Setting up a Facebook Page for your Practice

Question:

We are thinking about creating a facebook page for the practice.  Could anyone give me any advice on the best way to set up a practice page – my initial research suggests that you are unable to set up a business page if you already have a personal facebook page.   Are there any ways around this?  What have other practices done to over-come this? Can anyone offer any tips or advise on the best way to set up a business facebook page for the practice?

Answer:

We had help from ApexHub and we do have a business page 

Answer:

I set up my practice FB page a while back, I also have a personal page and another hobby page, so there isn't an issue with having multiple pages.  I can't recall the process however, but all by pages show on my FB home page.

Answer:

To create a business page, you do need to have a personal account. The way i try to describe the difference between them is you "add a friend" and you "like a business".

You need to be logged into your personal facebook account and then click on this link – https://www.facebook.com/pages/create/

From this page, you choose the type of page you want setting up. Once the page is set up you can then add the profile image (i recommend you have this as your company logo.) This needs to be a square image otherwise it doesn't always display correctly. The cover image is the same as your own personal account. This is a set size, but facebook allows you to move it around to fit.

You can then edit the rest of the page, so adding your practice address and contact details, website address, open hours, etc.

When you set the account up, you can assign multiple admins of the page. so for example, our own company page we have 3 members of staff all have control to make posts on the page.

There are other things you can do differently with business pages over personal pages. You can schedule posts to appear on a set time and day. Once you have 25 likes, you can also give the page its own url so for example our page is https://www.facebook.com/EnvizageGroup

I think after 30 likes, facebook keeps a track of how many people see your posts as well.

October 2013

Question:

Does anyone use an online booking system, in particular AppointMentor?

We are currently looking at these systems and would be grateful for any feedback.  Has anyone encountered any particular problems?  Are you pleased with how it works, and has it eased the workload from the receptionist?

I would be grateful for any feedback.

Answer:

We use the software of excellence online booking system for exams and hyg recalls. It works very well and has certainly eased the reception workload.

Answer:

We use SOE, it's not without its faults, and patients constantly book for treatment in a slot available for check-up which leaves them short of time. They don't seem to get the "new patient" being one who has not been seen before as opposed to a new booking!  I think time will improve it, when it works as it should its great,   however you still need someone dedicated to check the online bookings each morning so it doesn't save as much time as you'd hope.

Answer:

We use SOE on-line booking system but it can only be used for recall appointments and new patients.  Existing patients with treatment OR who do not have a recall date cannot book on-line.  This means that it is limited.

There is a limit to time settings so it is not ideal but we have not had many problems but we have not had that many booking either.  Probably about 25 in all over 4 months.

We were told that it takes a while about 12-18 months to get patients on-board with the system.

We are trying it as it is another service that we can offer.  Costly so we will review in 6/12 + 12/12, interestingly it has appealed to young and old which has surprised me.  

November 2013

Question:

I was talking to one or two managers at BDTA about training for our front of house team with an emphasis on customer service etc. and was wondering if anybody has any contacts or recommendations of anybody who can come and do either a full day or half day training in this area?  I will be very interested to hear of any contacts who would be willing to help us.

Answer:

We have an annual bespoke training day from Denplan once or twice per year – they are excellent, and tailor the training to suit your needs.

Answer:

We've always found Denplan or the BDA to be very useful in customer care training for receptionists etc.

Answer:

Tracy Stuart, this is very much her area of expertise.

Answer:

I recommend Lina Craven of Dynamic Perceptions. www.linacraven.cominfo@linacraven.com

Anwer:

I would recommend talking to Tracy Stuart.  I have been on one of her day courses & she was excellent.  I believe she has just started her own business & will go into practices for the day.  Her company is called NBS Training.  Look up   www.nbstraining.co.uk

Answer:

It might be worth contacting your local college as they quite often run 1 day courses in these areas. Otherwise dentcom's Anthony Asquith does a fantastic 1 day communications skills workshop in your practice, it really does help to understand patients and how to communicate with them effectively.

Answer:

I would strongly recommend Emma John at Absolute Dental and Absolute Dental Training. She is excellent in training all of the team in customer service and front of house services.

We have had two training sessions with her about two years apart and the sessions changed the way we work and think about customer service.

She comes to the practice and holds an informal session – like a very productive practice meeting and she has great yet simple ideas that you may not have thought of.

I could not recommend her enough,

Answer:

I would highly recommend Ashley Latter most of our dentists have attended his Ethical Selling 2 day course and all of our receptionists have attended his reception course, over the past few years.

http://www.ashleylatter.com/

Question:

We have recently had our CQC inspection. He asked to see if our Chaperone Policy, which was fine but then he asked what formal 'Chaperone' training we had done and suggested an accredited course may be a good idea. I would be interested to see what training other practices have undertaken, if any?

Answer:

I was not asked to show a chaperone policy!

Answer:

I’ve never done any chaperone training apart from in house when we discussed in a practice meeting what was expected from both clinician and nurse so no one was ever left on their own but formal training we’ve never done!  Unfortunately some of the inspectors are from care backgrounds where it is a formality for care homes etc to do formal training in this area.  During my cqc inspection I was grilled for 2 hours on safeguarding – I think he felt comfortable talking about this

Anbswer:

This is the first time I have heard of this!

Our own inspection with CQC didn’t flag this up either.  I am puzzled as to what training (accredited or otherwise) could be done for this policy.   From my own policy is sets it out clearly that the purpose of the policy is to state that training and understanding has already taken place with regards the protection of patients (and staff).  This includes the protection of vulnerable adults and children right through to confidentiality.  I am sure your policy is worded very similarly to this.  If that is the case then CPD etc., has already covered your team if these points have been covered.  Why then would you need another course for something which I only in existence as a demonstration of compliance to all the other policies/guidance/legal requirements?

Answer:

Wow, I find that quite unbelievable.

In light of his comments, I would be tempted to email him or ask the CQC quite what they suggest.

I think you would have a hard job finding a course, let alone an accredited course in Chaperone Training that was actually relevant to Dentistry.

October 2013

Question:

I am interested in knowing if all practices follow the procedures below for cross infection control.  If you do have you been obliged to allow in your day additional time or staff for these procedures to be carried out.  If you do not allow additional time, how long does it usually take to complete the procedure?  I would be eternally grateful for any feedback. I am desperate.

Cross Infection Control

Procedure

At the beginning of the day after putting on uniform wash hands with soap and water following the procedures outlined in the hand washing guide.

Put instruments and hand pieces in a box which is some moisture, but not overly wet.  Put the cover on the box.

Remove mask and gloves.  Do not put masks or gloves in your uniform pocket.  Be sure that they are placed in the clinical waste bin.

Carefully transport the instruments to the decontamination room

Upon entering the decontamination room wash hands again with either soap or hand disinfectant following   the procedures outlined in the hand washing hygiene guide.

Put on face mask, eye protection (goggles or visor), If you wear the visor, you still have to wear the mask, apron, gloves and heavy duty (black) gloves.

Take the lid off of the instrument box. Place instruments in the disinfection solution.  HAND PIECES DO NOT GO INTO THIS SOLUTION.  The instruments may stay in the solution for a random period of time.

Remove instruments from the disinfectant solution and place in the ultra-sonic bath for a minimum period of ten minutes.

While the instruments are in the ultrasonic bath run clear plain water into the blue plastic bowl which should be located above the sink.

Place the instruments into clean blue bowl filled with warm water.  Rinse them and inspect them one by one under magnifying light before you place them on metal autoclave tray.  If you find dirty instruments at this stage you must place them back in the ultrasonic bath or clean them manually in the metal sink with water temperature below 45 degrees C using appropriate disinfectant and long handle brush.  Scrub them under water to avoid splashing.

Hand pieces do not follow this procedure

Hand pieces do not follow this procedure

Place instruments in the autoclave. On the required cycle.

When cycle has finished remove instruments from the autoclave.

Wash the now empty box with water and spray with disinfectant.  This box should be transported back to the surgery with lid on and empty. Disinfect the blue bowl by spraying.  Wash and disinfect gloves with spray.  Wash brushes in hot water and store upright on the clip provided.

