Dental mythbuster 27: Well-led?

Page last updated: 13 September 2023

Clinical governance

Clinical governance is the system through which organisations are accountable for:

continuously improving the quality of their services
safeguarding high standards of care

They do this by creating an environment in which clinical excellence will flourish. Clinical governance encompasses quality assurance, quality improvement and risk and incident management.

When we look at the well-led key question, we look at a provider’s arrangements surrounding good governance. This will include a provider’s systems and processes to ensure the safe and effective running of the service.

Leadership

The GDC standards for the dental team state:

‘you must demonstrate effective management and leadership skills if you manage a team.’

Good leadership affects how the whole practice is run and, in turn, the experiences of patients. An empowered practice manager with delegated responsibility can make a valuable contribution. Yet many small practices are well-led without a manager.

We focus on how leaders:

assure high-quality care
support learning and innovation, for example, through audit and peer review
promote an open and fair culture.

‘Leaders’ in a practice can be:

the principal dentist
nominated individual
others in management positions, for example, the practice manager

Our inspections

We reserve the right to consider all prompts within the inspection framework. Our inspectors use their professional judgement to tailor the questions asked at each individual practice. Providing the practice meets the requirements of the regulations, we would consider them to be well-led. So a dental practice does not need to provide documented evidence against every inspection prompt to meet the relevant regulations.

The regulations relating to the well-led key question are:

Practice strategy

This does not need to be written down.

You can have a written strategy, and some corporate providers do this routinely, but it is not essential. A practice must be able to explain their plans for the future to the inspection team. This should include how they would implement any necessary service improvements. A strategy may be to continue to operate as usual and not make any changes. This is acceptable if the practice is operating satisfactorily.

Policy on modern day slavery (MDS)

You do not need a written policy on MDS.

Inspectors might ask about MDS to assess a practice’s approach to safeguarding, but a written policy is not essential.

A written policy for safeguarding and/or MDS can help support knowledge and reduce risks so the practice runs safely and effectively. Inspectors assess the knowledge of staff.

Written policies are one source of evidence that inspectors consider. So not having a written policy would not automatically impact on our judgement of the quality of care offered.

Deprivation of Liberty Safeguards (DoLS)

These are relevant to dental practitioners.

DoLS were introduced as an amendment to the Mental Capacity Act (MCA) and came into force in April 2009. They are additional safeguards to protect the rights of people who are deprived of their liberty in their own best interests to protect their health and safety.

DoLS are used in hospitals and care homes, so their significance might not be immediately obvious to the dental profession. Yet practices need to understand the safeguards and the implications when someone who is subject to a DoLS order moves in and out of their care.

Find out more

There is substantial evidence that culture, ‘the way we do things around here’, and leadership can support services to deliver high-quality compassionate care. The well-led key question is an important element of our assessment framework.

How we monitor, inspect and regulate primary care dental services