Sick Pay & Performance Bonus

Question:

1. Do you pay company sick pay and if so how many days?

2. Do you use performance related bonuses/pay? If yes how does this work in practice?

Answer:

1. No we don't. There are three days without pay, then SSP is paid.

2. Yes. Pay extra per attendance at each each implant. Pay extra if qualified ohe – £5 per patient seen. Pay extra to be keyholder etc.give tesco vouchers at Xmas if year has been good

3. Pay an extra increment for each qualification passed eg OHE, radiography etc, if the practice decides we need that qualification at the time/

Answer:

In our staff contracts we pay 5 days sick over the year on a pro-rata basis for part timers.

No performance related pay though just an annual pay review in Jan. We do give 1 extra weeks holiday if the staff member has been in the practice for 5 years and a £45 per month loyalty bonus.

Answer:

We pay SSP for the first 2 weeks of any illness then full basic pay for a further 10 weeks. This cuts down on people abusing the system by taking an odd day off her and there but it does provide security to staff members if they had an illness lasting a number of weeks. If an illness lasted over the 10 week period staff pay would revert back to SSP.

Answer:

We pay sick pay after 2 years of employment. 1 week fulltime pay and 1 week half pay. We don’t do any performance related bonuses but it might be something to look into in the future.

Answer:

We only pay SSP – no company sick pay. We do pay an attendance bonus though of £50 per month for full attendance.

We pay a performance related bonus at year end which is tied in with performance reviews where the staff are rated 1-4 (1 being poor and 4 being exceptional)

1 No bonus

2 £100

3 £150

4 £200/£250 based on the level of exception.

Answer:

As well as SSP entitlement where applicable, we pay our staff an annual attendance bonus.

They can have 6 days' paid sick leave per year, but if they have not used all or some of those days, they are paid as a bonus in the December wages. EG. if someone has had 2 days' sick leave in the year, they will receive 4 days' attendance bonus at Christmas.

It's worked well over the years and sickness rates have dropped dramatically.

Answer:

We used to pay sick pay, however we found the girls were taking advantage of it. We changed their contracts to state they would receive 3 days paid sick in any 12 month period, then SSP. This has drastically reduced the amount of sick days.

We also used to give performance related pay. The girls loved this as they came out with some fantastic bonuses, however the year the business lost money they kicked up a huge fuss as we were unable to pay them a bonus, so we reverted back to pay rises. In effect if the business losses money should they take a pay cut!

Answer:

I manage a practice in Eastbourne and we have about 20 staff. We pay 5 dayssick pay and any more would be statutory sick pay. But what we also do is a bonus for no days sick. Any nurse, receptionist or myself, if we do not have any days of sick we pay 1 weeks’ pay in January (just great after xmas). If they only have 1 day off we half it and 2 days we pay a third. It’s very popular.

Answer:

We don't have any company sick pay at our practice. It is strictly a case of if you're sick you do not get paid unless they are entitled to SSP when they've been off for a few days. I know this may sound harsh but, it really cuts down on the amount of time the girls have sick. If they know they're not going to get paid suddenly that cold/flu doesn't seem so bad! We went through a patch where girls seemed to be ill on a Monday or Friday.

This has also improved since we introduced return to work interviews. Keeping an attendance record shows up any patterns of sickness and faced with a "chat" when they return to work also seems to deter them from having a long weekend.

We don't use performance related pay/bonuses. We tried this once when we were having some backstabbing between some of the girls. How naive were we! As soon as they received the bonus they returned to backstabbing. We do occasionally allow someone the odd afternoon off paid if they’ve performed really well. This also works well when we have too many girls when a dentist is off and we need someone to take time off. Hope this has been of some help.

Answer:

Before I was manager and looked into it, the staff would take up to 3 days paid – often several times in a year, so some staff had 14 or so paid days off in a single year! This, combined with the cost of agency replacement was rediculous.

On looking at their contracts, it was actually worded 3 days PER ANNUM!( If they had been employed longer, it goes up to 5 days.)

So that is what is now implemented.

Interestingly I asked this very question at a meeting last year, and many many practices pay nothing. One or two reported that they did give sick pay, felt taken advantage of, so withdrew it, and the number of days sick reduced dramatically!

The response varied from one practice who gave 2 weeks per annum – not many of those – to many who gave nothing.

A sick pay policy template is available in the Template section.

Question:

Does any one have set guideline in your practice for paying nurses, receptionist and dentist in terms of their experience, qualifications etc.

How do you justify their pay rise in terms of additional postgraudate courses they do/additional roles they take on in the practice/or any thing else?

If you have any information in relation to this subject that you are willing to share will really help.

Answer:

We pay a qualification pay rise of 25p an hour for additional qualification; ie x-ray, oral hygiene exams etc.

Other to this we pay cost of living rise each April but we do have a structured pay scale with bands for levels of experience and duties.

Question:

We currently have 3 self employed hygienists, and are currently looking at changing the way the self employed ones are paid, as currently our practice bears the full costs and burden of any empty appointment slots.