Remove PPE in this order.  Gloves, plastic apron, face mask, eye protection. Wash hands again either with soap or disinfectant.

Answer:

We employ 2 decontamination nurses to ensure the unit is fully covered, and the nurses can concentrate on their job.

Answer:

We broadly follow this procedure but have employed an additional nurse as scrubs nurse in the decontamination room!

Answer:

I have had to employ a person to run the decontamination room, it doesn’t work if you have your nurses doing it in between patients there isn’t enough time.  I don’t know how many surgeries you have we have roughly 7 so with all the guidelines etc we took the decision to man it.  We don’t use a qualified nurse as this is not cost effective but employed a person who works the room and as long as they are fully covered with Hep B etc and are learnt what to do then this will be the most cost effective way.

Answer:

We have a member of staff working within the decon room every session (barring staff shortages when everyone chips in), so all these jobs are done within the session, it works very well for us, we are very busy and couldn’t manage without an allocated person

Answer:

With the changes to cross infection control and the subsequent timing issues, we have now contracted a start time 30 mins prior to the start of the practice opening times, to give us all an opportunity to get set-up without too much stress.  We do the same at the end of the morning session we close at 12.30pm to give 30 minutes or so for the end of session procedures.  (It gives me a chance to bother the dentists with admin!!!).  Of course, we do the same at the end of the afternoon session which ends around 5.30pm allowing 30 minutes clean-up (end of day admin as well).  If you would you like a copy of my infection control policy/hand cleaning policy etc., just let me know.

We have a designated member of staff working in the decon room full time – not sure how you’d be expected to work this into your daily routine and maintain seeing the same amount of pts?

Answer:

Yes all of this apart from the soaking.

We have a central decon room for the processing as to do this in surgery between each patient would have taken up a lot of surgery time.  I believe that it is still the case that a patient should not be in the room for certain sections of the decontamination process so again this lengthens the turnaround time between patients.

I am under the impression that now the guidance has moved away from “Soaking the instruments” as this can cause prions to harden to the instruments.  The spraying option with a specific product is the preferred method of use before the instruments go into the ultrasonic bath.

Once the patient has been treated the nurse should place the dirty items safely in the box and then change her gloves and wipe down the surgery.

Is one of your dentists a BDA member?  If they are you may have a source of telephone contact to the BDA for advice.  This would be recommended.  Are you or one of your nurses indemnified? If so you will have access to advice via this route too.

Do you have an NHS contract?  If so it will not just be what the HTM01-05 dictates but also NICE guidelines and any quirks by the PCT will be applicable.

Answer:

Every day one of the nurses is the assigned decontamination nurse and all our nurses are given an extra (paid) 20 minutes at the start of the day to ensure cross infection procedures are carried out and surgeries prepared for the day’s patients.

Answer:

We pay the girls 15 mins in the morning overtime for setting up, and also if needed 15 mins at end of day overtime to do end of day duties, bearing in mind they usually have 30 mins after the dentist has left to complete all tasks, and it seems to be working. All end of day jobs are listed for them, so they just need to tick off and sign when done.

It might be an idea just to provide each surgery an extra secure lidded box to transport clean instruments, they are not very expensive. We label our tubs, CLEAN/ DIRTY.

Answer:

Our practice has 3 surgeries running at one time and we have a designated nurse to carry out all the decontamination procedures.

Answer:

We do not have a decontamination room at the moment but I would envisage employing a member of staff to work in there as we will not block off time in the dentists book for this. I think it is more economical to employ someone else and run 3 full surgeries and on a rota basis have someone to cover all these extra duties.

Answer:

I am practice manager in a large NHS Surgery.

We found the only viable solution was to employ an extra nurse to enable us to have a full time ‘scrub nurse’.  Each nurse takes a turn to do this which means all the staff have a really good knowledge of the infection control routine.

Our procedures differ slightly to yours but are tailored to our practice.

October 2013

Question:

Can anyone list the evidence for outcome 4 cqc please?

Answer:

Outcome four Care and Welfare of People who use the Service

Require: Pt experience effective, safe and appropriate care and treatment which meets their needs

Example

Maintenance of up to date clinical competence and training

Full pt history, including patient expectations and needs, identified at initial appt

Pt are fully involved in the assessment and planning of care

Risk management is in place to detect, evaluate and prevent or minimise risks to pt such as:

• #significant indecent reports
• Medical emergencies training, policies and protocols
• Fire Drills undertaken and evacuation procedures in place
• A preventative approach is taken to patients care and treatment wherever possible

Evidence:

Practice risk assessment

Hlth & safety policy

COSH and RIDDOR assessments

Fire precautions

Emergency training, Collapse procedure and Equipment

Adverse drug reactions and medicine-related adverse events

Staff training logs – CPR and medical emergencies training

Patient records or treatment plans showing patient involvement

Answer:

Denplan had extremely useful information in their compliance portfolio:

Outcome 4 – Care and Welfare of People who use Services

• Practice risk assessment
• Health and Safety policy
• COSHH and RIDDOR assessments
• Fire precautions
• Emergency training, Collapse procedure and Equipment
• Adverse drug reactions and medicine-related adverse events
• Staff training logs – CPR and medical emergencies training (CPD evidence)
• Patient records or treatment plans showing patient involvement

Answer:

Care and Welfare of those who use the service, right?

I've got:

Practice risk assessment, Health and Safety policy, Emergency collapse procedure, Evidence of training in first aid, Medical emergencies etc, Emergency drugs and 02, Fire drill and evidence of training in use of extinguishers, COSHH policy and evidence of training, Significant event protocol and forms ( They will defo want to see some filled in, and evidence of what was done about the event to prevent it happening again). Also added that we use the service of hygienists to facilitate patient's own homecare and oral health.

I haven't got, but would assume that any quality control audits would be good evidence as well.

Answer:

The audits you will probably need are as follows:

Record keeping audit

Fair and Accessible care audit

Post and pre op instructions (both sedation and non-sedation patients)

Post op sheets and call logs.

OUTCOME 4

Care and Welfare of People who use Services

Lead team members: Elena Barlow, Georgina Ingham, Charlotte Rooke, Ginny Lax, Deborah Buckley & Miles Arrowsmith

Requirements:

·       Patients experience effective, safe and appropriate care and treatment which meets their needs

Examples:

·       Maintenance of  up to date clinical competence and training

·       Full patient history, including patient expectations and needs, identified at initial appointment

·       Patients are fully involved in the assessment and planning of care

·       Risk management is in place to detect, evaluate and prevent or minimise risks to patients such as:

o   Significant incident reports

o   Medical emergencies training, policies and protocols

o   Fire drills undertaken and evacuation procedures in place

·       A preventative approach is taken to patient’s care and treatment wherever possible

Evidence:

      Health and Safety Policy (also refer to Health & Safety file)

      Practice risk assessment (refer to Risk Assessment file)

      COSHH assessments (refer to COSHH file)

      RIDDOR procedure & reporting forms

      Fire precautions (also refer to Risk Assessment file)

      Emergency training, collapse procedure and equipment (also refer to Medical Emergency File)

      BDA Medical history Form

      ASA categories guidance

      Adverse drug reactions and medicine-related adverse events (refer to Outcome 1)

      NICE Recall Practice Guidance

      NICE Dental Recall Quick Reference guide

      NICE Oral Cancer Guidelines

      Antibiotic Prophylaxis and Infective Endocarditis

      NICE Guidance on Extraction of Wisdom teeth

      Policy for patients receiving Bisphosphonates

      Staff training logs (refer to ‘practice documents’ at the beginning of this file) and CPD evidence (refer to individual appraisals in the personal files)

Based on the above, is the practice Compliant with this outcome?  YES/NO

If not, see the Action Plan, with date, to achieve compliance attached.

June 2013

Question:

I would like to find out if we are required to renew the Legionella Risk Assessment on an annual basis. If so, should we contact the authorised company who did the initial risk assessment for us or is this something that could be done by ourselves? Cost wise, I know what I would prefer, but where do we stand legally?

