Mr. Nigel Monkman Also known as Nigel Monkmans Dental Practice

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We found this practice was not providing effective care in accordance with the relevant regulations. We will be following up on our concerns to ensure the provider has made the required improvements.

During our assessment of this key question, we found concerns related to:

the completeness of patient care records.

These concerns were in breach of Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can find more details of our concerns in the detailed findings below.

Find out what we look at when we assess this area in our information about our new Single assessment framework.

The judgement for Assessing needs is based on the latest evidence we assessed for the Effective key question.

We looked at 20 dental care records from patients seen between November 2025 and 26 January 2026. Some of these records were missing details including an updated medical history, intraoral and soft tissue checks, extraoral examination, Basic Periodontal Examination (BPE), risk assessment and diagnosis/prognosis. Additionally, X-Rays were not consistently justified or reported on.

Staff told us that they obtained patients’ consent for treatment in line with legislation. However, evidence that consent had been obtained was not consistently recorded in patient care records.

The practice had systems for prescribing and dispensing of medicines in line with current guidance. However, improvements were required to ensure that the practice carried out antimicrobial prescribing audits to monitor and measure prescribing practices against current evidence-based guidance.

Patients were referred to primary and secondary care specialists for treatment the practice did not provide. This included referring patients with suspected cancer under the national faster diagnosis pathways. However, improvements should be made to ensure that effective systems were in place to monitor and track whether referrals were received by the intended recipients and acted upon in a timely manner, particularly for urgent referrals.

The principal dentist kept up-to-date with current evidence-based practice, and had the skills, knowledge and experience to carry out their roles.

The principal dentist understood their responsibilities under the Mental Capacity Act 2005. They described how they involved patients’ relatives or carers when appropriate and made sure they had enough time to explain treatment options clearly.

Staff felt the practice supported them to develop and enabled them to take on responsibilities.

The judgement for How staff, teams and services work together is based on the latest evidence we assessed for the Effective key question.

The judgement for Supporting people to live healthier lives is based on the latest evidence we assessed for the Effective key question.

The judgement for Monitoring and improving outcomes is based on the latest evidence we assessed for the Effective key question.

The judgement for Consent to care and treatment is based on the latest evidence we assessed for the Effective key question.