I would like to know if you pay your hygienists when they have gaps – be they unfilled slots, FTAs or cancellations, and if you do, is it at their full hourly rate. Do you know of anyone who does not pay for these empty slots but pays a higher hourly rate to incentivise them and if so, does this work or does it do the opposite? Or is anyone doing anything different?

Answer:

We pay our self-employed hygienist for a full day’s work irrespective of how many appointment slots have been filled. This is because I would regard it as the fault of the practice, and our booking system, not the hygienist if we have been unable to fill her slots.

We use Software of Excellence and have a waiting list for patients wanting appointments, so if one cancels, in theory another will be slotted in.

Answer:

We pay our self-employed hygienists on an hourly rate regardless of gaps, although I would consider changing this policy if anyone can provide a fair alternative. One of our hygienists works elsewhere and only gets paid for the patients he treats.

Answer:

We employ 4 hygienists and they are paid 50 % of the work they do. If patients fail then the hygienist still gets paid for the FTA. They don’t get paid for cancellations or if the appointments are not booked. It is very rare that the appointments are not filled and also cancellations are at a minimum.

If they are fully booked it works out at £38.32 per hour, obviously the odd cancellations and unfilled appointments affects this but our hygienists seem perfectly happy with this arrangement.. If I have to bring in locum hygienists I normally pay them a straight £32.00 an hour.

Answer:

If your hygienists are truly self employed, then they should not be paid if they are not treating patients. We used to pay ours, but this will mess up their self employed status and the HMRC will not be impressed

If a pt FTA's with the hygienist, we charge the pt, then pay the hygienist the money, but she does not get paid otherwise; dentists who are self employed don't get any money if they have spaces, FTA's, etc.

Our hygienist is not very happy with this system, but we do our best to keep her booked.

Your other alternative is to make them employees, which is the preferred status of BDHTA and HMRC. The hourly rate is less, but the hygienists do not have to worry about their tax or NI. You would also need to supply them with uniforms and equipment, but that would remain the property of the practice for you to use if/when they leave.

Whichever route you choose there will be problems.

Answer:

Bum's on chairs and half an FTA cost.. only.

Answer:

We pay our hygienists 50% of the payment but only when a patient attends the appointment, nothing if the patient FTAs or there is a gap in the books. If the patient FTA the patient will be charged £15 and the hygienist will again get £50% of this fee. The hygienists are self employed and this is quite common in dentistry.

Answer:

We pay flat hourly rate regardless of patient attendance.

Answer:

We have been looking at this situation, at the moment we pay the hygienists for the hours they work eg 7, even if they have gaps, but we are thinking of paying them a percentage of the days taking, therefor the practice would technically be paying for any unused appointments.

Answer:

We do our best to rearrange appts to flow through the day but if there is a gap, as we are are large practice with lots of odd jobs to do, like photcopying, stuffing envelopes etc I get them to help out.

If its a bad day to come in the diary we will push the appointments up together and advice hyg that she is finishing early, normally 1 week ahead or more. I'm lucky that our 3 ladies are ok with this arrangement but I know what you mean; I had 1 in the past that would swan off shopping etc in between pts and never even did the tea round!

On the day of gaps we tell all surgeries so they may have a patient in who could see hyg as well.

Answer:

The whole self employment issue is truly a nightmare!! I have looked into it – in my opinion, unless they are paid a percentage, bear the loss of FTAs etc, buy their own equipment and pay for their own locums they shouldn't be self employed!!

Having said that,ours are self employed. I did a comprehensive audit of their unfilled appointments, and put their rate up to allow for this.

I then increased that by £5 per hour and charge them £5 per hour rent of surgery, fixed equipment and admin services.

To further sweeten the deal, I pay them half rates for FTA etc, (although this is not in the best interests of the practice vis a vis the self employment situation) and only charge them £2.50 rent.

They had originally been treated the same way as all staff – eg paid to come to staff meetings, training meetings etc. paid for all gaps in appointment books etc, so tried to consolidate the whole situation without being too harsh on them when I took away the nice bits that made them look as though they were employees in all but name – if that makes any sense!!

Answer:

We also have 3 self employed hygienists. We pay them £10.50 per patient (20 min slot). The rest of the fee is divided between the referring dentist, practice etc. If there are empty slots the hygienists don't get paid. If they have an FTA the patient is charged and the hygienist receives their £10.50 bit. We also have a list of patients who are happy to come in at short notice if we have any gaps and they maybe want to bring their appt forward. All hygiene appts receive a text/e-mail/phone reminder the day before and this has really minimised the amount of FTAs.

Answer:

We solved this problem by working out how much the hygienists were paid if every appointment was booked. Then we divided the cost of the hygienists wages pro rata between the dentists. That means our 3 day a week paid 3/5ths our full timers paid 5/5ths our 1 day dentists paid 1/5th and so on. Then they could all use the hygienists as much as they wanted. Prior to this system we had a dentist who never referred to the hygienist because they didn't want to pay for the service, now that dentist constanly uses them. Definately worked for us. If they get DNA,s now it doesn't cost the practice anything. And as for the hygienists holiday if you work out what the hygienists cost over 12 months last year that included time when they took holidays.

