The CQC is really not having a good time of it at the moment – two critical reports ripping its methods apart, and three chief executives in a year, with the last one leaving at very short notice.
The CQC’s “single assessment framework” was touted as being the way forward, although we had been told that most of it did not really affect dentistry. As it transpires, this was lucky, as the Dash report was damning of a number of its systems and processes. Under one of its recommendations, it said:
“Aspects of the single assessment framework could be retained – with some modifications. Other aspects should be suspended and almost certainly scrapped, including the evidence categories.”
The disarray at the CQC has been further reinforced in a recent letter from the new chief executive, where it states that the CQC has not “been able to give the public and providers a comprehensive view of quality across the sectors we regulate”. It goes on to say that it has “already started work on re-setting our values as an organisation”. As part of this reset, we have been asked for a meeting to establish our “perspective on where things have gone wrong”. Strong words indeed, and we will be following up on the invitation.
Some of the key changes to CQC inspections
So, it appears, at least for dentistry, that the CQC has reverted to the tried and tested method of using the “monitoring approach”, which it first developed under the COVID restrictions. Although the majority are physical practice inspections, it is also utilising upfront telephone calls. These are designed to ascertain if any inspection is actually required and if so, to make any such inspection smoother and less time-consuming.
Some practices have had virtual inspections, and the CQC is taking that idea forward. A few such trial inspections have been undertaken, subject to the practice meeting relatively tight criteria. Practices must have been registered since 2017, been inspected (and been compliant) and had no issues of concern received. The inspector undertakes a pre-assessment call to explain how the virtual inspection will work and will ask for a list of documents in advance. The virtual inspection will then be carried out using remote technology, with a physical site visit not being carried out, unless certain issues deem it necessary.
These inspections, and the other physical ones, are still undertaken on the bases of the CQC-wide five key questions, which are whether the practice is safe, effective, caring, responsive and well-led. It is still looking at the same issues; and after all, there are only a certain number of subjects that can be examined at a dental practice, and we can provide help and advice on these compliance issues.
The process for submitting your CQC application has also changed
In addition to the devastating Dash report, the much-trumpeted provider portal, the system designed to make applications and notifications smoother, was taken offline indefinitely on 18 November.
Now providers must revert to using the old application forms, something many dentists actually preferred. We have received many complaints over the last few years from providers about the portal and have passed proof to the CQC of members’ poor experiences with the system.
With the return to Word-based forms, we can give advice to members much more easily on what to put on these forms and where. We were not given access to the portal, so could not help so effectively with the online application process.
What happens to your CQC application now the portal has been removed?
If you have submitted your CQC application using the portal and it has been validated and accepted by the registration team you will not need to resubmit it because it will be in the queue to be assessed.
If you have submitted your application using the portal, but have not yet received confirmation, the CQC will contact you within the next few weeks to confirm that it has been forwarded for assessment. If there is a problem with it, the CQC will contact you with instructions on how to resubmit it, but, importantly, this resubmission will not be put to the back of the queue.
Read more about changes to registering with the CQC.
The CQC has said that applications will still be approved or refused based on the outcome of the registration assessment, and they will continue to assess applications in date order. This means that the removal of the portal will not have an impact on timeframes. We have received a number of complaints from members about the time being taken with some applications and the CQC assure us that additional resources have been deployed to address the problem.
In a time of considerable change at the CQC it appears that most of the updates do not affect the dental profession. However, the senior management including new Chief Executive Sir Julian Hartley will have to look at the fallout from the Dash report, and that may lead to changes in the dental sector, but it is far too soon to predict how these changes might manifest themselves.