Answer:

I was told by Brodex because we don’t store any cold water on the premises we only have to do the assessment and test every 2yrs. We do are water temp check every month. Hope this helps.

Answer:

The Legionella risk assessment needs to be repeated annually. The Company who actually carried out the water testing can provide this at cost, however if you are a member of CODEUK you can download their policies and assessments in order for you to conduct your own risk assessment.

Alternatively, you can find a template for risk assessments on the HSE website, thus being at no cost to you.

Answer:

The Legionella can be done once every two years. We use a reputable company called Aqua Analyse Tel. 01628 902 100. They carry out our tests and have been very efficient. As we share the building with two other practices, we share the cost between us but for the whole building check and full risk assessment, follow-up report and certificate we are being quoted £400.00 in total. I highly recommend them.

Answer:

The rules have just changed again with regards to the assessment, as long as you are able to carry out the risk yourself this will suffice, it was every other year.

We have however just had another assessment at a cost of £100.00 it will be difficult for us to carry the tests out as we have a loft to get into so we shall be looking at it

Again next year by which time I imagine the rules will have changed again.

Answer:

I think the risk assessment by a fully trained person is biannual with an annual assessment of the water which you can do as long as the company use supply you with the pots etc. Our company came out and took samples of the water which were sent away for testing.

We have been advised this and we also need to do monthly checks on the temperature of the water.

May 2013

A qualified and registered hygienist cannot work as a dental nurse unless she is registered as a dental nurse as well, there is no extra cost involved and no extra CPD.

Question:

Does anybody have a protocol for the suppling of Uniforms, i.e. how many do Practice’s issue a year, what happens if someone puts on / loses weight, is the Practice responsible for providing and paying for new ones?

Answer:

We tend to buy the jackets for nurses and reception when they join the practice. Staff supply their own trousers. We do not replace the jackets yearly, if they are getting worn and look tatty we would replace them. If the staff member loses it or damages it they would pay for a new one.

One of our receptionists lost quite a lot of weight and we paid for a new reception jacket for her but she has worked here for 4 years so her original jacket was looking quite worn.

We are a small practice and tend to look at each circumstance individually.

When we change the style then we would of course replace everyones uniform as well.

Answer:

We issue 5 tops and 5 trousers once a year (usually Jan). If there is a need outwith this time, ie different size, we issue them and use the ones not in use as spares. Again, for pregnant employees, we issue appropriate sized uniforms. The girls were asked a few years ago what they wanted to wear and they opted for scrubs, These aren't that expensive and therefore we haven't had much of a problem. The dentists and hygienist all purchase their own dental jackets and wear what they like. This hasn't lead to any problems. We don't have a 'corporate look' but we aren't that much out of pocket.

Answer:

We supply all our nurses with 5 uniforms for summer and 5 for winter (theses are a bit thicker material, with room for a neat vest top underneath for extra warmth when needed.)

The nurses buy their own trousers, as the fit is more crucial, and we then re-imburse them.

They have an annual allowance for this, so that if they spend too much on 1 pair, they don't get all the £ back.

If someone's weight changes dramatically, I would suggest that they fund their own new uniforms, but if the keep the weight off for, say, 6 months, they could be reimbursed.

We have a fairly stable team, but we do keep the uniforms if anyone leaves. We only replace uniforms as required, not routinely every year.

Answer:

We have always supplied uniforms to staff as required. It has never caused us a problem as yet.

Answer:

We just issue replacement/new scrubs when needed. As we tend to have an assortment of sizes in a box we have been able to supply anyone who has put on weight (doesn’t seem to have worked the other way?) with their new requirement at no extra cost. If they put their badges in the wash they have one replaced but any other mishaps they have to pay themselves.

Answer:

We tend to provide at least 2 tops for full time staff. Unfortunately because you want people to properly kitted out it is best to cope with the weight gain by still giving them uniforms. We also recycle old uniform with new staff ie they get an old one along if it is available in their size with the new one we provide. Uniforms always remain the property of the practice and it is always tidier that way.

Answer:

We provide new uniforms twice a year for all the staff. We provide for every day they work so they have no excuse but to look tidy. The girls are the face of our business so we want them to look smart all the time.

We provide 3 sets (pro rata for part-time staff), no it would be the individual responsibility to replace if 'grown out' of them, unless due to pregnacy of course.

Answer:

Our Company allows Bank Staff and anyone under 18 hours per week – £70 per year

Staff over 18 hours per week – £100

They have to buy the items first and provide receipts and then the money is refunded

We would not be responsible for weight gain/loss and this is made clear at the interview stage

We are an emergency service with 25 staff

Answer:

Our protocol for uniforms is done on a yearly basis, 3 tunics and 2 pairs of trousers for full timers and then it goes down depending on how many days they work.

I have made it clear though, if they lose them or put on weight then they are responsible for replacing them.

May 2012

Question:

Can anyone share with me what you are doing to comply with HTM 01-05 regarding ultrasonic bath testing and validation.

Answer:

Contact Henry Schein they are the experts on HTM 01-05- we attend a workshop 10/10

Answer:

3 monthly strip tests

Answer:

Because of the cost of testing and the hassle involved, as it isn't mandatory to have an ultrasonic we no longer use ours! what a stupid situation!

November 2011

Question:

Please can you let me know if your practices pay for your nurses registration or do they pay for it themselves. We currently pay for it but as there are so many now we are reviewing this.

Answer:

We pay for half of our nurses and they pay the other half themselves. We used to pay it all, but as you say we have so many now it is no longer feasible for us to pay it all.

Answer:

All nurses pay for their expenses themselves including Registration's fee, CPD's and etc.

Answer:

We used to pay the fees for them but since 2010 they pay for it themselves. Hope this helps.

Answer:

We paid for their first year registration then gave them a £10 per month pay rise to cover the cost in future, so now they pay their own. We did this because one of our nurses moved on after we paid her registration. So by giving them the pay rise they pay for it themselves and if they leave the cost is theirs. Hope this helps.

Answer:

We pay half of our dental nurses registration fee.

Answer:

We do pay for our staff GDC registration and Indemnity, but if they leave within the year they have to refund this.

Answer:

We pay on a pro rata basis depending how many days a nurse works here. The nurse initially pays for the full amount and we pay them extra, each quarter in their wages.

Answer:

I can confirm the clinic pays for all GDC registration for our nurses, we ask the nurses to sign off a form to confirm and agree if they leave the clinic within the year they would have to pay the full cost funded by the clinic £120.00.

Answer:

Our nurses pay their own registration fees, but I deduct £10.00 per month then add £120.00 to their net pay at the beginning of July so that they have the funds to pay – all my nurses appreciate this way of helping them 'save'.

Answer:

No we do not pay registration here as there are too many nurses now.

Answer:

No, we don’t pay for nurses registration fees but we do organise a reduction in salary over the year so that it isn’t a shock each summer (for those who want to do it). We do however pay for their indemnity with DPL Xtra.

Answer:

Basically we take this into account when reviewing pay rises.

We have 7 nurses in our practice and 2 self-employed hygienists who we pay for. This is a new policy for our practice as we felt that it helps the staff out and is a good motivator. When we reviewed pay in April we were initially looking at 2.5%. Instead we paid the staff 2% and then paid the GDC fees. This was beneficial to both parties as the practice claimed back the tax from the GCD fees.

Answer:

We are a large N.H.S. practice so we decided that  financially it wasnt viable, however we do offer the nurses a easy payment option by paying the amount in full and then deducting the fee over a period of 12 months via their wages.

Answer:

We are in same boat, we have decided not to pay this year, but have advised the staff to claim tax relief on it. There is a tax relief form, HMRC10/11 availble from HM revenue and customs website: www.hmrc.gov.uk. it is for tax relief for expenses of employment, they can also claim for laundry expenses, prof. membership fees and replacement of uniforms if they pay for it.

Answer:

Yes, we pay for their registration, and their verifiable CPD.

Answer:

We looked into this a few years back and decided it was best if the nurses paid themselves, especially when they left the practice and it is tax deductable for them.