Question:

I would love to have some feedback from other ADAM members on software systems. We currently only use computers for a digital x-ray system, and office work, otherwise we are still fully paper based. We are a large, mainly private practice, and so what I would like to hear is other people's experience of the change from paper to digital.

The owners have many issues with changing over, mainly concerning systems crashing and with providers of systems not providing sufficient back-up. I am very keen to move this forward but I need to find a reliable system to present to the owners. In the past we have looked at SOE and Bridge-it but they thought they were too complicated. We like using Mac as a rule, so to have feedback on their system would be very well received also.

Is it usual to install the reception system first and then roll out to the surgeries or would it be better to do the whole thing in one hit?

Is there anyone who has changed and wished they hadn't or actually reverted back?

I look forward to hearing people's opinions on this often divided subject.

Answer:

I have worked with both SoE & Kodak R4 systems & my experiences are as follows:

SoE in a fully private practice I used this system as a nurse & I found it to be the more superior computer system particularly for a private practice.

Whilst I appreciate it may seem complicated at first; like anything new the changes can be difficult initially but once you are fully computerised you will never look back.

SoE in a predominantly NHS practice as a practice manager; I found the software a little confusing but as I was working for a corporate company at the time we had our own IT section & also the other PM’s who used SoE were incredibly helpful.

SoE support was very helpful whenever we had any issues; they were always just a phone call away & very supportive.

After a few months I was used to it & found it easy to work although even 12 months later I was still discovering new tricks that it could do & short cuts to help me manage the practice.

Both of these practices were already computerised when I joined so I was always able to ask someone for help if I faced any difficulties.

Kodak R4 in a fully NHS practice & my current role; we took over the practice in October 2010 & installed computers in December 2010.

They provided 2 days training for everyone with the second half day involved us “going live” & the trainer being on hand to help out. Plus I was lucky that 2 of my dentists had used the system before so they were able to help the nurses in surgery.

Our receptionist struggled with the changes but she had worked here for 20 years without any problems using the paper way. Whereas; the “youthful” members of the team took to it much easier; mainly because computers are more of a way of life for the younger generation.

The Kodak R4 system is much more user friendly & in my experience a “simpler” system but then we are fully NHS with a very high uda contract & very busy.

The aftercare & support of Kodak R4 in my experience hasn’t been as good as I received with SoE.

It is definitely worth doing a complete change all at once as regardless of how much training you receive; like anything the only way to learn is to just do it & finding things out by playing around with it.

In my opinion SoE is more suited to private practices & Kodak R4 to NHS but there are more than just these 2 systems out there so it is worthwhile having different companies in to give you a demonstration before you make any decisions & commit to any one company.

I have never experienced any problems with regards to either system crashing at any of the practices I worked at; touch wood!

It will be a hard few weeks initially but well worth it in the long run as computers make everything so much easier.

Answer:

We use Kodak R4 and found that it works well for us. We are also a private practice and don't use the NHS part if the system.

I have been involved on in the conversion from total paper to computer and would say it is better for the whole practice to convert together.

My biggest piece of advice would be to make sure there is extra time put aside for training and make sure the software company give a detailed plan of how they will implement everything so that the whole team know exactly what they are doing.

Although companies don't like it the last practice we se up we insisted they set up the computers in a training room initially so that staff could train together and the once we were ready we had them installed in the rooms.

Answer:

We use SOE and have been for 8-10 years, very helpful when things do go wrong and can log in and correct the problem for you, which is great because trying to understand what they are telling you do to put anything right via phone is not easy especially if you are not a computer wiz.

Answer:

We use Pearl software from baker Heath. It is very simple to use and their back up is amazing. They have never failed to answer a call and can remote in to solve the problem instantly. Updates are free, no initial outlay, no contract, so if it doesn’t suit you can cancel, and just a small monthly fee. Please call them on 01162759995. We have been with them nearly 7 years now and have never had any problems.

Answer:

We have been using Kodak R4 for the last 5 years and the system is great and we have a support contract with them so they dial in remotely to fix any problems that very seldom happens.

They gave us training for 2 days when we first got it and after that everybody was confident to use the system.

My recommendation would be to move the whole practice over at the same time because reception is very linked to the surgeries and the 2 work hand in hand.

Answer:

From a clinical point of view, R4 seems to be the most popular here. I’ve always preferred SOE from a management point of view. However, from experience, I recommend you keep the paper records for clinical notes only. For everything else, use the computer system of choice. Only because treatment plans, charting, x-rays and general info can be stored on the computer. I would also recommend that you get a powerful designated server. We had the reception computer as the server for many years, it didn’t work well and kept cutting out.

Carestream who run R4 do a useful online back-up system which works throughout the day and a main one when the practice closes. This is useful as it includes anything extra on the computers which gets passed to the server. I would also recommend remote access from the administrator (manager) computer to all the clinical computers as well as the reception and server. This is really helpful when you need to pass on files that are not included in the dental software. IE. Updates of procedures etc.

