The regulation of the health and adult social care sector is changing and from next year, all providers of dental services will need to be registered with the Care Quality Commission as part of that change.
The CQC is introducing a new system of registration which brings the NHS, independent healthcare and adult social care sector under a single set of essential standards of quality and safety.
The new system of registration has been set out by the health department under the Health and Social Care Act 2008, under which the providers of dental services will need to be registered with CQC by April 1, 2011.
Registration is, in effect, a provider’s licence to operate. It means people can expect providers to meet essential standards of safety and quality that respects their dignity and rights.
One of the key purposes of registration is to give the public assurance and information with all up-to-date information on CQC findings on providers to be hosted on its website from April next year.
The new system is focused on outcomes, rather than systems and processes, and places the views and experiences of people who use care services at its centre.
Registration will apply to all providers of regulated health and adult social care services and for the first time this includes dental care providers as well as GPs’ practices, NHS trusts and independent ambulances that undertake a regulated activity.
Any provider delivering regulated activities, as defined by the Act, needs to be registered with the CQC. Regulated activities include the treatment of disease, disorder and injury, surgical procedures, nursing care, diagnostic and screening procedures and others.
A provider may be registered to provide services from more than one location so dental practices within a group or partnership will not need to register separately. It is the legal body that provides the services that needs to register as the provider.
Once a provider shows it is meeting the required set of standards, it will be registered and effectively granted a licence to provide services.
The 28 essential standards that providers need to meet for registration include ensuring essential levels of hygiene and safety are provided. For example, the outcome on the safety, availability and suitability of equipment directs that providers make sure service users are not at risk from harm from unsafe or unsuitable equipment. The care that people say they experience will also play an essential role in assessments.
The CQC will not be looking at the practice of individual clinicians but will be working closely with partners such as the General Dental Council and the NHS Dental Service to help inform its approach.
After initial registration, CQC will continuously monitor whether providers are meeting the essential standards of quality and safety. The CQC will hold a profile for each registered provider (a quality risk profile) that contains all the information relevant to their compliance. Each time new information arrives about a provider, it will be tested to assess whether it indicates a risk of non-compliance.
This information will be organised in a way that allows us to determine the risk of the provider not meeting the standards of quality and safety in the future along with bringing together information from other regulators.
One of the most notable differences between the old system of regulation for the health and social care sector and the new one is the new standards are legally enforceable, so to breach a standard is an offence.
If we find standards are breached, we will use our wide range of enforcement powers to prompt action. These escalate from warning notices to fines to cancellation of registration and the closure of services.
There is no set frequency for inspection, but CQC can perform a planned review of compliance, such as an inspection or an information request, as often as every three months but no less frequently than every two years. The frequency of these reviews will depend on the nature of the services provided, the people who use them and the information routinely received from the provider.
Responsive reviews of compliance will take place to target areas of concern. As a priority, CQC is discussing with other stakeholders how to coordinate inspection activity across the sector.
To manage a large amount of expected applications, CQC will handle them in application ‘windows’, which means some dental practices may be asked to apply for registration as early as October 2010.
Each group will be given a window to submit their application. To help prepare for this CQC is encouraging dental service providers to look at its website and to familiarise themselves with the essential standards against which they will be assessed. The CQC recently published Guidance about compliance: Essential standards of quality and safety, which makes clear to providers the outcomes it expects people to experience if providers are compliant with the new regulations. The guidance is focused on outcomes, the experiences people have as a result of the care they receive.
For further guidance on compliance, go to www.cqcguidanceaboutcompliance.org.uk.
If we receive a provider’s application by the deadline given, then they will be able to continue to operate legally after April 1, 2011, even if CQC has not processed the application.
From October we will be seeking dentists’ views on a proposed fee structure for the new system of registration via our consultation programme. There will not be any fees for the initial registration application but an annual fee will apply from April 1, 2011.
We will be writing to providers to advise on what will happen next and about further action that needs to be taken.
For more information visit www.cqc.org.uk/registration or email enquiries@cqc.org.uk