Answer:

Yes the practice pays ARF for nurses but it is a taxable benefit and is paid through the wages so the staff member pays the tax on it. The practice also pays the hygienist ARF but on a pro-rata basis as she works 2 days with us and other days elsewhere. The same goes for CPD costs

Answer:

Yes we do pay all their fees

Answer:

Currently paid by practice. Numbers and introduction of pension contributions probably means this willl change.

Answer:

We always pay for our nurses as it shows goodwill and it seems unfair for them to have to pay to come to work – we are fully NHS so don't have an excessive income either!!

Answer:

We have 12 dental nurses in our practice and like yourselves used to pay out nurses registration. However increasing costs of reg fees materials costs economic pressures on the practice lead us to make a decision over a year ago that the nurses would be responsible for their own reg fees. We discussed this openly at our regular nurses and practice meeting and all were in agreement. However we did give them the option of taking a monthly subscription off their monthly salary to go towards paying the full cost of their reg fee but all decided against this and are paying themselves.

Answer:

We pay full GDC cost for full time staff and partially for part time staff.

Answer:

We are only a small practice (4 dental nurses) but we pay for their registration and their indemnity.

Answer:

We do currently pay all of our nurses reg fees. Originally we agreed to pay the first three years for any registering nurse. We are now paying our fifth year. Mainly this is because we know that it is more easily afforded by us as a practice than by the individual living on a budget. Our nurses have been open to the idea of paying us back by taking a little from their wages each month but we have not yet done this.

Answer:

Our nurses pay their registration then claim it back against their tax…

The main thing is they get it back this way. The only reason we do not pay it is that we want them to take ownership of it. I have found that if they own the whole thing the CPD etc is much easier on the level of motivation.

We give them indemnity through DPExtra that covers the whole practice.

Answer:

We do not pay the nurses registration but the cost of it was calculated into their pay rise when registration first came in. It is difficult to be fair as nurses working part time still have to pay the same money although there is less benefit to the practice particularly if they are doing a job share with two costs of registration!

Answer:

We also pay for our nurses registration. I believe practices can afford and should do this for their nurses. With a new nurse just starting and not sure if she will stay we ask her to pay for her registration and we will refund her if she is still with us a year later.

Answer:

We pay both registration and indemnity for our nurses. The principal decided that nurses had no say over registration and therefore he should pay for it.

Answer:

Where ever I have worked DN's have covered the reg fee themselves which includes myself, they can get tax relief on the fee for registration as well as against laundry and any member subscriptions.

Answer:

We are a large NHS practice and have 15 dental nurses. We ask them all to pay for their GDC registration but do try to support their CPD so they have to pay very little or nothing for CPD and their time at courses is generally always paid.

Answer:

We pay for our nurses GDC Registration. However, for those who work part time for us and also work elsewhere part time we pay our share of their working time (regardless of what their other practice does). So 2 days a week with us (and 3 days at another practice) = we pay 2/5ths of the fee.

Answer:

We have a lot of nurses too, but I have persuaded the boss to pay it for them, as an incentive really as the hourly rate is still low that they earn. He pays for CPD from Purple Media to give them 10 hours minimum verifiable per year so we dont have too many days booked out of work on courses. We just ask that the nurses provide their own indemnity, normally BADN with membership.

Answer:

We pay all GDC registration fees and CPC costs – we currently have 12 nurses so it is costly however after review we decided to keep this perk!

Answer:

We pay for our nurses when they have been at the practice over 7 years.

July 2012

Question:

I'm looking to introduce the role of Treatment Co-Ordinator within our practice and wondered what experience you have had of this within your own practices.

I'd be grateful of any advice or tips you are willing to share with me.

Answer:

We were one of the first practices to introduce this role, the training was with Glenys Bridges. In the first 6 months we made an extra 36k. It's an excellent role.

I wouldn't dedicate it as a separate role but incorporate it into a competent employees role and uplift their wage.

Our treatment co-ordinator was trained so that patients can make separate appointments with her, but we feel that doesn't work, you gain more business through offering the service whilst the patient is already in the building. Hope this helps.

Answer:

We have 2 Treatment Co-ordinators who look after all our new patients. It enables us to focus on the new patient journey and capture every aspect of what happens from first contact through to outcome. It has also enabled us to drive up private income by 1/3 in 9 months! On days when we have no new patients, they can nurse or do follow up’s.

Attached our Job Description for you but have to say, it’s the best thing we ever did!

November 2011

Question:

Would anyone be able to provide me with any information regarding a good Safeguarding children and vulnerable adult’s course? Is there anyone that you would recommend?

We are a practice based in South West London and would be interested to have some guidance regarding this topic, also to know how other practices train their staff.

Answer:

Following an interview with CQC (not an inspection) we picked up on how important they regard this & actually got the whole team to do basic child protection online using SAFE. Two dentists also did lead on child protection & then both adult safeguarding courses.

The basic child protection course was easy to navigate & nobody in our team had any complaints. Have a look at www.safecic.co.uk, BDA members are entitled to a discount & the courses are recognised by the GDC for verifiable CPD (3 hours for basic child which took on average an hour to complete).

Answer:

There is an online course that has been recommended to us by our PCT and is CQC compliant; you may need to speak to them direct to get login details.  www.kwango.com/lbcrsalogin

Answer:

Your local PCT should have a safeguarding lead for Adults and children we currently have a link sent from them to complete online training for all our staff.

Answer:

There are courses available on ewisdom for safeguarding and child protection. The courses that we have so far attended through e widom have proved to be very good. We were lucky that PCT ran courses for dental and GP practices in our area recently free of charge for the whole team.

Answer:

We have just received information that our PCT are going to provide training. I did do a course myself with MELearning that maybe one of your staff members could do then relay it back to the rest of the team. That’s what I did, and when I had finished it I gave the team the account details so they could go on line and have a go! (Not that everybody did). It was very easy going!

Answer:

We have just enrolled with quest training & developement www.qtd.org.uk. Pete Chell

Answer:

I arranged our training through the local safeguarding children's board, which operates in conjunction with the city council. Completely on the wrong side of the country but it was the Bristol Safeguarding Children's Board (BSCB).

Answer:

We used our NHS Trust.

Answer:

I sourced our safeguarding training through the local pct who put me in touch with our local council who have provided me with access to e-learning safeguading training. Try your pct/council, they may be able to help… and it’s free.

March 2012

Question:

I am a practice manager and My principal has telephoned CQC’s helpline and has been assured that the legal responsibility has now been removed from the Registered Manager’s role, but there doesn’t appear to be a written updated version of the roles and responsibilities of the RM. Please can you confirm this is correct.

Answer:

Thank you for your recent email. The guidance states: A registered person must, in so far as they are applicable, comply with the requirements specified in regulations 9 to 24 in relation to any regulated activity in respect of which they are registered (see PART 4 QUALITY AND SAFETY OF SERVICE PROVISION IN RELATION TO REGULATED ACTIVITY page 236). Please also read the Essential Standards of Quality and Safety particularly on pages 184 – 187. This would therefore make them liable for enforcement action if the above regulations they were registered for were not complied with or contravened.

Kris Kristiansen
Shared Services Administrator
Customer Services – Correspondence
Care Quality Commission

Question:

At the meeting in Manchester presented by Code and Fiona Stuart Wilson where Amelia Bray was one of the speakers, we were advised to think carefully before taking on the role of Registered Manager in part due to the legal responsibility that the role carried.

My principal has telephoned CQC’s helpline and has been assured that the legal responsibility has now been removed from the Registered Manager’s role, but there doesn’t appear to be a written updated version of the roles and responsibilities of the RM. 

Can you shed any light on this? 

Answer:

In response to your query, it is the legal entity (the provider, partnership or organisation) that is liable for any fines that may be endorsed on the practice and not the registered manager.

I hope this provides you with clarification.