I have worked on many different systems and ‘paperless practices’. I have found that whatever happens, the clinical records usually land up being hand written. It’s a nice thought to be fully paperless but I haven’t come across a practice that has managed it yet.

Answer:

We installed SOE on reception intially in 2002 and a few years later in surgeries. Generally it has been very reliable and problems usually hardware based rather than software. Some issues initially with integrating our digital x rays – dexis, so systems run together.

We are a small private practice and if you are prepared to put the effort in initially to personlise it to your way of working you will certainly reap the rewards. We would not change it.

Answer:

We, as a private specialists practice run Schick (CDR software to take full mouth X-ray and SOE software for appointments).

Both of the software’s are very reliable and we have been using them for the past 5-6 years.

They also have reasonable monthly support cost. I will not think twice. We are happy with the above.

Answer:

We went over to R4 3years ago and yes we did it in one hit .We found R4 really good but they have since upgraded and have become more like SoE and alot of the staff don't like it as much!

I have now left that practice and have since become a Manager at a paper only practice (at the moment) as we too are looking ourselves at the moment .

I can't wait to return to computer system (you will love it).

We have had SOE in and yes I agree it is too complicated and too much money.

R4 is also expensive.

We are looking into Pearl.

Answer:

I can't imagine how you've managed without dental software, we have two practices one was SoE and the other R4, we recently changed to now use only SOE. It is amazing and has masses of uses. Get this system in both surgery and reception. Ask for the trainer Bernard to do your training and you'll never look back, (we do not like Microminder who they would suggest for hardware) you will need to have hardware support and remote back up.

Question:

Would anyone be able to provide me with any information regarding IC procedures and training.

It would be interesting to know how other practice managers manage to train their staff in order to ensure they read and understood and are able to maintain the essential quality requirements/ standards at the practice in order to comply with HTM01-05. I would like some guidance if possible on staff training systems.

All of the above is relating to meeting CQC outcomes, in particular, Outcome 8.

Answer:

We have sourced numerous courses and seminars to aid in adhering to outcome 8. I have found the best ones to be those that are run by your local deanery as they are not only CQC compliant but also conform to local PCT/cluster contractual requirements. Our local cluster has also run courses of their own so look out for those.

Last week, I went to The Dentistry Show at the NEC. I attended an IC seminar given by Bev Wasp from a Salford NHS body. She was straight talking and her approach was very practical. She answered all my questions in a way that I fully understood and could relay the information back to my team. She is worth tracking down if you can.

Answer:

I hope this saves you a bit of time. I’ve attached a copy of our Infection Control Policy. I have also attached the HTM 01 05 self-audit tool which you may find useful.

Policies are available to download in the templates section in the members area.

I used the audit tool with our senior nurse in mind. It meant she had to have a full understanding of the HTM to run the audit. It has points of reference to most questions and therefore it is used in conjunction with the HTM. This was supplied with the printed version of the HTM but as most people (like me to start with) downloaded the monster straight from the DoH, it initially was missed.

I have also found that Henry Schein run an Infection Control course at their local centres so this may be of use to you. Tel. 029 2044 2800 or 08700 10 20 43 (I spoke to Sue O’Rourke who is the Course Co-Ordinator.)

I hope this all helps, but if you need any more info, please do not hesitate to contact me. We’ve had our CQC inspection so I know the attached policies and audits are compliant.

Self audit tool dental decontamination pdf is available in the Downloads section.

4.1 Infection control policy is availabe in the Template section.

Answer:

We have two in house training days per year, every member of staff is encouraged to take responsibility for giving a presentation.

For instance in May I have mindfully delegated two nurses (working in twos is successful for less confident staff) to give a presentation on violent and aggressive behaviour.

I chose something that I feel needs exploring from our policies & procedures. We make them interactive.

Also another example at our monthly hour long staff meeting last week I gave a test & training on patient confidentiality. This is also a good way of seeing how informed your staff are with regards to future training etc.

Click here to download Sickness Pay Survey (March 2012)

Question:

Would anyone be willing to share what they pay their nurse? As a result of the receptionist survey it appears that we may be underpaying our staff.

Answer:

Just to let you know we pay comparable rates of pay to our Receptionists and Nurses. I know of quite a few practices that pay the same rate to both.

Answer:

Trainee £7.00ph, qualified £8.50-9.50ph depending on years of service.

Answer:

£9.50 for qualified.

Answer:

Our trainee nurses start on National Minimum wage for their age group. We then reward loyalty, by adding 10p per hour on completion of probationary period.

We add 50p per hour when they qualify, and also to reward extra qualifications that are relevant to our practice (eg my head nurse got extra when she did a sedation course, because it is needed and used) Don't pay them extra if the just fancy an extra qualification that is no use to you.

We also reward taking on of extra responsibilities, but my Head Nurse is paid a lump sum every month, rather than increasing pay.

We used to add between 10p and 30p, depending on length of service, on the anniversary of start date, but that was too time consuming, so I changed it to twice a year. We haven't done this this year because times are tough, but I am still adding the NMW increase, as that is our starting point.

