Under-fire CQC answers criticism

The Care Quality Commission (CQC) came in for a mauling from speakers at last month’s Westminster Health Forum.

But spokespeople from the regulator responded by calling for the dental profession to start talking about how it wants to be regulated.

The London event saw opinion leaders come together to discuss the changes in NHS dentistry and the future of the profession’s regulation. While the tone varied from wry commentary on the number of parties interested in monitoring dentistry to outright criticism, the message was clear.

‘Dentists in practice today have every reason to think that they are more observed, more under the microscope than the Big Brother house inmates are,’ said Chris Morris, a partner at Hempsons solicitors.

Dr Henrik Overgaard-Neilsen, a London dentist and chair of the federation of London LDCs, was less charitable, labelling some of the expectations on dentists as ‘ludicrous’ and the ‘real culprits’ wasting dentists time and making their working lives ‘unbearable’.

He said: ‘The problem with both the CQC and Information Governance Toolkit is that both sets of regulation and guidance are written for large organisations. While 114 detailed conditions for control of information might be appropriate for large hospital trusts, they are ludicrous for a single-handed dental practitioner.

‘The Department of Health and the quangos who designed these regulations could not be bothered to tailor the requirements to the organisations that had to comply with them. So instead of a few people adapting the guidance to make it fit for purpose, 9,000 dental practices had to do the work individually.’

Dr Overgaard-Neilsen lambasted the CQC for its ‘eagerness for unimportant detail’, and put decontamination regulation HTM 01-05 into the firing line as well.

He continued: ‘HTM 01-05 burst onto our radar because a survey showed that there were dentists out there not cleaning their instruments properly. If there were dentists not complying with infection control under the old system then why didn’t the Department of Health deal with them?

‘Instead of tackling the difficult cases they decided to write some more regulations for us all to comply with.’

Citing the cost of meeting all the requirements, he said: ‘I think it’s time the Department of Health stops blaming bankers for wasting our money.’

But Amanda Sherlock, operations director of the Care Quality Commission, was eager to build bridges with the profession.

Admitting that there were going to be mistakes, she said: ‘This is a learning environment for our inspectors as much as it’s a learning environment for you as a sector, coming into regulation.’

But she nevertheless called on the dental profession to move on from ‘an undoubtedly torturous registration process’ and start talking to the CQC to work out a balance for future regulation.

She asked: ‘Do you want the CQC to be going out and marking providers’ homework, whether or not there are any concerns? Or do we want to move to a model where we are driving out unacceptable poor practice, and that’s where we focus our time and attention? I think that’s a conversation we need to have with you as a dental sector.’

She admitted: ‘I absolutely agree that we need to simplify the system. ‘So how do we be proportionate? How do we simplify, and how do we target? Should we be working with you to identify that, against those 16 essential standards, some are actually more essential than others? I think that’s a good way forward.’

She called for a ‘real partnership’ between the profession and the CQC, adding: ‘If we carry on driving forward, but looking in the rear view mirror, we’ll carry on crashing the car.’

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