy at first – it takes a lot of courage to accept criticism, but remember that no practice is perfect and it’s not personal.

By looking at the answers as a team, you may be pleasantly surprised by how good your patients think you are.

Playing the game of assessment is an inevitable part of our professional lives. If we embrace the challenges together, hopefully it will be easier for us all.   

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