Highest paid nurse is on just under £10.00 per hour.

Answer:

Our nurses range from £8.00 per hour, most of them are on £11.00 per hours and I have a senior nurse who is on £17.00 per hour. Hope this helps. We are in Newport South Wales.

Answer:

Our trainee nurses have just gone up from £7.95 to £8.11, with a bigger rise anticipated when they pass their exam this year – probably another £1 an hour.

Nurse with several years experience but no other responsibilities than her dentist now £10.66 and head nurse with responsibility to mentor juniors, check emergency drugs and do/delegate ordering, also with 10+ years experience with us gets £11.63. She is able to work on reception.

Answer:

We have 3 nurses here at The Smile Team. 2 of the nurses have been at the practice for nearly 20 years and their pay is £11.50 per hour with £46 a month loyalty bonus. Neither of the nurses have any other qualifications. The other nurse has just joined us as a newly qualified nurse and is still in her probation period she is on £9.50 per hour with the scope to go up according to performance and loyalty.

Answer:

Our rates are as follows: Senior nurses £10.92, General nurses £10.35, Trainee nurse £7.20.

Answer:

We are a practice in Central London and our nurses get between £11 to £12.50 per hour.

Answer:

We pay between £10 and £12 per hour according to experience.

Answer:

We here in Norfolk pay between £6.80 (apprentice) to £8.60 to our nurses.

Answer:

I have 1 nurse who has been with us since Jan 2002. She qualified in June 2006 & passed her radiography exam in Dec 2008, although as we are a small single handed practice she has not really had the opportunity to use this qualification.

She is paid £9.70/hour.

The other has worked for us since Jan 2009 she qualified in Dec 2009 & is paid £8.75/hr

Our working day is 7.5 hours but we pay 8 hours daily to cover any hours worked over

We pay the nurses registration fee, membership to the British Dental Nurse association & also their CPD through the FMC publication cpd in practice

Staff employed prior to 2008 also have private health insurance

Answer:

We are in Bath and we pay £8.32 per hour.

Answer:

Approximately £9.50 – £10.50 per hour

Answer:

We pay our nurses from £7 (unqualified but training) – £11 per hour dependent on additional qualifications such as sedation training and additional responsibilities.

Download the Result from the BDA 2010 DCP Pay Survey

Question:

Could you please enlighten me re: the Bribary Laws – would giving the nurses/receptionists free treatment, bleaching, cosmetic dentistry etc be considered a bribe or a perk too far ?!

Answer:

When I spoke to the legal guys he told me that free treatment was just a perk and not a bribe. If the principal/owner wants to give his services there is no obligation to charge for his services – it is his choice.

However, if an associate or hygienist does this without the consent or knowledge of the owner it could be classed as theft.

Question:

Would anyone be willing to share what they pay their receptionists?

We have 2 older ladies who have been with the practice 20+ years. Both have cut their hours right down, and the boss thinks they must be pretty much at the top of their pay scale.

I have no idea if there is a recommended rate for receptionists – these two are on £11:10 per hour with pay reviews due. Due to how long they have been with the practice, they earn more than some of our nurses!

Answer:

Our receptionists are on £10.35 an hour and we have not increased staff salaries for the past 2 yrs. If yours are at the top of their pay scale, perhaps give them increases in line with inflation?

Answer:

It is a real problem isn't it because if they are really good and have genuine rapport with the patients and know the patients really well that is worth the £11.10.

I live down on the Kent Coast (need to know where we are to be able to compare) so wages here are reasonably above average I would say.

Our receptionist pay: One receptionist is a qualified nurse but wished to switch roles and she has just taken her radiology qualification. Been with us for 8 year and she gets £9.25 per hour.

Receptionist two has been with us for 11 years and is on £9.65 an hour . She is absolutly fantastic with the patients and has great IT skills (I wish I had two of her). She acts as my Head Receptionist and has great common sence and understands that we run a business so when I am away she will shoulder some of my responsibilities such as staffing levels, counsellor, calling the plumber when needed! etc.

Answer:

The going rate for a fulltime Receptionist is anything from 24 K to 30K. Hope it works out as they are both part time you may end up paying more.

Answer:

We are a busy NHS practice, but our staff wage rates are nowhere near those!!

SENIOR RECEPTIONIST £7.35

RECEPTIONIST £6.10

I wish we were in a position to offer better rates but sadly we can’t.

I think your ladies should think themselves very lucky, even some Practice Managers don't receive that rate!

Answer:

We pay our receptionists £15k per annum. Both have been here over 5 years.

Answer:

With regard to your email, I am happy to share receptionist hourly rate with you. It ranges from £8.70 – £10.50.

The receptionist who is on £8.70 has been with us for 2 years, two receptionists that have been here for 7 years are on £9.50 (however they do have a lot of sick leave)! We have one lady who has been with us over 20 years and she is on £10.50 per hour.

We are situated on the borders of South West London / Surrey.

