Last Monday 14th August 2017, I had another meeting with Jonathan Green (Head of FtP) and Matthew Hill (Head of GDC Strategy). 
It was a no holds barred meeting and I was free to ask any questions. I wasn't locked in dungeons under 37 Wimpole Street at any point! 
Here is the agenda of the 90-minute meeting, along with the GDC answers in blue. 

It raises some important considerations about what we need to do as a Profession. I think we need to think about the answers and discuss a strategy for the Profession. 

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I just wanted to write to let you know how your package is working for us in our practice.

I’m not sure you are aware but we relocated premises in August 2014 moving from one surgery to three surgeries.  We recruited new staff and increased from five to sixteen, which included a trainee nurse, a nurse who had not worked in general practice for a year or so, an apprentice and a new housekeeper who had not worked in a dental practice.  It did feel like I was running around in circles as I did naively think you just transfer from one site to another.

I then came across the RightPath4 CQC package and purchased it at the start of the year and what an enormous benefit it has been to our practice. 

Having read all the information I delegated everything to all the staff, we then come together during lunch times, staff meetings etc to discuss, plan, and modify.  All the staff have completed the poisoned chalice, which is an interactive series of questions regarding each room.  I can then review their answers and add any questions they were unsure of or did not know, to the agenda for our next staff meeting. It has led to interesting staff meetings, with debates and staff keen to demonstrate what they do and what we should do.

The virtual inspection and clinical governance have been areas that the assistant manager and myself as practice manager have completed, and what a huge help they have been.  They look at: how we work in the practice, who should be doing it, why we should be doing it, when it should be completed, how it is completed and what we need to complete.  We have looked at every aspect at what we do, again, working closely with all the staff, who have helped by giving their input on the paperwork, processes and procedures we need to complete.  We have even kept all our working documents as evidence of how we have moved on.

From my point of view it’s all very well, writing a policy and procedure but does it really work in practice, I found that by getting all the staff involved, helps with morale and motivates them more to know they are being heard, and that their input is valuable and taken very seriously.

I know the package is something which we will use continually, to review and monitor our practice, and any questions I might have, I know I can email you.

Sorry for going on I just wanted to let you know how grateful we are for your package and the help you have given and continue to give to us.

Kind regards,

Janette

Noah’s Ark Dental Practice 

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Pantomime season with a Grimm warning   

I’ve had a busy couple of days and upset some applecarts; perhaps I should apologise if I have bruised any fruit?

On Friday the 21st, I spent an interesting day in Corpus Christi College, in Cambridge with my fellow NADA (National Association of Dental Advisers) colleagues as well as a selection of the great and the good and quite a few of our younger dental colleagues who had come along for the verifiable CPD and to find out what sort of profession they were entering into.

Sarah Rann (assistant medical director East Anglia Area Team NHS England) kicked off proceedings by asking us and then telling us what we should be doing as National Dental Advisers. The only aspect that she missed off her list was influencing the Regulators, (aka upsetting the established applecart by proffering an expert opinion).

We were then treated to a relatively complimentary double act between Barry Cockcroft and John Milne’s views on Contract Reform. There was a large amount of agreement even concluding with synchronised retirement from their respective roles early next year. Barry emphasised that ‘access’ was less of a political hot potato now than it had been and he saw this as one of his successes during his tenure. John talked about the impact of pilots and possible implications.

A little local difficulty about a dental practice not far from Nottingham was briefly mentioned.

A question regarding access to certain less privileged groups was aired and this is where I must apologise. I raised the question of ‘access to what quality of care?’ And I then asked ‘who was responsible for the World Class Commissioning of such ludicrously large and unmanageable contracts?’

Well there was a stunned silence and poor Barry looked like he had been stabbed in the chest. Fortunately John was on hand to ride to his rescue and acknowledge, although not answer the question and then draw stumps on this part of the meeting.  

We were treated to some joined up thinking from David Geddes (National head of primary care commissioning) who discussed intelligently and without too much smoke and mirrors what the future 5 year plan may mean to dentistry, please read this if you haven’t: http://www.england.nhs.uk/ourwork/futurenhs/

Amanda Crosse (consultant in Dental Public Health) went a little off piste with her unguarded comment regarding perhaps planning to have dental NHS commissioning overseen by CCG’s. An interesting idea which seemed to irritate the level headed David and which he was forced into backtracking a little.

David Behan was cut short, the previous part of the agenda having overrun by 50 minutes meant that David only had 10 minutes to get his message across about the new CQC. He did it very well I thought and was only sorry that it was necessary to tell the gathered throng of dental advisers that he was disappointed in their union attitude to pay and perhaps we would like to put something back into the profession. He was having no more of discussing an inflationary fee. Actually I agree and am happy to spend my time for free advising the CQC.

This is where all of you come in…...’Efficacy and the CQC inspection, on the right path now? ‘It’s your opportunity to get the message across and its coming to GDPUK soon.

 Poisoned apples for ‘afters’………..,

The afternoon was devoted to a Brother’s Grimm pantomime about a dodgy dentist with decontamination and NHS gaming tendencies, played brilliantly by Bryan Harvey (DDU), who was frighteningly good at getting into Character.  We were assured that this was not based on any recent situation and I pointed out that it couldn’t have been, since they failed to notify the Press or recall 22,000 terrified patients…., Oops!

