You’ve got CQC hindsight, but have you seen what’s coming?
The CQC have ‘Fresh Start’ plans for us in 2015
It’s part of their strategy for 2013-2016, Raising standards, putting people first).
They are more focused than the previous ones and inspectors will be more
experienced in assessing dental practices.
The new standards are divided into eleven Fundamental parts.
Fit and Proper Person (Directors) and Duty of Candour are 2 new standards.
The CQC have also beefed up their enforcement powers, meaning that they
may not give you a warning before they prosecute.
How do the old ‘Outcomes’ relate to the new Standards?
The simplest way to explain this is for you to complete my CQC survey: https://www.gdpuk.com/index.php?option=com_rsform&formId=57 and then I will send you an explanation of how to relate the old CQC to the new CQC and the new (ish) GDC principles. I will also send you an explanation of what the ‘Key Lines Of Enquiry’ (KLOE) is all about and how it will be applied in April 2015.
What effect have the CQC had so far?
Many of you kindly told me about your CQC thoughts in my survey, (see link above) which is still running. By sending it back to me, you will now know what or who KLOE is. The CQC inspector will use these KLOE’s to guide the inspection process and make a judgement. The CQC still haven’t decided about publishing these.
I have summarised what you have told me so far from my surveys and will be discussing them with the CQC. We may yet be able to have a sensible regulator looking at the right things in an intelligent way.
My prediction for 2015 is that FEES, Cosmetic dentistry and dermal fillers will also come under the spotlight.
Brief analysis (from 76 surveys)
I have used this as a pilot survey to determine whether there is a need to gather more information on how well the CQC registration and inspection process is received and what the beneficial effects may have been in driving improvement.
I think relatively few will have experienced re-registration and therefore a low %age answering YES to Q1 may be expected. However it is disappointing to see that 48% still felt that the process has not been made clearer.
There continues to be much confusion over legal entities and I know (from personal experiences of clients that this is still a problem now, 76% of respondents agree.
81% felt that the inspection was not structured to reflect dental practices; even higher (87%) saying that the nuances were not understood and many said that a dental adviser is required.
It seems that few felt that they understood what the CQC expectations are regarding safe, well-led and managed practices. I was particularly pleased that our own clients were in general more ‘upbeat’ about the potential benefits of CQC compliance and also felt more empowered and knowledgeable (judging from some open question comments).
The open questions were designed to test whether the process of declaring ‘compliant’ 48 times in the original application had sparked an interest in them to get things done before inspection, just in case. It seems that this was the case in as much as 72% said they had done some things, although I need to look more closely at this figure because some of what was said was fairly minor ‘window dressing’ was one comment.
The most significant results I feel were relating to the perceived benefit of CQC registration and inspection.
The positive improvements noted by patients and staff reached only 14% and the consequential improvements to the business reached 21%. Finally regarding your additional thoughts, there were many suggestions and yet only 6.5% of these were positive. I have concluded that an improved and much larger survey spread amongst a wider audience is required.
OK, so what?
From April 2015, CQC inspection reports will look quite different. Instead of considering just 4 or 5 Outcomes; the inspection will be constructed in a different way to test whether your practice clearly demonstrates that it is safe, caring, responsive, effective and well-led? A CQC inspector has described how the new process enables them to ‘get under the skin’ of the practice and see what is really happening.
Safety is now considered of paramount importance following on from the terrible instances of poor care graphically illustrated in the past few years. Although the CQC had considered that dentistry was relatively much lower risk; there was a severe jolt to this belief recently in Nottingham. The GDC are also convinced that there are also still much greater problems within the Profession. So it is my guess that safety will share top billing with being well-led.
It is hard to imagine that a well-led practice would be unsafe or that there would be many unresolved complaints or that there is a high staff turnover or patients don’t have fees explained properly.
RightPath4 can provide a system of governance mapped to 2015 CQC requirements which is simple to implement and does not cost £thousands or run to thousands of pages. It is easy to bespoke it to your practice and use as an important part of your practice meetings and induction. We have a unique template tool which helps you give confidence to the CQC that your practice is safe, caring, effective, responsive and well-led.
In the next blog article, I’m going to discuss how the CQC are going to assess and inspect in 2015.
Here’s wishing you a Happy, Healthy and Prosperous New Year,
Keith Hayes BDS