Answer:

Our receptionist is on £9.20 ph we are in Northamptonshire.

Will be interesting to know if there is a scale

That seems a very generous wage! I know in my practice I have moved towards rewarding responsibilities like CQC and HTM rather than just rewarding long service.My Receptionist has been with us p/t for 16 years and she covers surgeries and is on £9.70. We have rewarded more holiday for length of service.unless your receptionists have additional responsibilities or have outstanding performance I think their at the very top. With all the additional pressures a nurse faces daily I think they should be better paid than they are in general. I hated it when our fantastic trainee who gave 100 percent was paid a fraction of our (now retired) receptionist who gave 50 percent.

Answer:

If you refer to the latest BDA Pay survey it provides you with the current rates, and your two are very well paid.

Answer:

We have just employed 2 members of staff

1 = Receptionist pay = £15,000 a year pro rota with 4 weeks holiday a year + bank holidays

1 = Just passed her dental nursing exam pay = same as above.

We have a pay bonus scheme where they can earn an extra 1.5% at the end of each year depending on their sickness record= 0.5% etc and performance =0.5% extra etc throughout that year. Shrewsbury.

Answer:

Our receptionists are paid between £8.50 and £9.50ph our longest serving has 22 years experience. Both have nursing experience. They retain their status on the GDC register via competence so they can assist the operator during nurse sickness and leave.

Answer:

One of our receptionists earns £7.50ph as she has no qualifications like the nurses do, nor does she have to do CPD, but the other receptionist does the banking too, and she earns £10.20ph.

Answer:

My part-time receptionist has been with us for three years and is currently on £9 ph. We are in Bristol, I think your £11 per hour is a generous amount

Answer:

We pay our receptionists £11.10, this is normally increased annually by 10p as we feel they are on a fairly good wage already!

Answer:

Our receptionists have always earned more than our nurses. This is not because their job is any more important than the nurses, but they tend to have a higher stress factor, as they deal with all the patients' grumbles etc., whereas the nurses don't (although I am well aware that the new regs have put increased pressure on the nurses' workload.) £11.10 is quite generous – more than mine get paid by about 50p, though mine have not been here as long as 20+ years. We tend to reward loyalty, as you obviously do, and also pay a little more for extra tasks that they accept – this has been particularly relevant for me, as I had heart by-pass surgery last year and everyone is very anxious to reduce my stress. I usually add on the amount by which the national minimum pay increases to everyone in the October pay. I used to add loyalty on at the anniversary of their start date, but that gave me too much extra work!

Answer:

ANYTHING FROM 9 – 10.50 BUT IF THEY ARE LONG STANDING MEMBERS OF STAFF 11.10 IS QUITE ACCEPTABLE.

Answer:

If I were you I would leave their pay as it is. I use to run a dental practice and my girls were classed as well paid. Reception staff were on just under £10.00. My nurses were on just over £11.00 an hour. I do understand that as they have been there a long while and they have built up their earnings (are they worth it?)

Maybe in stead of paying more maybe give them extra holiday for there loyalty.

The surgery that I work at now pays less that £10 for both (as most in the Braintree area do).

Answer:

I am really shocked how much your receptionists are earning that is indeed more than some nurses earn, not sure what you can do about the situation, our receptionist gets £8.95 she has worked with us for a long time and I think that is fairly much the going rate in most dental practices in our area.There is no way I could justify paying such a high hourly rate.

Answer:

Ours are on £7.14 an hour, we are based in North Yorkshire.

Answer:

We are paying £7.21 ph.

Answer:

We have excellent receptionist, they are paid £8.50 per hour, they're very happy and we are happy… patients happy also. I pay qualified nurses £10.00 per hour!

Answer:

Our receptionists are on more than some of our nurses too. We are in Wales and we pay the receptionists £10.80 an hour with a pay review in April. I feel my nurses’ work harder and have all their CPD requirements to hit.

Answer:

We have the same thing here! I always think it is strange that reception earn more than the nurses?!!! We pay our reception staff £11.68 per hour and the head receptionist who has been with us many years is on £13.18.

Answer:

Currently we pay our dental receptionists £8.91 per hour (not nurse trained).

Answer:

I think the average varies depending on location – our Southwest and West of UK clinics receptionists are on £8.00 to £9.00 per hour, whereas our Southeast and London clinics receptions are on £10.00 to £12.00 per hour. Medical receptionist especially experienced ones are usually paid 20/25% more than salon or hotel receptionists.

Question:

Does anyone have a robust Policy for Legionella they could share with me?

Answer:

Just to let you also know you have to use a qualified inspector to carry out the risk assessment the company we used was:

Aqua Analyse Ltd
9 Bridge Avenue
Maidenhead
Berks SL6 1RR
Tel: 01628 902 100
www.aquaanalyse.co.uk

I highly recommend their services.

You can find a Legionella policy template in the members area of the website under templates.

Question:

I wondered if you could recommend a steriliser/disinfector servicing and maintenance company to us please.

We have dealt with a company for a few years now and we are less than pleased with their customer care!

