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What to expect from an inspection of your dental practice

Our compliance inspectors started their visits to dental providers at the end of 2010, and our target of visiting 15% of practices by 1 April 2012 is well underway.

Wherever possible, inspectors give advance notice of an intended visit, since we do not want patient appointments to be disrupted, and certainly not cancelled. So far, CQC visits have been planned reviews of compliance where, on the whole, we will not have had any concerns about the provider beforehand. However, we may make an unannounced visit when a PCT, ‘whistleblower’, or another agency alerts us to a possible major concern.

Compliance inspectors come from a wide range of backgrounds. They are trained to ‘regulate whether providers are complying with the regulations’ and use a number of methods to review compliance, including talking to patients, talking to staff, looking at records and documentation, and observing the practice at work. It is anything but a tick box exercise. Having structures and processes in place are obviously necessary, but we will look to make sure that all members of staff understand them when we check that a dental provider complies with our outcomes.

Visits will last for about three hours, and in certain situations a second visit may be necessary, with or without a dental specialist to check more details or actions required. Although CQC inspectors are not registered dentists, they can access these dental specialists who are spread throughout the country, and have vast experience in appraising, regulating and running both NHS and private dental practices.

Much of an inspector’s time will be spent observing how staff work. For example, for outcome 1, they will see how staff interact with and respond to patients and handle any anxiety, and whether they answer the telephone discreetly and maintain confidentiality, etc. They will want to spend time with clinicians, as well as the practice manager, nurses and receptionists.

The focus of our reviews of compliance is on outcomes for patients, and inspectors will spend time talking to them about their experiences. Inspectors will ask questions to any available staff during the initial ‘walk-around tour of the practice’, and later have a more detailed session with the practice manager and clinicians. They may also look at a small selection of patient records. The inspector could ask questions related to any of the outcomes. 

It is important to remember that each inspector will probably have inspected many dental practices before yours, and therefore will be familiar with what is normal or expected in primary care dentistry. They will try to tour the practice in a logical order, rather like a patient’s visit, and will spend some time sitting and listening in the reception area. They will be looking at signs, hazards not dealt with, breaches of Health and Safety regulations, information for patients, how staff speak to people, whether full explanations about care are given, etc.

Our inspectors realise that an inspection visit can be stressful for some practices and will endeavour to be friendly and helpful.

After leaving the practice, the inspector will compile a report, which will be sent, in draft, to the dental provider for any comments on factual accuracy, before it is finalised for publishing onto the CQC website.