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Remove dental professionals from regulation by the Care Quality Commission

Background
The Dental Law Partnership is a specialist solicitors’ company which acts exclusively for dental patients, representing them in clinical negligence litigation. The Directors of the Dental Law Partnership are doubly qualified dentists and solicitors. We therefore have a special interest in the safety of dental patients and the quality of dental care. We are profoundly concerned regarding the impact of CQC regulation upon the delivery of dental care in England.

Relevant Legislation
The former Secretary of State for Health introduced the Health and Social Care Act 2008 (Regulated Activities) Regulations 2009 which came into force on 1st April 2010. The impact of those regulations was to widen dramatically the jurisdiction of the Care Quality Commission (CQC) which had originally been established to regulate only the large organisations involved in the delivery of health and social care – NHS Trusts, Private Hospitals etc. Just one year after the establishment of the CQC, the introduction of the 2009 Regulations brought individual health care professionals into CQC regulation including, by operation of Schedule 1, s5(4)(a) and (d) of the Regulations, the activities of all dental professionals including dentists, dental nurses, dental hygienists and therapists, dental technicians and orthodontic therapists. Following the Regulations the CQC set the date for the proposed registration and regulation of dental professionals at 1st April 2011.

Comparison of CQC regulation with existing regulation of dental professionals by the General Dental Council
Dental Professionals are currently regulated by the General Dental Council. We have considered the likely impact of proposed CQC regulation of dental professionals upon the activities of dental professionals, and in particular have compared the existing regulatory jurisdiction of the General Dental Council with the proposed jurisdiction of the CQC in order to determine whether or not additional CQC regulation of the dental profession from April 2011 is likely to improve patient safety or treatment outcomes.

The comparative analysis involved a consideration of the CQC’s own guidance regarding compliance with Health and Social Care Act 2008 (Regulated Activities) Regulations 2009 and Care Quality Commission (Registration) Regulations 2009 published in December 2009, and the professional guidance for dental professionals issued by the General Dental Council since May 2005. The Headings considered are those of the CQC with the relevant CQC ‘Outcomes’ recorded. It should be noted that a number of CQC ‘Outcomes’ are not relevant to individual dental professionals and have not been considered.

Involvement and Information
CQC Outcome 1 Respect for individuals
CQC Outcome 2 Consent to care and treatment
CQC Outcome 3 Fees

Our conclusion is that in the area of involvement and information, the CQC proposals duplicate existing regulations set out in General Dental Council’s Standards for Dental Professionals May 2005 s1, s2, s3. GDC Principles of Patient Consent s1, s2, s3. GDC Principles of Patient Confidentiality s1, s2, s3.

Personalised care, treatment and support
CQC Outcome 4 Care and welfare of people who use services
CQC Outcome 6 Co-operating with other providers

Our conclusion is that in the area of personalised care, treatment and support, the CQC proposals duplicate existing regulations set out in General Dental Council’s Standards for Dental Professionals May 2005 s1, s2, s4, GDC Principles of Dental Team Working s1, s2, s3, s4, s5

Safeguarding and safety
CQC Outcome 7 Safeguarding people
CQC Outcome 8 Cleanliness and infection control
CQC Outcome 9 Management of medicines
CQC Outcome 10 Safety and suitability of premises
CQC Outcome 11 Safety, availability and suitability of equipment

Our conclusion is that in the area of safeguarding and safety the CQC proposals duplicate existing regulations set out in General Dental Council’s Standards for Dental Professionals May 2005 s1, s2, s3, GDC Principles of Raising Concerns s1, s2, s3.

Suitability of staffing
CQC Outcome 12 Requirements relating to workers
CQC Outcome 13 Staffing
CQC Outcome 14 Supporting workers

Our conclusion is that the CQC proposals duplicate existing regulations set out in General Dental Council’s Standards for Dental Professionals May 2005 s1, s2, s3. GDC Principles of Dental Team Working s1, s2, s3, s4, s5, GDC Principles of Raising Concerns s4

Quality and management
CQC Outcome 16 Assessing and monitoring the quality of service provision
CQC Outcome 17 Complaints
CQC Outcome 21 Records
CQC Outcome 25 Registered person: training

Our conclusion is that in the area of quality and management the CQC proposals duplicate existing regulations set out in General Dental Council’s Standards for Dental Professionals May 2005 s1, s5, GDC Principles of Complaints Handling s1, s2, s3, s4, s5, s6, s7. GDC Principles of Raising Concerns s1, s2.

Overall
Our analysis indicates the regulation of the dental profession by the CQC would create widespread duplication of existing areas of regulation both in terms of coverage and substantive requirements.
 

Why does this matter?

Conclusion
Our analysis indicates widespread duplication of existing areas of regulation both in terms of coverage and substantive requirements. We have concluded that the additional burden of the proposed CQC registration and CQC regulation of individual dental professionals amounts to substantial duplication of the existing regulation of the dental profession, and is therefore not, on a balance of probabilities, likely to produce any significant improvement either in patient safety or treatment outcomes. However it is certain that regulation of dental professionals by the CQC will result in an increase in the administrative and financial burden both on individual practitioners and the CQC, and therefore ultimately on Central Government. It is our view that the proposed registration and regulation of dental professionals by the CQC would be an unnecessary and a wasteful use of significant resources.

We propose immediate amendment of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2009 to withdraw all designated dental professionals from listing within the Regulation and therefore removal from regulation by the CQC. This could be achieved by amendment of Schedule 1, s5(4)(a) and removal of Schedule 1, s5(4)(d).

We commend this proposal to HM Government and the Department of Health for consideration.
 

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