governance Flashcards
describe the CQC and what they do (4)
- independent regulator of health and social care in England
- monitor, inspect and regulate services - ensures minimum quality standards, safety outcomes
- reports and publishes findings
- concerned with premises, management, organisation policies, procedures, protocols, documents
describe the GDC and what they do (2)
- UK statutory regulator of all members of the dental team
- protects patients and regulates the dental team against published standards
describe the Dentists Act 1984 (6)
legislative framework for DCPs which gives the GDC powers to:
– grant registration only to those who meet requirements
– set standards for UK dental education and training providers
– set standards of conduct, performance and ethics for dental team
– investigate complaints against DCPs and take action where appropriate
– require DCPs to keep skills up to date (CPD)
what main 5 things does the CQC look at when they assess a practice/service?
- patient-centred care - effectiveness, communication, CPD
- consent - autonomy, informed
- pt safety - premises and infection control
- complaints system and response
- leadership, management, governance
what kinds of things regarding patient safety may be assessed by the CQC? (5)
- policies - safeguarding, raising concerns, underperforming
- decontamination (HTM 01-05)
- drugs within date (medical emergency, daily materials)
- registration of staff and working within competence, DBS checked
- clinical waste separation and collection
what kinds of things regarding leadership/management/governance may be assessed by the CQC? (5)
- specifically appointed leads (safeguarding, radiography, etc)
- fulfilling duty of candour
- being open and transparent (interview the newest team members)
- regular team meetings and audit
- updated policies to ensure safe practice
give a brief history on how NHS dentistry used to function and why that is no longer the case (5)
- established in 1948 with dental tx free at point of use
- fees introduced in 1952 due to high cost for providing care
- fee per item, any dentist able to provide NHS care if they wanted
- but concerns over drill and fill attitude and overtreatment, high costs for government
- now there is a set budget for NHS dentistry
describe how practices and associate dentists are commissioned by the NHS (5)
- a practice holds a contract with the Area Team to perform NHS PDC (certain number of dentists per town)
- target for amount of work per year and how much the practice will get paid for this = based on local treatment need, paid per month
- must achieve within 4% of goal otherwise reduced target next year
- 2% overperformance = clawback
- associate dentists agree with practice owner what % of the UDA value they receive
what are the UDA values of each band and what treatments are included? how much is the patient charged?
1 (1 UDA): £25.80
- examination, radiographs, prevention and PMPR (if clinically needed)
2a (3 UDA): £70.70
- fillings/extractions of 1-2 teeth
2b (5 UDA): £70.70
- non-molar endo (permanent teeth)
- fillings/extractions of ≥3 teeth
2c (7 UDA): £70.70
- molar endo (permanent teeth)
3 (12 UDA): £306.80
- crowns, dentures, bridges (lab work)
emergency (1.2 UDA): £25.80
- urgent assessment and specified urgent tx (pain relief, temporary filling, appliance repair)
who is exempt from paying NHS dental fees? (6)
- <18yo
- 18yo and in full time education
- pregnant or gave birth within last 12 months
- receiving low income benefits
- <20yo and a dependant on someone receiving low income benefits
- tx in NHS hospital by hospital dentist (but pay for dentures or bridges)
limitations of the old UDA model (up to 10)
financial:
- low remuneration for complex work
- unfair for patients with lower risk (same cost)
- FTAs = no money to dentist and no penalty to pt
unrealistic:
- bandings too simplified
- capacity issues (unable to reach targets)
pt-centred care:
- may encourage supervised neglect
- prevention is not rewarded
- target-driven
- limited referral pathways
- doesn’t allow for team-based approach
benefits of the old UDA system (3)
- provides access to relatively good quality care for many pts who would not otherwise be able to afford it
- stable source of regular income
- good pension scheme for NHS dentists (under review) and income protection if sick
what is included on the FP17 form? (5)
- provider
- pt details
- patient charge collected or if exempt
- number of UDAs performed
- treatment banding information
give all 9 GDC standards in order
1 put patients’ interests first
2 communicate effectively with patients
3 obtain valid consent
4 maintain and protect patients’ information
5 have a clear and effective complaints procedure
6 work with colleagues in a way that is in patients’ best interests
7 maintain, develop and work within our professional knowledge and skills
8 raise concerns if patients are at risk
9 make sure our personal behaviour maintains confidence in us and the dental profession
what is GDC standard 1?
put patients’ interests first
what is GDC standard 2?
communicate effectively with patients
what is GDC standard 3?
obtain valid consent
what is GDC standard 4?
maintain and protect patients’ information
what is GDC standard 5?
have a clear and effective complaints procedure
what is GDC standard 6?
work with colleagues in a way that is in patients’ best interests
what is GDC standard 7?
maintain, develop and work within our professional knowledge and skills
what is GDC standard 8?
raise concerns if patients are at risk
what is GDC standard 9?
make sure our personal behaviour maintains confidence in us and the dental profession
define informed consent
- voluntary and continuing permission of the patient to receive a particular treatment
- based on adequate knowledge of the purpose, nature and likely effects and risks of that treatment, including its success and any alternatives