All registered providers of health and social care must meet the Code of Practice on the prevention and control of infections.
The Code states:
"Good infection prevention (including cleanliness) is essential to ensure that people who use health and social care services receive safe and effective care. Effective prevention and control of infection must be part of everyday practice and be applied consistently by everyone.
"Good management and organisational processes are crucial to make sure that high standards of infection prevention (including cleanliness) are developed and maintained."
We use the Code of Practice and related guidance on infection prevention and control when assessing whether a provider is meeting the regulations. They reflect our expectations for dental providers on:
- what cleaning is required
- how organisations can demonstrate that cleaning services meet these standards
The 2021 standards reference a star rating system. There are no expectations that we require you to display star ratings or logos in dental practices.
General requirements
You should have an effective infection prevention and control (IPC) policy. This should be:
- relevant to your practice
- accessible to all staff
- updated regularly.
The policy should include:
- specific requirements for higher risk procedures
- staff training requirements and frequency of training updates
- the use of personal protective equipment (PPE), including staff training in safe use and disposal of PPE
- responsibilities for cleaning specific clinical equipment.
There should be an IPC lead with overall responsibility for infection prevention and control and the authority to lead and implement change where needed.
There should be an IPC audit programme, so policies and procedures are effective and up to date. The audit should show evidence of issues identified and how they have been addressed. The Health Technical Memorandum 01-05: decontamination in primary care dental practices advises providers to use the Infection Prevention Society’s audit tool.
Cleaning contractors should have a schedule of general cleaning. The schedule should include cleaning frequency of specific areas, fixtures and fittings. This includes high frequency touch items such as keyboards, telephones, door handles and light switches. It should be checked regularly for compliance and in line with what the public would expect in healthcare premises.
Staff should have access to occupational health services. They should be immunised according to Public Health England’s Green Book.
Specific issues
Healthcare waste
Primary care providers have a statutory duty of care that requires you to take all reasonable measures to deal with healthcare waste appropriately. This is from point of production to final disposal.
Healthcare Technical Memorandum (HTM) 07-01 Safe Management of Healthcare Waste is a framework for best practice. It makes sure that providers meet legislation such as the Health and Safety at Work regulations.
General clinical waste
Bins should be easily accessible to staff at the point of use. In clinical areas, they should have a lid and be operated with a foot pedal.
Waste should be assessed and segregated appropriately. Waste bags should be:
- maximum two thirds full and securely tied
- labelled with the address and date before being collected
- stored in a secure, clean designated area while awaiting collection.
Medicines waste
See our guidance on medicines management in dental practices.
Sharps
See our guidance on use of safer sharps.
Hand hygiene
See our guidance on hand hygiene.
When we inspect
When assessing how practices manage infection prevention and control, we look at:
These regulations remind providers that they must:
- assess the risk of, and prevent, detect and control the spread of, infections, including those that are healthcare associated.
- ensure healthcare premises are clean, secure, suitable and used properly and that they maintain standards of hygiene appropriate to the purposes for which they are being used.
We will assess how providers:
- maintain standards of cleanliness and hygiene
- have reliable systems to prevent and protect people from a healthcare-associated infection
- maintain and use facilities and premises in a way that keeps people safe
- manage waste and clinical specimens to keep people safe.
Further information
Healthcare-associated infections: prevention and control in primary and community care (National Institute for Health and Care Excellence)
Dental framework – Supporting Guidance for Primary and Community Care Dental Settings (NHS England)