Answer:

We use Eschmanns, we did swap to DBG, but they were nowhere near as efficient, and we had far more breakdowns when theyw ere servicing, than when Eschmanns do it. I know they're dearer but we would rather pay and have a good service.

Answer:

The guy who has had a maintenance contract for our 5 autoclaves in Devon over the past 10 years said he could recommend a colleague – the firm is called Sterilizer Consultancy Ltd and he believes they would cover your area. The contact no is 01977680033.

Answer:

Have you tried QA dental engineers? We have worked with them for at least the last ten years and I would easily recommend them. The owner is called Stuart and his contact number is 07973728737.

Answer:

We are local to your area and use Steriliser Consultancy based at Sherburn-in –Elmet. We have always found them efficient and helpful. They can be contacted on 01977680290.

Question:

Should we have a restraint policy in place for CQC compliance? If so, does anyone have a policy draft I can work from please.

Answer:

Please find attached a link which was provided from our PCT in Northampton which covers restraining patients, it's very informative and all staff can register and download certificates once completed. Please type in the top bar.

http://www.embrace-learning.co.uk/LMS/Code/PHP/Pages/OrgPages/OrgHome

Once you have the page up you can register and login to course with codes below:

For Safeguarding Vulnerable Adults please enter HXTEVE.

For Mental Capacity please enter RTPSWY.

For Deprivation of Liberty Safeguards please enter HSHFG.

If you are unable to use this link I would advise speaking to your Safeguarding Adult Lead at your local PCT and she/he should be able to provide you a source or training for your clinic.

Answer:

Our policy is that we would not restrain a patient.

Answer:

The BDA guidance "Care Quality Commission Essential Standards of Quality and Safety” is a wonder full document! It identifies:

• Underpinning legislation
• States the CQC requirements
• Provides suggestions on what you might do to comply
• Suggests how you might demonstrate
• Identifies sources of useful information

They have done ALL the work, have a look what they say under 'Safeguarding and Safety'.

Answer:

I would suggest going on the BDA CQC toolkit. It has templates for all the policies you would wish to have including Outcome 4 compliance recommendations. There is not a template for a restraint policy but I am writing my own. This outcome seems to be a hot topic for the CQC inspectors in our area so I am covering every angle.

Question:

Would anyone be able to provide me with any information regarding IC procedures and training.

It would be interesting to know how other practice managers manage to train their staff in order to ensure they read and understood and are able to maintain the essential quality requirements/ standards at the practice in order to comply with HTM01-05. I would like some guidance if possible on staff training systems.

All of the above is relating to meeting CQC outcomes, in particular, Outcome 8.

Answer:

We have sourced numerous courses and seminars to aid in adhering to outcome 8. I have found the best ones to be those that are run by your local deanery as they are not only CQC compliant but also conform to local PCT/cluster contractual requirements. Our local cluster has also run courses of their own so look out for those.

Last week, I went to The Dentistry Show at the NEC. I attended an IC seminar given by Bev Wasp from a Salford NHS body. She was straight talking and her approach was very practical. She answered all my questions in a way that I fully understood and could relay the information back to my team. She is worth tracking down if you can.

Answer:

I hope this saves you a bit of time. I’ve attached a copy of our Infection Control Policy. I have also attached the HTM 01 05 self-audit tool which you may find useful.

Policies are available to download in the templates section in the members area.

I used the audit tool with our senior nurse in mind. It meant she had to have a full understanding of the HTM to run the audit. It has points of reference to most questions and therefore it is used in conjunction with the HTM. This was supplied with the printed version of the HTM but as most people (like me to start with) downloaded the monster straight from the DoH, it initially was missed.

I have also found that Henry Schein run an Infection Control course at their local centres so this may be of use to you. Tel. 029 2044 2800 or 08700 10 20 43 (I spoke to Sue O’Rourke who is the Course Co-Ordinator.)

I hope this all helps, but if you need any more info, please do not hesitate to contact me. We’ve had our CQC inspection so I know the attached policies and audits are compliant.

Question:

Do you have any information on implant nurses? We have a nurse who has some experience in implant assisting and can be considered competent, but is there regulation or recommendation for formal training in this area?

Also her indemnity insurer suggests she declares that she nurses for implant procedures, but they so far only amount to about three in six months.

And lastly, if we started providing implant consultations and placements after our CQC registration, should I be informing them of this activity?

Answer:

We are an implant practice. If you registered with the CQC at the beginning with diagnostic and surgical procedures, this should cover yourself. If you are still in contact with your inspector, it might be a nice touch to ask them. Amazingly enough, there is no need for formal training at present for this as implantology isn’t recognised by the GDC as a Specialist subject yet! I am aware they are looking into this and it will probably be added in the near future.

As for your nurse, I know that Kings had a course as our own nurse attended it last year. It has to be said, she wasn’t too impressed with it and didn’t feel it really prepared her for the examination. However, she was very well experienced (as it sounds as your nurse) so she passed. I understand that the tutor has decided to run an internet version. I’m afraid I haven’t kept those details as we didn’t intend to use them again.

