Dental practices given clean bill of health

Dental practices given clean bill of health

The latest Care Quality Commission (CQC) report, State of Care, gives dental practices an almost clean bill of health, with over 95% needing no action following an inspection, in such critical areas as safety, effectiveness, ‘caring’ and ‘responsive’. But the report says that increased demand for frontline NHS dental services has led to ‘challenges’ in accessing appointments.

In primary care dental services, the CQC found that the pattern of inspection outcomes was broadly similar to last year. Inspections of 1,033 dental practices represented approximately 10% of all practices in England. For the vast majority of inspections (85%), they took no regulatory action as these services were providing care that met the regulations associated with their five key questions.

However, where they did take action, 13% of inspections resulted in a Requirement Notice and in 2% of cases, they took enforcement action. The proportion that resulted in either form of regulatory action had risen from 10% in 2018 to 15%. Again, performance was poorest for the well-led and safe key questions, particularly the well-led key question, with action taken following 16% of inspections compared with 10% in 2018. There was some regional variation in inspection outcomes, with the North East having the highest proportion of regulatory action, although based on a smaller number of inspections than elsewhere.

Looking at access to primary dental care, 22 million adults (50.2% of the population) saw an NHS dentist in the 24 months to 30 June 2019, which was approximately 100,000 fewer than in the 24 months to 30 June 2018. When they looked at visits to a dentist by region, a higher percentage of adults and children in the North of England saw a dentist, with London having the lowest number of visits as a percentage of the population.

In the GP Patient Survey 2019, London had the highest proportion of respondents who had never tried to get an NHS dental appointment and who relied on private dental care. Of those who had tried, respondents in the North East and Yorkshire region were most successful in getting an NHS dental appointment in the last two years, while those in the South West had the lowest success rate.

From their inspections, they have seen that increased demand for frontline NHS dental services led to challenges in accessing appointments, but private patients did not experience the same barriers as NHS patients. They also heard from inspectors that difficulty in accessing NHS dental care had resulted in patients increasingly relying on walk-in centres. Some inspectors had found several examples of dental providers handing back their NHS contracts to commissioners across England, and unless services are rapidly re-commissioned this will further affect access to NHS dental care.

As at 31 March 2019, 87.6 million UDAs were commissioned, to be provided from 1 April 2019 to 31 March 2020. This is slightly fewer than the previous year, and numbers have been falling slowly for the past six years. However, the population has continued to rise, which means that fewer UDAs are being commissioned per person, with 1.67 UDAs per person in 2012 falling to 1.56 per person in 2019. This potentially means that it is more difficult to access dental care.

Link to news release: https://www.cqc.org.uk/news/releases/growing-pressures-access-staffing

Link to full report: https://www.cqc.org.uk/sites/default/files/20191015_stateofcare1819_fullreport.pdf

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