Kind regards

Nazia Hayat
Shared Services Officer
Customer Services – Correspondence Team
Care Quality Commission
Tel: 03000 61 61 61
Email: enquiries@cqc.org.uk   07/12/2010

Question:

I have a query about CQC and the legal ramifications and responsibilities connected with it. I am the Practice Manager of a surgery which is run as a limited company. The actual owner is a GP who is the widow of the Principle Dentist who sadly passed away almost three years ago. She is a Director with two other Dentists both of which do not work at the practice. We have 3 Associate Dentists who work at the surgery all of which have no part in the ownership of the practice.

In terms of CQC, there are certain roles in which you have to name people and I an very uncertain about this. Of course I over see the running of the Practice day to day but I have no part in the ownership. The owner is not here day to day. I have been given various advice from colleagues and other Practice Managers about whether or not I should put my name down as the ''registered manager'' or ''nominated individual''. I have spoken to the BDA and they say I should not do this but I am feeling under pressure that I must by the owner.

Please could you advise me on what I should do??

Answer:

In response to your query, a provider should register as an organisation if they are, for example, a registered company or charity, a limited liability partnership or other corporate body.

You will need to provide details for a main point of contact (a ‘nominated individual’) at your business for each regulated activity.  They must be someone responsible for supervising the management of the activity and should therefore be a director, manager or secretary of the business.

There is no reason why you should not have the same person as your nominated individual for all your activities, so long as they are responsible for supervising the management of them.

Where the provider is an organisation or a partnership,the person responsible for the day-to-day running of the service must also register with us as a ‘registered manager’.

It is possible for the nominated individual to be the registered manager also.

I hope this information is of help.

Kind regards

Nazia Hayat
Shared Services Officer
Customer Services – Correspondence Team
Care Quality Commission
Tel: 03000 61 61 61
Email: enquiries@cqc.org.uk  22/11/10

Question:

Do we have a legal obligation to provide yearly training in basic life support for our staff?

Answer:

Great question! we do it anyway to cover outself and ensure that we meet basic requirement. I have never thought of the legal obligation except that staff has a legal obligation to have current certification and competence.

Answer:

Yes you do have a legal obligation

Answer:

I believe it is seen as best practice to provide the training. Therefore in Scotland it is a legal obligation but I believe it is still highly recommended in England.

Answer:

Yes, I believe that you do, even though it is on the 5 year cycle for GDC registrants.

Answer:

I’m not sure if it has a ‘legal’ tag attached but certainly the GDC and the CQC would say yes, and medical emergencies have been a core part of the annual CPD requirement since DCP registration came into being. This is something our practice has done for years and we consider it compulsory that every member of staff attends for the 2 hour session; no one is allowed holiday on that day.

I suppose staff could find their own course to attend individually but the monitoring of this, to ensure that everyone has attended at least once a year, will be quite onerous. All the practices I know locally, provide this for their staff, free of charge.

It costs the practice about £350 per year, and think that it is well worth it, as we are all fulfilling our professional responsibilities to our patients and staff alike. Hope this helps.

Answer:

We are about to do first aid training this year and it is validated for 3 yrs; this will be the first time we have done first aid and we will all do it. But legally you only have to nominate one or two named members of the team.

We do Defib and CPR every year as a separate course.

May 2012

Question:

Does anyone have any ideas on where I can get an information security Risk Assessment document?

It's one of the requirements for compliance with the information governance toolkit.

Answer:

If you go on http://www.psnc.org.uk/pages/ig.hmtl you will find the PSNC have given permission for us to use their template policies this covers a lot of the IG requirements

Answer:

I used the Information Mapping Tool guidance to help me with this, which can be found in knowledge base resources on the IG website.

Answer:

If you have registered with the toolkit there is a template document on the toolkit. All the documents you will need under the resources tab.

July 2011

Question:

I wonder if you can help, we have recently started implants in our surgery. I would really appreciate feedback on implant costs. We are finalizing payment terms with our dentist and it will help to learn from other practice manager’s experience on how costs are shared.

For instance:

If dentist bring their own implant kit how do they share the percentage.

Do they share cost of lab bill, materials, nurse etc.

I do realize that what might work in one practice might not be suitable for another but it will be really helpful to get a general idea of each practice’s experience. As it is our first time with implant this information will be extremely helpful. I am sure some of you have useful experience which you might not mind sharing.

Answer:

Within our practice the costs of implant and prosthetic work is shared equally between the Principal and the Associate. All other costs are cover in the standard manner, for example the cost of the nurse, sutures, anaesthetic is covered by the Principal.

Answer:

Our specialist pays 50% of lab bills and we cover materials and nurse costs. Then we pay him a % of the income each month.

Answer:

I agree that this is a difficult one as dentists have to invest a considerable amount of time and money in training to be able to offer implant treatment. On top of that the implant kits are very expensive etc. I am assuming you are talking about an associate undertaking implant treatment and consequently the usual associate agreement would not be fair. Our principal dentist here was once in that situation when he worked as an associate in another practice. The agreement there was for him to pay a rent for the surgery and a nurse on one morning to carry out his implant treatment. The fees he earnt from implant treatment then went 100 % to him. In theory this could work quite well provided a reasonable rent is agreed (which it wasn't in his case!). I would certainly recommend that a proper agreement is drawn up because you will also need to think about any time taken up by the reception staff booking appointments etc. You also have to remember that there are a lot of hidden costs involved in providing implant treatment – such as all the treatment planning which is much more time consuming than most conventional dentistry.

Question:

I was wondering if anyone else employs a dually qualified hygienist/therapist who works almost exclusively as a hygienist. In our practice (which is completely private) there are issues developing as a result and I would be grateful to find out the experience of other practices e.g. nursing support: we have a nurse working alongside the hygienist/therapist – not only is this expensive but it is quite boring for the nurse. Does anyone else employ a nurse to work with a hygienist and if so how do they manage this?

Answer:

We have 2 hygienists/therapists and 1 hygienist at our mixed practice. Having therapists did not work for us, they took a lot longer, met with more resistance from patients who felt they were getting a lower standard of treatment and generally we found the dentists were having to redo some of their work! I agree it's very boring for a nurse to work with a hygienist and apart from any new nurses who are ideal for hygiene support while they get to grips with suction etc; our hygienists very rarely have a nurse. Someone will set the surgery up and clean down at the end of the session but our main concern is cost. It is not cost effective for us to employ a nurse solely for the hygienist. We usually ask the decon nurse to pop her head in every now and again to the hygienist and this usually works ok. Our hygienists are very good and have now accepted that they don't have a nurse and we don't have a problem.

Answer:

We are a completely private practice and employ 4 hygienists altogether on a part time basis sharing two surgeries. The two employed by us are exclusively hygienists and the two self-employed are hygiene / therapists.

We have two nurses who work with them and it works well for us. The hours suit the nurses and by having a nurse to support the hygienists, allows us to see our patients for 15 minutes each.

I haven’t had any problems with this arrangement in my time here with the nurses if I’m honest as we made it clear about the role when we took on the staff and the job description suited them better as it was less stressful etc.

Answer:

The only minor problem I have encountered with Therapists is that the patients don’t want to see them. They feel they pay good money for a dentists to see them and their children and don’t want to be referred to anyone else that’s not a dentist so they don’t get to practice as a therapist with us. We are looking to create more awareness of the role of therapists through our newsletters etc, but I reckon this will take a long time to change this amongst our patients.

Answer:

Yes we do employ a nurse for the hygienist/ therapist as lone working according to our defence union and the BDA would have been an issue should anything arise. Our hygienist works in 2 other practices and this is the only place she gets a nurse.

Answer:

Our nurses work on a rota basis so no one nurse is saddled with the hygienist all the time. When the nurse is working with the hygienist she also carries out admin duties to utilise the time.

We worked out that the extra time the hygienist needed to turn the surgery around would almost cover the cost of the nurse.

Answer:

I know what you mean we have had similar issues here. We have solved it by asking a nurse to go in and help clean and decontaminate between patients. Have had to explain that this is the only way we can do it for the reasons you mention.

Answer:

We have a hygienist/ therapist, we separate her working days, Tuesday is therapy where she has a nurse and Wednesday is hygiene where she doesn't have a nurse. We have a full time hygienist and a 2 day part time hygienist, neither of them has a nurse.

