We will look at recruitment procedures when we review the safe and well-led key question.

This specifically relates to our key lines of enquiry (KLoEs):

• S1: How do systems, processes and practices keep people safe and safeguarded from abuse?
• W4: Are there clear responsibilities, roles and systems of accountability to support good governance and management?

Providers should have safe recruitment procedures to ensure that staff, partners and associates are suitably qualified and able to carry out their role.

Recruitment checks

The recruitment checks required are specified in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Schedule 3).

When we inspect a practice, we expect them to have a staff recruitment policy and process that reflects this guidance. We expect the practice to follow its recruitment policy when recruiting all staff.

On inspection, we ask about recruitment procedures and check a sample of staff records. This is to make sure the practice is implementing its own policy and meeting these requirements. The recruitment information should be readily available and accessible in the practice. It should be kept securely in line with information governance requirements.

Requirements summary:

• All staff:
  • Proof of identity including a recent photograph
  • A full employment history with explanations for gaps in employment. (We do not expect references from people who started work with the practice before the Health and Social Care 2008 Act, Schedule 3 was implemented in 2014).
  • Documentary evidence of qualifications relevant to the person's duties.
  • Documentary evidence of registration or membership of relevant professional bodies, for example GDC
  • Information about any physical or mental health condition relevant to a person’s capability, after reasonable adjustments are made, to properly carry out tasks they are expected to perform. We do not expect to see the health certificate stating they are suitable for work.
• Staff working with vulnerable children or adults, who previously worked with these groups:
  • or if they previously worked in health or social care: satisfactory evidence of conduct in previous employment
  • satisfactory verification why their employment in that position ended

DBS criminal record checks

Practices must consider whether someone is eligible for a DBS check and, if so, what level the check should be.

They should:

• Have processes in place for criminal record checks for staff who require them.
• Assess the different responsibilities and activities of staff to determine if they need a DBS check.
• Recognise the need for checks depends on the roles and responsibilities of the job and not the individual. The need is based on the level of contact staff have with patients, particularly children and vulnerable adults.

We do not decide who is eligible for a DBS check. We look at whether suitable procedures are in place and that checks are being carried out appropriately.

To help decide about eligibility:

• use the NHS Employers DBS check eligibility tool
• contact the Disclosure and Barring Service.

We would not normally expect to see a member of staff working whilst awaiting the completion of a DBS check. If the practice does begin a member of staff’s employment while waiting for their DBS check to be completed, we would expect a risk assessment to have been carried out and action taken to mitigate any risks.

Clinical staff

Guidance states that all clinical staff require a DBS check. This includes dentists, dental hygienists, dental hygiene therapists and dental nurses.

NHS contracted dentists should have completed DBS checks as part of their Performers List checks. In some cases, practices may use these checks rather than obtaining an extra DBS check when the dentist begins working for them. If so, the practice must show suitable assurance from NHS England that an appropriate check has been completed. We would also expect the practice to carry out a risk assessment to identify and mitigate against any associated risks involved.

Non-clinical staff

There is no general requirement for non-clinical staff (for example reception or administrative staff) to have a DBS check. This depends on their specific duties and responsibilities. Practices may not be breaching regulations if some non-clinical staff have not had DBS checks. Consider this on a case-by-case basis. For example:

• Access to medical records alone does not mean that non-clinical staff need a DBS check.
• Staff who carry out chaperone duties may need a DBS check due to the nature of these duties and the level of patient contact.
• Staff who supervise a baby or child while their parent or carer is having an appointment will need a DBS check

If a practice decides not to carry out a DBS check for any non-clinical staff, they need to provide a clear rationale for the decision. This should include an appropriate risk assessment.

Renewal

DBS advise that there is no general requirement to repeat checks for staff that remain employed if there is no change in their place or terms of work. It is up to the employer to decide if and when a new check is needed. Practices should be able to provide evidence that they have appropriately considered where new checks are needed. This includes carrying out risk assessments to support the decision.