Dental Tribune UK Edition, September 20-26, 2010, Vol. 4 No. 22

A s a solicitor dealing pre- dominantly with the business affairs of den- tists, I am acutely aware of the concerns in the dental profes- sion, which flow from the Health and Social Care Act 2008, over measures being introduced. The Act contains 173 sections, 15 schedules and provides for the introduction of further regula- tions, codes of practice and guid- ance to be published by the Sec- retary of State if required. Subsequently, there have now been 28 published regula- tions setting out certain essential and politically correct standards of quality and safety that dentists are required to acknowledge. The outcomes are apparently meant to be helpful by provid- ing dentists with prompts to help them comply. On top of all this, there is written guidance to help interpret the regulations. The main objective of the Act is a sweeping one: to protect and promote the health, safety and welfare of people who use the health and social care services (s.3 (1)). The Care Quality Commission In order to provide services all dental practices, NHS and pri- vate, have to be registered with the newly created, integrated regulatory UK public body, The Care Quality Commission (CQC), by 1 April next year: Thereafter, they can look forward to compli- ance monitoring. Eager dentists can enrol from 1 October, although there is some suggestion that the CQC still doesn’t know what it wants from dentists to facilitate this. At least doctors are more fortunate as they have a year longer to reg- ister. There are harsh potential penalties for not registering, with fines of up to £50,000, 12 months’ imprisonment, or both. Under Section 86 of the Act, dentists could be issued with fixed penalty notices for non- compliance and there will be powers for the CQC to take en- forcement action if practices are not up to scratch; practices may even have to have their own reg- istered managers. Practitioners can seemingly take no comfort at all, consider- ing one of the stated aims of the CQC, which is a commitment to reducing bureaucracy and un- necessary regulatory burden - to avoid duplication and promote “joined up care”. They seem to be doing the reverse of the state- ment: they think that by saying what they are not going to do will fool us, and that nobody will notice when they go on and do exactly the opposite. Local decontamination units One of the main issues for pri- mary care dentists is, of course, the requirement to have on site their very own Local Decon- tamination Unit (LDU) - a ster- ile unit for the decontamination of reusable dental equipment. The 95-page best practice ad- vice booklet, A Health Technical Memoranda, gives full details. Incidentally, this is only part of a suite of nine such useful memo- randa, comprising assorted core health subjects. The LDU issue is an important one and seems in part to have originated in 2001 with The Glennie Report, which reviewed the sterile serv- ice provision across the NHS in Scotland. There is of course a question mark as to the effectiveness of LDUs; the sterile equipment is inevitably moved into the non- sterile environment of the sur- gery where there is no effective control over what happens to it. Nevertheless, one of the prof- fered objectives behind LDUs is to try and counter the risk of the human variant of CJD/mad cow disease being caught from re-usable, steel dental instru- ments; add to this further con- cerns about passing on MRSA and hepatitis B – one can hardly deny a highlighted need for pa- tient safety. Negative impact? Concerns that dental practices might have to close, due to the cost of creating LDUs or because of a lack of available installation space, appear unfounded. One product manufacturer found on the internet is advertising a 2.7m by 1.6m LDU for a reasonable £2,499, although many dentists remain sceptical of their ben- efits and feel coerced into buying expensive equipment on the ba- sis of what they feel is inconclu- sive evidence. Undoubtedly, the work of the CQC has created a new range of work for some manufacturers and also those eager to advise dentists on their new responsi- bilities – best-practice advisers and CPD providers, to name a few. Published information on Wikipedia about the CQC does not help inspire confidence. A recent staff survey identified that 86 per cent of them have no confidence in the executive team and 82 per cent thought it unsafe to speak up and challenge what they were doing. The high-pro- file CQC Chairman, the Baron- ess Young of Old Scone, resigned her post at the beginning of the year in an apparent breakdown with Labour Ministers; raising serious questions about Lady Young’s confidence in the Gov- ernment and the Health Service. The future It does seem that despite the change in government and the promise of less bureaucratic interference and state control in all our lives, this is an area where the influence of the ‘Nan- ny State’ continues to dominate. Looking to the future, one also wonders how far compliance with the new quality rules, aside from pleasing patients, will be used as a pre-requisite to qualify dentists to undertake NHS work and indeed also qualify them for membership of organisations such as Denplan and Practice Plan. Compliance will certainly help all those bodies, private and public, in determining who they favour. DT Following the rules Chris Hindle looks at how measures flowing from the Health and Social Care Act 2008 will affect dentists and their business plans About the author Chris Hin- dle qualified as a solicitor in 1991 and is a partner with Leeds-based specialist den- tal lawyers, Cohen Cramer. He has extensive experience acting for clients who are buy- ing and selling property and of landlord and tenant matters, including drafting leases and landlord consents. He acts for clients in the acquisition of development sites and retail/ industrial estates. To contact him, email Chris.hindle@co- hencramer.co.uk. ‘Concerns that den- tal practices might have to close, due to the cost of creating LDUs or because of a lack of available installation space, appear unfounded.’ 13Practice ManagementSeptember 20-26, 2010United Kingdom Edition 13 converting to private practice can be easier than you think relax...If you’re thinking of opting out of the NHS please give us a call, we have the plans and expertise to help you make it happen. 01691 684135 www.practiceplan.co.uk G12236 PP relax 390x90mm ad.indd 1 13/9/10 16:41:55

Please activate JavaScript!
Please install Adobe Flash Player, click here for download