Answer:

We have always employed a nurse to work with the hygienists here. We now have a dual qualified person as well now.

We have always started our trainees in this location, so that they can begin to understand the principles of cross infection, practice policies, etc.

If there are any spare sessions, once the trainee is a bit more experienced, we have them in the surgery with the head nurse to begin to learn more, ready to start the NEBDN course.

Once more experienced, my nurses are happy to swap around for a few days, to keep the nursing skills up for the 'trainee'.

Yes, it is boring, but it is the only way to learn all the aspects and you have a nurse already trained to your standard should any of your qualified nurses’ leave.

Answer:

We are a fully private practice and have a hygienist who does 2 days a week with a nurse and a therapist/hyg who worked one day a week until this month when she left due to children. She also had a nurse. The Therapist was paid about £6 per hour more than the hygienist because of her qualification but she mainly did hygiene work and the occasional filling. It can be boring working in hygiene for the nurses but we work on a rota basis and I try not to put the same nurse in for more than once a week. Our nurses quite like it as it is an easy day for them. We are not at present going to replace the therapist.

Answer:

We have 2 hygienists and they both have a nurse on a permanent basis. The nurses who are with the hygienist do tend to have an easier day but they are on a rota system of working in the same surgery for 2 weeks so every 6 weeks they get 2 weeks with the hygienist on 3 days of the week. Most of the girls dont seem to mind and they do extra jobs like checking stock etc whilst in there.

Although it is very expensive to have a nurse with the hygienist it is a good service to offer the patients and helps keep on time and aids the hygienist with the note taking, advice, charging and plaque scores and BPEs etc.

Answer:

It is tricky to manage we have the same situation, but recently have a part time nurse off on maternity leave which we have not covered. This means some sessions the nurse operates the central steri room & nurses for our hygienist/therapist. The only time this doesn't seem to work is if therapy is booked in but this is so infrequent it is not worth the cost of another nurse.

We have also used trainees in the past, but as they become more experienced they do become board.

Answer:

We have 2 hygienists and one dual qualified who works only as a hygienist. None of them have a nurse, never have had, unless a dentist is on holiday and there is absolutely nothing else that needs doing.

I made it clear at interview that we needed a hygienist. not a therapist, so there have never been any issues around what she actually does.

I am, however, aware that these dually qualified individuals are by and large under used,and complain they will loose their skills – probably true. But the hard fact is that Hygienists are in great demand, whilst as of now, Therapists aren't.

Answer:

We no longer have a Therapist working at our practice, but up until 2010 we did. As you mentioned, our Therapist also ended up doing a lot of hygiene work. I found there to be three factors for this, the first was obviously the need for the Hygiene appointments and lack of time with our ‘solely Hygienist’ available in the appointment book. It was difficult debating the decision on increasing the hygienist book but then not having enough work to fill the Therapist book.

The second being that our therapist used to work for us as a Hygienist and our long standing patients LOVED her and wanted to stay seeing her!

The third factor was that it took our dentist quite a while to get into referring treatment over (she found it hard letting go) which impacted on the time left available in the book that required filling – hence the time being used for hygiene work. This then created an issue on hourly rates as our hygiene rate was lower than our therapist rate.

Nurse wise we rotated the nurses around and all the nurses had at least one session with the hygienist, most reported back to me that it was nice to have one day that predictable and ‘easy’. We provide nurses for all of our clinicians (including the hygienists).

As I said we no longer have a Therapist as she re-located to Devon, but when she was here it did get to the point of assessing our options. I think the clinicians referring HAVE to be behind the idea otherwise they just won’t do.

May 2012

Question:

To help fulfil our contractual obligations we are looking at extending our working day to include an evening session. I would be most grateful for any information from members who have implemented this change, from problems with existing staff to expected average number of UDA’s for the evening session. We are a large NHS practice with 6 surgeries and 11 dentists! Many of our girls have been with us for over 20 years. I’m sure this service would be very popular with our patients.

Answer:

How long is a piece of string?

Depends how many hours you do in the evening, how many patients you see, how fast you see them.

Tell your staff it’s a PCT requirement and we are all lucky to have a job.

We have always done it, working late is a pain in the rear but patients appreciate it in general in the present economic climate.

As Nike say.. Just Do It!!

Answer:

When we started doing a late evening, the first thing we did was ask all the nurses individually if they would like or mind to work a late sometimes or once a week etc.

We were lucky as one of our nurses really wanted to do it as it gave her some time in the morning to get things done, she now works 11-7 instead of 9-5.

If none of them really want to then I would probably have done it on a rota basis so that they only had to do a late every so many weeks.

Answer:

We have evening sessions for a different reason we are Ortho and our evening sessions are for our Private patients, we offered the nurses and receptionist overtime at the rate of time and half, this meant we had a good response and have been able to offer this to patients for nearly 5 years now.

May 2012

Question:

Does your practice pay for the CPD for the staff? Or do the nurses have to pay for their own?

Answer:

We pay for the core CPD verifiable but they are responsible for the non-veri themselves.

Answer:

At the Practice where I work everybody pays for their own.

Answer:

We often arrange lunch/learn programmes from the dental companies/suppliers during the day which are CPD verifiable and usually FOC.

We have purchased the CPD 4 DCPs workbooks, which the staff use to fulfil their requirements.

Answer:

We pay for all employed staff CPD at Bourne End Dental

Answer:

We agreed to pay for all core subjects but the employee loses the hourly rate if it is on their day of work, but if the principal requests you to go on a course out of the core subjects then the course and hourly rate is paid.

Answer:

We pay for the CPD but they do it on their own time. And they need to recognise that we are making a big goodwill gesture….!

Answer:

We pay for all the CPD. The only thing we don’t pay for is the radiology course as we have no use for that.

Answer:

Yes we do pay for CPD. Obviously if it is an in surgery training such as cross infection or resuccitation the practice pays & we purchased the FMC publication Team in Practice which provides all the required CPD. It is accessible for staff & economical for us. We also pay registration & BADN membership.

Answer:

We pay for core courses like first aid, radiology and childprotection.

Answer:

Our Practice will sometimes help us depending on the course!

Answer:

We pay for all CPD and any they do out of their normal working hours is paid at time and a half.

Answer:

We do actually pay for our nurses. We buy CPD in Practice which covers all verifiable and non verifiable GDC’s annual requirements and includes all GDC compulsory subjects.

Answer:

We pay annually for an in house emergency procedures training. We also provide two in house training days per annum which are verifiable.

We have also paid for all staff to attend the annual British Orthodontic Society conference.

Answer:

All our nurses pay their own CPD except for the meetings of the Exeter CPD group and our local BDA meetings which the practice pays for. We do quite alot of training in-house at our monthly practice meetings and if this is appropiate we class it as verifiable – ie with evaluation forms and certificates.

Answer:

We do currently pay all of our nurses reg fees. Originally we agreed to pay the first three years for any registering nurse. We are now paying our fifth year. Mainly this is because we know that it is more easily afforded by us as a practice than by the individual living on a budget. Our nurses have been open to the idea of paying us back by taking a little from their wages each month but we have not yet done this.

Answer:

We pay for all of the core CPD subjects for all staff even non clinical staff plus 2 additional courses per year. They also get paid for the two days they are at the courses.

Answer:

The way I manage the CPD and registration fees for my team is by a payment of £250 per year to each DCP. This is divided into 12 and paid with salary as ‘registration’ each DCP received the same whether they are part-time or not as the CPD and registration has similar costs for each team member.

I also give paid study leave up to 15 hour per year as I was paying overtime for the team to attend CPD courses.

Answer:

Our practice pays but I book a lot of lunch and learns which are free + lunch included.

Answer:

Yes, our practice pays for all CPD we currently do the majority of this through the CPD for DCP’s module.

Answer:

We pay the DCP’s ARF for GDC and any courses/in-house training for nurses and reception staff that benefit the practice by way of increasing their knowledge and skills, including all necessary GDC CPD for employed nurses. Self-employed hygienists and dentists also attend the in-house training and don’t need to contribute financially. The latter pay for their own external courses.

