September 2010 Roger Matthews


UNDERSTANDING DENTISTRY


What’s in a word (and does the Trade Descriptions Act apply)?


with descriptions that would land the average and unwitting dental practitioner in a GDC case, a formal complaint or at least a knuckle- rapping from the PCT. The case in point (in my case) was


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what was laughingly described as a “pop-up” gazebo. Let me assure you (in case you’re in a pre-gazebo ownership situation) that “pop-up” is the last word I would use. I might say: “requires at least three co-ordinated adults over six feet tall to erect” or “may significantly damage your health, patience and fingers” – but “pop-up”? Never! Undoubtedly, the word of the


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year (century?) is “quality”. We’ve had “essential quality” from HTM 01-05 in England. Presumably that’s to distinguish it from non-essential quality. Next will come the Care Quality Commission, which as I understand it will not commission anything (and neither will PCTs in a year or so). They too have “essential quality standards”. And finally, I see that it’s on the cards for any NHS dentists in England, whose gross earnings exceed £130,000, to produce “Quality Accounts”. This latest impact – which will do


nothing I suspect for the “quality” of practitioners’ lives (nor their long-suffering practice managers,


WAS musing the other day about how advertisers so frequently manage to get away


should they be fortunate enough to have one) – will require all practices to produce a long and detailed document by 30th April 2011 and annually thereafter. The particular “quality” that is


sought is nowhere made clear. Instead what is proposed is a sort of business plan, which is not a bad thing in itself, but I suppose any title quite so craven and mired in down- to-earth economic facts would not sit well with the Powers That Be. Get set then to first: draft a Board-


level statement that your Quality Account is true, accurate and verified. Oh, and get that countersigned by a senior employee, and your PCT. Part two: prepare a retrospective


section detailing how your practice has performed over the past 12 months. Include at least three points under each heading: Patient Satisfaction, Clinical Effectiveness and Patient Experience. You can of course use your Vital Signs report from the Business Services Authority (who already know what you did). You might like to include things


like how many new patients you’ve seen, what your UDA band split was, patient satisfaction reports and your compliance with HTM. List out your staff and their registration status with the GDC. Now, the PCT and BSA already


know most of this, but they won’t release it under Freedom of


CQC regulation ‘will cost dentists


thousands and not benefit patients’ PLANS drawn up to have dentists regulated by the Care Quality Commission will cost practices thousands of pounds each in extra administration and provide no significant benefit to patients, claims Dental Law Partnership. Registering with the CQC will cost a dental practice up to £5,700 in the


first year and hundreds of pounds a year thereafter, and introducing the new regime would also incur significant costs to central Government, yet would still deliver little to no significant benefit to patients, DLP says. Costs will involve registration with the CQC, annual self-assessment and self- declaration, plus inspections. “Yet all this is in order to comply with a new regulatory regime which we remain convinced will deliver no improvement in patient safety or treatment outcomes whatsoever,” it adds. The revelations over the cost of the new system come after hundreds


of individual dentists, together with the Dental Professionals Association, supported a submission to the Government’s YourFreedom website by DLP calling for dentists to be placed outside CQC regulation. While the Coalition Government has not yet promised to respond to any


of the submissions made since the site was launched, it is hoped that those which are well-supported will be considered for reform. To support the submission against CQC regulation, register at http://yourfreedom.hmg. gov.uk, then visit http://bit.ly/cqcregulations to vote.


6


Information. Simple – in future you will be responsible for publishing it yourself! Finally, you have to do a forward


look. It’s suggested you identify at least three, but no more than five, things you can Do Better Next Time. At least one under each of the three headings, please (write on one side of the paper only). Obviously someone, somewhere,


has thought that dentists will be feeling a bit bored and lonely next April, what after getting their CQC registration done and their UDAs off on time, so this task will come as a welcome relief from playing golf, watching the telly or spending time with the family. If you have a business plan, I can’t


really imagine that this will tell you anything you didn’t already know (or the PCT or the BSA). If you haven’t, then that might be a more profitable use of your time (although the “p” word is again not something we should be talking about in public, is it).


The idea is that your Quality


Account will indeed be published for patients and other interested parties to look at. I can just see families saying to themselves: “Hey, Facebook is boring and there’s nothing on Sky, let’s check out the local dentists…” There is, admittedly, a slim chance


that dentists might yet be ruled “out of scope” for this new and exciting “quality” initiative, at least until 2012, but don’t count on it. Governmental anti-bureaucracy campaigns don’t seem to extend to primary care dentistry these days. How about a “quality of life”


survey? Maybe that would be an interesting exercise – that is if anyone had the energy left to actually do it.


Dr Roger Matthews is Chief Dental Officer at Denplan. He spent 22 years working in general dental practice, followed by employment as a dento-legal adviser for the Medical Defence Union. He holds a Masters in Healthcare Quality Assurance.


www.dental-practice.org


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