The GDC on this NADA inspired day was represented by Mike Ridler (Head of Hearings) who displayed distressing figures on FtP hearings.  Mike expressed his inability to understand the reasons since in his experience there had not been an associated decline in professional standards. Somebody in the audience mentioned that it might have something to do with National advertising?!! Mike did not wish to be drawn further on this.

He obviously didn’t feel inclined to join in with the GDC pantomime either and suggested that if anyone wanted to talk about other ARF type issues they could do this individually later, although it wasn’t his ‘field.’ He then failed to answer the other questions, since they weren’t his field either.   

The meeting closed with another unplanned shedding of apples just as stumps were drawn and flat hats were on; Jason Stokes leapt up on stage and shouted that if the younger members of the audience felt slightly dismayed by opinions voiced by the demobbing great and the good; NOW is the time to make their voices heard. Oyez, oyez!

Keith Hayes

Right Path Ltd

Whistleblowing and responsibility

The UK law related to whistleblowing changed significantly at the end of June with the result that legal protection for employees who report wrong-doing by their employer is only now afforded to those raising allegations of public interest. In other words, now the element of “good faith” required previously has been removed, disputes over personal issues, such as pay or performance management which lack a public interest element, will no longer be protected under the legislation.

So perhaps you should ask yourself; should I be blowing a whistle and what is the purpose?

Team members are often the first to realise that there is something amiss within the practice. However, they may not wish to express their concerns as they may feel that speaking up would be disloyal to their colleagues or to the practice.

Whistleblowing should primarily encourage and enable team members to raise serious concerns within the practice rather than overlooking a problem or 'blowing the whistle' to an external body. It is important that every organisation, whether it be a dental practice or even a body such as the Care Quality Commission (CQC) itself recognises their responsibilities and takes them seriously and intelligently.

Raising awareness of serious concerns when you work within an organisation asks a lot of the individual and this is the reason why it is necessary to emphasise that they are protected in law by taking appropriate actions. It should be a clearly stated Policy that the practice recognises that the decision to report a concern can be a difficult one to make. If what you are saying is what you believe to be true, you should have nothing to fear because you will be doing your duty to the practice and the patients alike. Furthermore the practice will not tolerate any harassment or victimisation and will take appropriate action to protect the team member who raised a concern in good faith.

Sometimes circumstances have a habit of being rather more intertwined don’t they?

Whenever there is a problem within a dental practice, whether this relates to patient care directly or working relationships; it is wise to attempt a locally agreed solution. Usually a discussion of the circumstances involving all relevant team members will itself point to the correct solution. However sometimes the problem may be so serious or the reaction of the management so ineffective that as a GDC Professional Registrant you feel compelled to take matters further. Whilst doing this, it is extremely wise to examine one’s own position carefully. A thorough investigation will include all parties. All concerns will be treated in confidence and whilst every effort should be made not to reveal the identity of the team member who raised it; at the appropriate time they may need to come forward as a witness.

So that’s clear is it?

I want to encourage everyone to re-confirm the legitimacy of their intending whistleblowing and to be certain that they have:

·         Disclosed the information in good faith.

·         Believe it to be substantially true.

·         Not acted maliciously or made false allegations.

·         Not sought any personal gain.

These points could have a significant bearing if you are shown to have decided to speak to the Press or acted in connection with another practice or organisation which work in competition.

There may have been a number of situations where organisations have been subjected to malicious whistleblowing. I imagine that it’s not a pretty sight and I’m afraid it would have a habit of rebounding badly on the perpetrator as well as the victim. Some of these people may even have found it necessary to leave Dentistry.

The more one thinks about it; the more one can see that whistleblowing can be used in a positive way for the general good, but equally it can be used in a negative malicious way.

One may envisage a situation where a regulatory body has experienced ‘difficulties’ with a Provider and has then approached another regulatory body to re-examine the Provider. This used to be referred to as ‘double jeopardy’, although now it could even be triple jeopardy. You may possibly feel that such things could never happen in this fair Country of ours; I couldn’t possibly comment.

How to raise a concern in your practice

As a first step, anyone with a concern, should raise it either verbally or in writing with the Practice Manager or the Principle if it involves the practice manager.

All concerns must be taken seriously and the team member treated with respect and dignity.  The matters involved should then be investigated and the team member advised of what is happening at all times.

Thank you

Thank you for reading this and whichever of the R’s you feel you may be; Registrant, Regulator or Registrar, I would like to remind you that the use of intelligence, proportionality and responsibility are not your exclusive rights.

Our Commitment

RightPath4 is committed to the highest possible standards of openness, probity and accountability. In line with that commitment we look forward to working with all dental practice teams to help them be the best they can be and be justifiably proud of their achievements.

RightPath4 will continue to work on behalf of those in peril on the C, whether that be CQC or GDC and you may be interested in inviting us to visit you. We hope that you will find that you can spend a small amount of money, very wisely!

You could arrange a practice visit from me for as little as £275.00.

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