The bill has gone up since new regulations, CQC and HTM01-05 came into force!

Answer:

We pay for the courses that they have to do, then give them a £100.00 per annum allowance, but we only let them use it for courses that we think will benfit the practice as well. If they want to do a course that is of interest to them alone, then we expect them to fund it themselves. Works well for us!

Answer:

If the CPD is for in-house training then the practice will pay, but if the course is out of practice then the staff pay for themselves.

Answer:

We pay for all staff CPD at the moment. It is purely at the practice owner’s discretion as far as I am aware.

Answer:

Yes, up to now the practice has organised, and paid for all staff CPD. One staff member has been unable to come to some of these sessions, and is lacking in hours, she is expected to find alternative CPD to catch up, and may therefore have to pay for this part on her own.

Answer:

Yes, we fund our staff’s CPD. Although we don’t necessarily have to, it is a great motivator for the staff and we have benefited from this.

We use www.ProDental.com which is has been popular amongst the team. My biggest bugbear about CPD is that most of it isn’t very measurable, but Pro Dental has a test at the end with a certificate you can print off at the end.

We also provide CPR and training days with Denplan, and recently internal with our dentists going over treatments such as Cerec etc. to improve their product knowledge.

Answer:

We only cover the Medical Emerg, disinfection, CPR – they hunt the web relentlessly for any free CPD, the dental nurse network is a good one!!!

Answer:

Depending on the course and agreement with the nurse concerned, we either pay for the day off or for the course for a dental nurse.

July 2012

Question:

I was wondering if anybody who has had a CQC inspection could let us know if they looked at Washable Keyboards, Touch Free Soap dispenser's, Sanitiser dispenser's and moisturiser dispenser's.

Answer:

I had my inspection 10 days ago, and the inspector did not look at any of those, apart from the Sanitiser dispensers in the waiting areas, this does not necessarily mean that a different inspector won't have a look at those, better safe that sorry 🙂

Answer:

They checked our surgeries and noted what we used and also asked our nurses about handwashing routines.

Answer:

Our inspector didn't – at the time we didn't have any of those, just plastic keyboard covers. However, each inspector will notice different little things. I also think that the more dental surgeries they inspect, they will get to know what sort of things to look for – past the obvious I mean. For instance if they see a basic level, then one that goes the extra mile, or 2 miles – if that makes any sense!

Answer:

For ours they did a thorough check of surgeries and all decom procedures. We have all those in place and passed with no problems.

Question:

Does anyone use the DOCMAIL system to send out recalls. I am concerned about patient confidentiality issues and would love to know more if anyone is using this with dental management software such as Software of Excellence – is it as cheap as they advertise and is it effective?

Also does anyone currently use the Barclays PINGIT for Payments – this is an app added to mobile phones which enables your practice to receive payments via the mobile direct to your bank account.

Answer:

We use the software of excellent sms text messaging service. It costs 8p per text you buy 1000 at a time. They invoice you direct when you have used them up so there is continuity of service. The texts go out automatically 48 hours previously (even over the weekend).

You have to ensure that you have the patients mobile numbers ticked on the patient detail screen ( next to phone numbers). If you wish to send a message to a home number you have to have the patients consent (we usually ask them to write this on the top of their record card. ) otherwise there could be a breach of confidentiality.

We only use this for appointment reminders not recalls.

Answer:

We use Kodak R4 and I have experience with Exact and Orthotrak. When new patients complete their medical history forms (and existing patients update their medical history) we have incorporated a box on the form they can tick if they don’t want this form of recall or telephone reminders. It therefore covers the practice with reminders as well as we tend to send out 24 hours before the appointment a reminder text of their appointment, or in some cases, telephone them. I wouldn’t say it’s a great advertising tool. If anything, it’s made patients more aware of my presence as I am the one who calls to remind.

So we can keep track of payments, we do not use any software that allows direct payment. Only one or two patients who request to pay electronically are given the bank details and asked to send an email to confirm payment. This way it is easier to monitor.

May 2012

Click here to download.

Dear Colleagues,

Our inspection was today and to say I was ready for the worst, was putting it mildly. However, our Inspector was a really pleasant chap who spent time at the start explaining what he was going to check and how we work towards the outcomes.

An interesting point is that because we are quite small the outcomes covered would only be 1,4, 7 and 8 (already warned by other PMs) but, he told me larger practices will also be checked on any of the remaining 16 outcomes – so please note if you are a large practice!

Our inspector stayed until Lunchtime and I am happy to report all was well. He spent time chatting mainly to me, then I had made allowances with the appointment books for him to have an opportunity to speak to the dentists and nurses. This did reduce the stress level as it wasn’t a rush between patients or running late.

Outcome 7 is a difficult one, we have child safety training and patient safety policy, but he was also looking for adult safety training and recognising abuse in adults! He told me no practice he visited yet had this correct. So, there is a warning for everyone. However, I must ask if any practice has been visited and they had the correct policy and procedures set-up, would you be prepared to send me a template proforma? Or, guide me where I can obtain one?

I wish everyone who hasn’t had their visit yet, good luck.

Jan 2012

Dear Colleagues

We have had our CQC visit, which was unannounced, the inspector just turned up on a Monday morning, and just to help matters, I was away at the time.

So my advice to all and sundry would be don’t put off getting ready. Fortunately I had debriefed most of my staff before hand, so the inspection went quite smoothly. A small issue with staff contracts (which of course were locked away) I was able to resolve on my return.

The only problem which was mentioned on our report was the concerning outcome 7 and lack of safeguarding training regarding vulnerable adults. Even though we have a Vulnerable Adult policy our inspector wanted to ensure that all our staff have or are having programmed suitable training.

This is a warning to everybody to be prepared.

Jan 2012

Dear Colleagues

Following on from previous e-mails, we recently had our first CQC inspection which went very well and fortunately brought us a clean bill of health with no recommendations for improvements.

Here is some feedback and suggestions which may help others prepare.

Our visit lasted around 4 hours and we were told of the main findings at the end of the inspection with a draft report coming through after about 10 days. You are giving a short period of time to check the content before it is published to the CQC website where it can be seen by the general public. I understand that other organisations such as the NHS/PCT are likely to provide a link on their own website to the published report for each practice.

Practices are usually given 48 hours notice of a visit and you will be told which outcomes are to be checked. I was advised that this may change as other providers such as care homes and hospitals are given no notice.

We were checked on outcomes 1 (respecting and Involving Patients), 4 (Care & Welfare of People who use Services), 7 (Safeguarding Patients from Abuse) and 8 (Cleanliness & Infection Control).

Current high priorities are Infection Control and Safeguarding (adults and children) both of which will almost certainly be checked.

Very interested in Medical Emergency procedures/training and more importantly staff awareness of what to do.

Whistleblowing awareness also important – particularly using the CQC as a contact point – circulate this document to staff for bonus points http://tinyurl.com/7ovpehu.

Very keen to talk to staff and patients and what they say has significant input to the final report.

On the day of inspection identify some good patients to speak with the inspector – three or four should be enough – what they say will carry a lot of weight.

Best practice is to keep a folder with separate sections for each of the 16 outcomes and store evidence and examples for each – the inspector went through this and it made a real difference.

Keep another folder containing copies of all your policies and procedures – use this as part of your induction training – again this speeds things up as the inspector is able to sit down and go through them one by one.

Speaking of induction training, the inspector likes to see induction records for a recent recruit – try to make sure something is available.

The inspector will also want to see your training logs and understand how you make sure staff who miss training are picked up.

Regular staff meetings with minuted discussions of significant incidents and lessons learned from complaints are also important.

Make sure there is a system in place to monitor and circulate Safety Alert Broadcasts/mhra alerts.

Not surprisingly, make sure you can show audit trails and service agreements/records for each of your autoclaves/washer disinfectors.

You will need to show how you listen to and respond to patient feedback – surveys, questionnaires, thank-you letters, comment boxes. Find a few good examples to show.

