CQC compliance requires an ever-growing amount of time, effort and resources in the dental sector. Ensuring effective protocols are in place in preparation for the crucial inspections is essential in order to avoid any nasty surprises or last minute panics.

The keeping of records is a particularly cumbersome yet vital aspect, and the equipment used for decontamination and sterilisation lies at the heart of ensuring compliance.

HTM 01-05 2.4n states: “Equipment used to decontaminate dental instruments should be fit for purpose and validated. This means that the device should be commissioned, maintained and periodically tested by a Competent Person (Decontamination) or service engineer, that records of maintenance should be kept and that correct functioning should be monitored and recorded”.

Therefore all testing reports are required to be kept for documentary evidence of the effectiveness of equipment in the dental practice. However, the meticulous task of record keeping can be time consuming and also has the potential for inaccurate logging of data due to inevitable human error. It is therefore crucial to try to find a way to enhance the efficiency of your record keeping and streamline this process, whilst maintaining the quality of data.

One area that can be especially time consuming is the recording of daily and weekly test cycle data of your autoclave and/or washer disinfector. From the everyday ACT tests completed each morning to measure the time, steam and temperature of the autoclave, to the weekly residual air and air leakage tests, each check requires detailed annotation, documented in a daily logbook for every piece of equipment in the practice.

Although absolutely essential in terms of practice inspections, manually having to record this data and then store it can often be seen as more than a mere inconvenience. Some autoclaves will have a printer installed, which will print off a receipt that should be kept, which makes the process a little easier and more efficient, but it still requires time and effort to collate these print-offs, not to mention the physical space needed to store the data.

However, there are new technological solutions that can make all of this a thing of the past. The latest autoclaves from Eschmann are compatible with computer software that can capture all of the data necessary from your tests and automatically save it onto your PC. This means you have no forms to fill in and store, and you don't have to transfer data using memory cards or USB devices.

With such software you will benefit from quick and easy cycle sign-off at the click of a button and you could even monitor the progress of your cycle from your PC or laptop. The latest software will also show you when your instruments are ready for use, as the software operates in real-time meaning it is always up to the minute, which is precisely what you need in a busy dental practice.

The Eschmann real-time Wireless Cycle Logger with automatic daily/weekly test cycle software is compatible with the company's own autoclaves and washer disinfectors. Providing automatic population of daily and weekly test cycle records, this software is making manual record keeping and storage a thing of the past, while also providing added security through accurately recorded and validated cycles and tests ready for official inspection.

To take away any unnecessary worry in the lead up to your next CQC inspection, make sure you have everything in place now.

For more information please visit www.eschmann.co.uk, or call 01903 753322

Open letter to David Behan, Chief Executive of CQC.

Are you really listening?

It is interesting after two full years of regulating dentistry in an illogical and frustrating manner, CQC has now changed its method of charging dentists for its dubious services to the nation. Has the CQC changed to some form of listening mode, rather than the one way, top down approach?

If so, the door is open, I’ll push and see . . . . . .

Dentists told the CQC 24 months ago the previous method of charging was not right but CQC ploughed on in its dictatorial way. I remain uncertain if the new method of charging announced this week is fair, especially when compared with the general medical practitioners, who have their own problems? Why are the medical practice annual registration fees so much less when CQC policy has insulted dentists by saying that medical practices are much busier than dental practices, so they get a two week notice of inspection. By implication, CQC thinks dentists are sitting around twiddling thumbs, therefore our profession can be given 48 hours notice of an inspection. If the medics are busier, they must need more inspection, therefore higher fees. Please explain, Mr Behan.

Inspections of dental practices are now to be three yearly, we hear, so why do total fees collected remain at effectively the same level? And if the CQC is not recovering 100% of regulatory costs from the medical practice sector, the dental sector should pay at the same rate or raise the medical fees. I suggest a solution, CQC should halve dental practice registration fees to make a semblance of equality.

From the early days when the CQC engaged with the dental profession, there has always been a stance of being in charge, the profession are in an adult-child relationship, and dentists must do as we are told. Otherwise the blunt, and oft-repeated threat is that our practices will be closed down. Even now your Fixed Penalty Notices are doled out without warnings, it seems, and are wildly disproportionate to the "crime". During March 2014, CQC sent a communication by email only, it was mandatory, a survey of dental chair numbers. This email contained a threat of a larger registration charge of £1300 if not completed. What if the email was not delivered, or found its way into spam folder? CQC still likes to use the big stick, even in a simple email question. Did the inspectors not record the number of dental chairs in each practice during the exhaustive inspection process?

Recently one colleague told GDPUK forum his practice passed a recent inspection with one proviso, the floor mops were stored the wrong way round, they must be kept with the mop head upwards. The inspector insisted on a further visit to check this, before signing off the livelihood of the practice. Life saving equipment counted for nothing, cross infection controls all passed with flying colours, reams of paperwork counted were discounted, vocal satisfied patients - nothing. The practice might be carrying our complex implant operations, or microscopic endodontic treatments. But it all came down to the mops. But if those mops are not the right way up - that is just not good enough - the public must be protected.

Yet another example of how the CQC have not adapted nor heeded the dental profession has been the issue of having a Nutrition Policy, Outcome 5. Even as a simple dental practitioner, it is easy to understand why, for example, a care home should have a policy for the nutrition of the residents. However, the fact that every dental practice, up and down the country, has to have a Nutrition Policy for its patients is a farce. Dental practices are not care homes, we do not have in-patients, we do not feed our patients. Let's see some sense and remove this glaring foolish error.

Inspections have also been done badly by the CQC, using lay inspectors, people with training in care homes or pharmacies who cannot check dental aspects with a knowing eye. They can carry the clipboard, they can empathise with patients, but what do they know about running a dental practice? A simple example - emergency drug boxes contain dangerous items - but they have to be easily accessible and not double locked and secured in a locked room, otherwise they cannot be accessed in an urgent moment. Dentists would understand this, some inspectors have not.

As a dentist myself, I do not know enough to properly inspect a nuclear power station, or an abattoir, and many other places. I am sure the right people check on power stations but my point is that the real knowledge of any sector, any profession or industry, is held by people who are immersed in that sector. Inspectors from the sector know the shortcuts, they know the boxes that are ticked without real care, they know where the secrets might be hidden, the true ins and outs.

The Health and Social Care Act dealt the CQC a hand that was difficult to resolve. Each health sector has to pay for the inspections and administrations for their activities, but dentistry continues to feel it has been given a tougher set of cards, then bullied by CQC carrying a big stick.

My message, Mr Behan – listen more, get off the back of the profession, cease the bullying style, and equalise the disproportionate fees our sector bears.

References:

CQC release http://www.cqc.org.uk/public/news/registration-fees-1-april-2014

Notes from CQC http://www.cqc.org.uk/sites/default/files/media/documents/20140331_fees_2014-15_legal_fees_scheme.pdf

GDPUK disucssion thread: https://www.gdpuk.com/forum/gdpuk-forum/cqc-no-fee-increase-in-registration-for-dentistry-16500