Dental Tribune United Kingdom Edition

Interview with the Care Quality Commission N ow that the impact of the CQC is finally upon us, the clarity of the CQC’s role, remit and function is still hazy, with many within the profes- sion still questioning its necessity. Whilst the coalition government’s pledge to abolish excessive regula- tion has made a tortoise-like start, it seems that, whether we like it or not, the next level of regula- tion involving compliance with the CQC must be adhered too. To help separate myth from reality, I raised many of the profes- sion’s concerns with Linda Hutch- inson director of registration at the CQC to see whether the fears of the profession have merit or are merely a result of scaremongering. Neel Kothari (NK): There has been a lot of speculation around the remit of the CQC; can you help sort out fact from fiction? Lind Hutchinson (LH): The Care Quality Commission (CQC) is the independent regulator of all health and adult social care in Eng- land. Our aim is to ensure the qual- ity and safety of care, wherever it is provided. We also seek to protect the interests of people whose rights are restricted under the Mental Health Act. We promote the rights and in- terests of people who use services and we have a wide range of en- forcement powers to take action on their behalf if services are unaccept- ably poor. We are introducing a new registra- tion system that brings the NHS, independent healthcare and adult social care under a single set of es- sential standards of quality and safety for the first time. Registra- tion is a legal license to operate. We register health and adult social care services if they meet essential standards and we continuously monitor them to make sure they continue to do so as part of a dy- namic system of regulation which places the views and experiences of people who use services at its centre. NK:HowjustifiablearetheCQC fees, given that the profession already pay for GDC regula- tion - and what sort of future increases do you envisage? LH: Registration with CQC is the law and the fees are calculated on the estimated cost of regulation. These were based on a similar pro- vider type, independent GPs, al- though the fees could change over time once we have a clearer idea of how much activity is required for this sector in terms of compliance monitoring. NK: How is the CQC ac- ually going to manage the practice inspection process? Are you going to target certain practices before others? LH: We will target our initial com- pliance reviews where we have the greatest concerns. We have recently carried out pilot projects on how we will monitor dental providers’ com- pliance with the essential standards of quality and safety. NK: What level of experience with dentistry will the practice inspectors have? LH: Our inspectors are experts in regulation and cover a diverse range of services which are already regulated by the CQC. An inspec- tor may have a portfolio of services they regulate including care homes, children’s health services, substance misuse services, prisons and inde- pendent doctors. We are confident that our inspectors and assessors can confidently add primary den- tistry care to this range. Inspectors and assessors are receiv- ing bespoke training on the regula- tion of dental providers currently. We also have a national advisor on dentistry and a provider reference group, which we consult regularly on registration issues. As with other services, we will bring in specific ex- pertise if required. NK: What sort of burden do you think this will impose on practice staff such as recep- tionists and nurses? LH: There are no specific require- ments for practice staff other than to contribute to essential standards of quality and safety for the provider. NK: How consistent has infor- mation from the CQC helpline been and has this thrown up any problems with the dental profession? LH: We are confident about the advice provided by our national contact centre. Our advisors receive five weeks’ training before they start handling calls and if advisors are unsure about how to respond to a query, they seek further advice from a range of sources. NK: If it is shown that over-reg- ulation directly or indirectly has a detrimental effect on pa- tient care, how would you as a regulator feel about it and would you recommend to the DH that your remit is scaled back? LH: Regulation is in the best in- terests of patients and providers. In fact, registration will be an en- dorsement to providers who meet the essential standards. Regulation is based around providers meeting the essential standards, which are based on outcomes, the experiences people have. This system puts pa- tients at the centre of care. NK: Why has CQC only focused on practice policies and protocols and not ac- tual clinical care at the point of delivery? LH: The system of registration fo- cuses on outcomes, which are based on the experiences patients have, rather than inputs, and we make no apologies for this. We only normally inspect policies and protocols if we are looking for answers about questions that we have identified about outcomes for people. Our system of checks and inspection is driven by monitoring outcomes, through quality and risk profiles. We define outcomes broad- ly so as to include both clinical out- comes and people’s experiences. NK: How will CQC monitor compliance after 1 April? LH: All providers will have a planned review at least once every two years and can have a respon- sive review at any time. Responsive reviews will happen if we have spe- cific concerns about a provider. If you are registered with conditions on your registration, you will be subject to review more than if you have no conditions. This is a risk- based regulatory system. So there we have it guys, did it help? Is there anything else anyone wants answered? If so please email me at neelkothari@hotmail.com and I will do my best to raise it with the CQC. DT Neel Kothari speaks to the CQC’s Linda Hucthinson About the author Neel Kothari qualified as a dentist from Bristol University Dental School in 2005, and currently works in Cam- bridge as an associate within the NHS. He has completed a year-long postgraduate certificate in implantol- ogy at UCL’s Eastman Dental Institute, and regularly attends postgraduate courses to keep up-to-date with cur- rent best practice. United Kingdom Edition March 28-April 3, 2011United Kingdom Edition