Complaints procedures and examples of how a complaint has been handled will be needed – have a good example to hand and make sure reception staff are familiar with the complaints procedure.

Feb 2012

Question:

I wonder if anybody could tell me if they have been asked for a second payment of £800 from the CQC.

As a practice we registered last April and paid our £800, in May 2012 I recieved an invoice for another £800 and rang them straight away to enquire what this £800 was for. The lady on the phone said she had no idea and would find out and let me know. I noted the name, date and time I rang but heard nothing untill this week when I received another demand for £800. I am a bit reluctant to pay it as I rang again and they still don't know what it is for and I have not heard of another practice in the area receiving this bill. I was wondering if anybody could enlighten me to the reason for this bill and has anybody else paid again?

Answer:

I have received a further account for £800 for our practice but this is correct as it is an annual fee!

It would have been more if the BDA hadn't stept in and fought it!

Answer:

Yes we had the bill, and paid it. (You have given me some hope to think I might be able to ask for it back…!? We presumed it was to be paid, and didn't query even tho' it seems over the top!)

Answer:

I had one in April & called CQC to query mine. The payment apparently is for your annual registration with CQC, and we will be getting one every year from now on(I know-they didn't mention this initially!)

Answer:

Exactly the same happened to us. I phoned CQC and also checked on Google and apparently every practice has to pay this fee every year. I still don't understand exactly what this fee is for. If anyone knows I'd like to know too. The whole thing is just a money spinning operation. What next?

Question:

We are considering putting air conditioning into our practice. Can anyone recommend a company or let me know of any difficulties encountered when having it put in.

Answer:

We used a company called JGAC we found them to be friendly and professional company to work with and very good on price, they were quick and very clean when our units were being fitted, we now use them for servicing on all our practices. there contact details are JGAC – Jay Gascoyne 07976980824

Answer:

I can recommend Blandford's for your air- conditioning units we had them installed 3 years ago and the equipment and service they have
provided has been wonderful-no problems and little disturbance from them when installing the units and they have never really given us any bother, we have a service contract with them yearly and they service them twice a year. I would highly recommend them.

Answer:

We used a company called Equazion, they were very professional, the product is fab, and I would thoroughly recommend them contact Ken at the following address for more info. Has made a very positive difference to our surgery and waiting area! ken@equazion.co.uk,

Answer:

We installed it years ago. Look at at least 3 quotes. They vary so much. Also what varies is the operating system (look out for legionellia) cheap is not always best. We installed the system over 2 floors and in 6 rooms and it cost about £5500 (wouldn't be without it). Look out for the continuous contracting service costs and what is their call out response time. Is the company registered with an affiliated body (if they go bankrupt will your guarantee still be covered).

The company we used did go bankrupt and we have been covered with another company that took up the mantle!

Answer:

We have air conditioning installed at both our practices.

The first practice was many years ago and once the units were fitted we later found out that we needed planning permission which was granted but we had to move the units after installation.

If the units are to be used for heat and or cooling purposes ensure the staff (and dentists!) know that they need to let the unit reach the desired temperature by giving it time, not putting the heat up to 28 degrees then back down again when it is too warm! We have a min / max temperature which can be used, without this people do not use the units as they are designed and consequently run up large electric bills and ensure the units are not left running when the practice is closed!

Answer:

We had air con put in about 2 years ago. It has been a life saver, even if it was only for a fleeting moment of summer!

No problems encountered, but do have them serviced every year.

I would recommend shopping around for quotes and asking for references. We chose a family run business, as they are local and they are always around to help with any advice, if required.

Answer:

The one point you may wish to take in to consideration is the way the air flows due to cross infection control.

Our units are over the doors facing into the surgery and we were told this was not the best option.

Check with your PCT cross infection control nurse if you are an NHS practice, if you are a private practice maybe consult the HTM 01-05 document to see if that has any information or the BDA.

Answer:

We have used a company called Airtech for 16 years with no problem but it is alway advisable to use a company close by to you for ease of access. A company that comes highly recommended for personal touch in your are is Ian Hanson 07813 095367 he maintains my home aircon and if you mention my name he might give you some discount.

April 2012

Question:

Has anybody got a domestic cleaning policy and protocol for the practice cleaner, that they would be willing to share with me please?

Answer:

We downloaded our cleaning policy from the DPL extra web site and filled in the spaces where applicable.we also downloaded COSHH and Manual lifting regulations from the HSE website.

March 2012

Question:

I have been tasked to find out average costs, if such a thing exists, for dental fees as we are planning on a price increase and want to know how our fees compare to others. We are based in Buckinghamshire. Is anyone prepared to share how much their practice charges for:

Exams
Exams scale and policy with dentist
Hygienist treatment
Emergency appointments
X-rays

Answer:

Every six months I usually look at other practice websites, in our area, and compare prices that way. Most practices have their fee schedule on their website.

Answer:

We looked at this a few months back for our practice. We choose another 4 practices in our area and looked at their website then for what information was not available on the websites we called and made patient enquires. I have attached the log sheets we used.

Log sheet can be found in the template section

Answer:

Exams £45.00, £65.00 new patient
Exams scale and policy with dentist WOULDN'T HAPPEN
Hygienist treatment from £50.00 half hour
Emergency appointments £60.00
X-rays £18.00 small and £45.00 OPG

Answer:

Our dentists don't do scale and polishes, our fees are as follows:

Exam (10 mins) £48.50 (includes x-rays)
1 x H20 £49.50
1 x H30 £74.00
1 x H40 £99.00
10 min emergency appt £51.00
20 min emergency appt £76.50

Answer:

Full Gold Crown £350
PBC £300
Core Fabricated £50
Post and Core Lab Fabricated £85
Empress Crowns £450
Empress Vaneers £400
Zirconia Crowns £495
Onlay/Inlay Gold £300
Onlay/Inlay Composite £250
Only/Inlay Ceramic £275
Co-Cr 1-3 Teeth £650
Co-Cr >4 £700
Extractions (Routine) £60
Extractions (Surgical) £85
Bleaching £150 per arch
Biteguard £15 

Answer:

New patient consult £48 + x-rays
Exam £22.00
S&P with Dentist – £33 for 15 mins
X-ray £6 each
OPG £48
Hygiene visit £33.00 for 20 mins £47.50 for 30 mins

Emergency appointment 15 mins £35-£48 depending on treatment for the relief of pain. Antibiotics, dress drain, temp dressing, etc.

Answer:

The one point you may wish to take in to consideration is the way the air flows due to cross infection control.

Our units are over the doors facing into the surgery and we were told this was not the best option.

Check with your PCT cross infection control nurse if you are an NHS practice, if you are a private practice maybe consult the HTM 01-05 document to see if that has any information or the BDA.

Answer:

Our fees are as follows, bearing in mind we are in Devon:

New patient exam £70.00 (40 min appt incl. 2 bitewings)

Routine exam £38.00 (15 mins)

Scale and polish (dentist or hyg) £48.50 30 mins £66.70 40 mins £ 97.50

Emergency appointment £50.00 + any treatment

X-rays £9.00 PA / Bitewings £29.00 OPG

April 2012

Question:

We are looking to recruit a new hygienist and I would be very grateful for any pointers and advice on what others have found to be the most effective places to advertise, or any particularly effective recruitment agencies.

Answer:

We had to recruit two hygienists recently and we got the best responses by advertising for free on Gumtree.

Answer:

We have found BDJ the best, as agency fees are around £1500 for part-time.

Answer:

Hi, we found our new hygienist by getting details from the GDC website of hygienist living locally to our practice and writing to them directly.

Answer:

I have found the best magazine to advetise in is the Hygeinist/Therapist association magazine. They advertise one month on line and the next month in their magazine. I also contacted the local universities where the courses were held.

Answer:

Ask your local reps if they know of any, otherwise Brown's but they charge

Answer:

We always go with BSDHT. 01452 886365 or enquiries@bsdht.org.uk. Adverts go online straight away I think, plus the next magazine.

I once tried the local newspaper, but it was a waste of time. Any hygienist or therapist looking for work will check out their official organisation's site.