I went to my dentist last week. He’s a close member of my family and an outstanding dentist, but I couldn’t help wondering if the pain I felt after leaving was in some small way the consequence of me telling him that much of my work was Care Quality Commission related. Perhaps I should have been more clear that I do not work for CQC; I advise the regulated not the regulator.
I’m not being entirely serious, of course. My dentist is a most consummate professional like most dentists and would never cause anyone undue pain. It is true to say, however, that the whole process of applying for CQC registration leaves him frustrated and irritated. That feeling is undoubtedly shared by much of the profession. After all, why should regulators with no dental experience or qualifications be considered qualified in any way to make judgments about standards of treatment? And in any event, what cavity in General Dental Council regulation did the health department consider needed filling by CQC?
Unfortunately, the health department did not listen carefully enough to dentists when these questions were being asked and deadlines for dentists to apply for registration now loom. The main purpose of this article is to help dentists through the process.
Deadlines
By now, all dentists who carry out any NHS work should have received a letter or email to enrol them onto the registration system. All dentists (including dentists who carry out private work only) must enrol. If you have not done so already, do so now. This can be done online at www.registration.cqc.org.uk/datacollection/welcomePage.htm
Once you have enrolled, CQC will give you at least 28 days notice of a deadline by which you must apply for registration. CQC refers to these 28 day periods as application ‘windows’. The first window opened on November 15, 2010, and the last ends on December 31, 2010. If you are unsure when your window is, contact CQC and ask.
It is important to apply before your window closes. If you do so, the transitional arrangements mean that CQC will not be able to take any action against you if it fails to consider your application by April 1, 2011 from which time you will technically be committing an offence if you practice without registration. However, if you apply after your window closes, and CQC fails to consider your application before April 1, 2011, CQC could take enforcement action against you after that date. CQC has a policy that late applications will be decided after applications made in time. That increases the likelihood that you will be left in a position of having to choose between ceasing practice until CQC reaches your application or committing the offence of carrying out a regulated activity without registration. On a practice management point, applying late will also create an unfortunate first impression on your new regulator. So perhaps the most important point to make is to ensure that you apply before your application window closes.
Helping hand
If you have not already done so, watch the two online video presentations about the registration process. They are available at https://registration.livegroup.cqcdentistevent/webcasts/presentation1/Default.aspx
There is also a written guide which is useful to have to hand as you complete the form. It is available at www.cqc.org.uk/publications.cfm?fde_id=16021
Who must apply
If you are a sole practitioner, you must apply yourself. If you are in partnership or employed by an organisation, a person duly authorised by the partnership or organisation must complete the form. Who the authorised person and how they are authorised is an internal matter for each partnership and organisation.
One question that is bound to arise frequently is in respect of practice co-operation models which fall short of full partnerships. CQC’s view is that if there is no agreement between the dentists which results in shared liability, such an arrangement does not constitute a partnership and each dentist must apply for registration as individuals, even though they are practising from the same location. The guidance provides some information about this issue. If in doubt, ask CQC but try to get a response in writing. At the very least, keep a careful note of the discussion, including who you spoke to and when, so that you have a written record if CQC challenge you on the matter at a later date.
Nominated individual
The role of nominated individual is relevant to organisations only. The purpose is for there to be a person to have overall supervisory responsibility for the way regulated activities are conducted. The person must occupy a senior role such as a director or senior manager of the organisation. For details, see the guide.
Registered manager
Organisations and partnerships require a registered manager. So too do individuals if they are not in day-to-day charge of managing the practice. The registered manager will be the person who carries out the day-to-day management of the practice. The manager should apply for registration at the same time as your application. Unfortunately, at the date of writing, the form was not yet available on the CQC website. The registered manager can be the same person as the nominated individual provided the person appreciates the roles are separate and involve different responsibilities.
Common queries
If you do not yet have one, you can use a template from the CQC website: www.cqc.org.uk/statementofpurpose
What regulated activities should be applied for? For most dentists the relevant regulated activities would be:
- treatment of disease, disorder or injury;
- surgical procedures; and
- diagnostic and screening procedures.
Have a look at the full list in the guide and if you have any queries about whether any other regulated activities apply, contact CQC.
How do you complete the long form questions? The important points here are to refer to evidence (without enclosing it) for every factual claim you make. For example, in answer to the question, ‘What are you doing to increase the influence of equality, diversity and human rights issues on the planning and delivery of the services?’ it may be useful to indicate that you have undergone training on the issue and it is the practice’s policy that all staff receive such training on a regular basis.
Don’t worry about writing perfect answers. It is far more important that you get your application in on time.
Compliance
You will need to form a view on whether your practice is currently compliant. The best way to do that is to read CQC guidance on compliance (also known as Essential standards of quality and safety). CQC appreciates that you may not yet been in compliance. Declaring non-compliance will not necessarily result in your registration being refused. More likely, it will result in a condition of your registration based on the remedial action you specify on the form. It is therefore important to be realistic on the form about the dates by which you will become compliant. Specifying a date which you cannot then meet will only set you up to fail.
Conclusion
Whilst dentists will not be looking forward to completing the application form they may find that procrastination only makes things worse and 90 per cent of the pain is in the anticipation. Make sure you apply on time and contact CQC if you have any queries. If you get stuck contact me.
Contact Jonny Landau on 020 7317 0346, email jonny@ridout-law.com or visit www.ridout-law.com