As for indemnity, I looked into this last year, we have a group policy via Dental Protection and I suppose as we are a specialist practice, we are covered for implants. If your Principal hasn’t got this type of policy, it may be cost effective as it covers nurses as well as the practice manager (especially if GDC registered). Its handy to use when you need clear legal advice.

We also have a policy here that any staff receiving training courses and CPD have to remain at the practice for a two year period after qualifying otherwise, they have to refund the practice for the course fees. Again, if you haven’t got this in staff contracts, its worth discussing with your Principal if they are intending to train up staff, but are afraid once trained, they leave.

Answer:

I am the practice manager of a dental practice – implant centre in Scotland. We do have two dental nurses, one attended a course called" Introduction to Implantology" which helped her a lot ( 7.5 CPD.) So I believe there must be courses that give a better understanding to the nurse. However I dont think it is required by the CQC.

When ever we have implant procedures (implant placement days) we have two dental nurses in surgery. (clean and dirty dental nurse) The implant nurse assists only, the other nurse does the other surgery duties like notes, sterilising, etc.

Question:

What would you do if you had a patient who didn’t speak any English regarding CQC?

Answer:

We have multilingual emergency book on reception or we would use intran for translation.

Answer:

If you are an NHS practice your PCT should have telephone numbers for an interpreter .

Answer:

Here in Suffolk we have a service called Language Line which is a service for dental practices to use for non-English speaking patients. This service is free to all practices offering NHS treatment. Perhaps your PCT could give you details.

Answer:

We have recently spoken about this scenario and we decided we would ask that the patient brings a translator with them.

Answer:

We have access to an interpretation service and British sign language (BSL) service funded through the PCT.

Answer:

We are registered with Pearl Logistics, via our PCT, they are an interpretation service for many languages and we have used them. We are based in Derbyshire, but if you want to ring them direct their number is 0800 022 4230.

Answer:

Contact such as Scais interpretor in Sheffield don't know if they would cover Chesterfield.

Answer:

In our practice we have  a card with different languages on that states if a person can not speak English then they must bring a person over the age of 18 who can translate.

Answer:

The onus on communication is on the practice, not the patient. We are expected to use translators where necessary.

Question:

We are looking to refurbish a surgery and I was wondering if anyone could recommend anyone in the North Yorkshire area (we are in Harrogate). We would like to ideally use a local firm but would look at the larger dental suppliers if they are recommended.

Answer:

We have recently refurbished 3 surgeries. Initially we used Henry Schein for 1^st one but the project management was not very good and the cost was extortionate. We therefore moved on to use a local plumber/electrician (one’s that we use regularly anyway) and a fabricator who made us corian worktops for 1/3 of the price of henry schein. We re-used our cabinets as they fitted fine. Much more cost effective and looks fab!

Answer:

I appreciate my contacts are Scottish based, but can recommend them to anyone. Lab Plus installed my LDU and also specialise in surgeries too.

Peter Connolly is an excellent Project Manager who remains on site and makes sure the job gets done. Everything was done on time and well within budget.

Answer:

I would recommend DB Dental equipment whole heartedly. They will supply, fit and service equipment and cabinetry. They are located at 53 smithy carr lane, Brighouse West Yorkshire tel: 0148 401015. we are located in Nottingham and have always received 1^st class service

Answer:

We recently had a surgery refurbished & used the services of DB Dental who are based in West Yorkshire.

They project managed every aspect of the job & through no one’s fault when there was a miscommunication & the floor needed to be replaced; they ensured this was done free of charge.

The aftercare has been good too & the job was completed on time.

I appreciate you are looking for someone in the North Yorkshire area but they travelled to Manchester for our refurbishment & I know of another dentist who has used their services in Leeds who recommended them to us.

Answer:

We have just had a refurb by a local company to us, but they would be more than happy to work in Harrogate. MWC construction, contact name Martin Watson 07816303118.

We have had a larger supplier in last year for a single surgery and hand on heart what I will say is – we did not know martin’s guys were even here, they came in got on the job was completed quickly and its beautiful. Timelines were kept to and there was minimal disruption to our working day – which the dentist’s loved.

Answer:

We are part of a small corporate and recently had our surgeries fitted out by RPA Dental based in Wigan (telephone 01942 245808). We are very happy with the quality of their work.

Answer:

We have recently relocated and renovated an entire building ; installing 7 new surgeries and a decontamionation room . Although not local to you I would highly recommend “Armstrong Young” Amberley House, beacon Road, Crowborough East Sussex.TN6 1AS . I cannot fault any aspect of their workmanship, an extremely professional company that looks after your requirements from start to finish.  Excellent customer care. Highly recommended.

Answer:

I would highly recommend McKillop Dental.

Simon Pearce from there is really good – gives good advice and never tries to sell you anything! Also customer care before, during and after surgery placement is superb. They also have an engineer who is based in Yorkshire.

Our practice uses R4 software, we are looking at offering 0% finance to patients for treatment plans incurring large costs. The finance company deduct their subsidy at source and then deposit the remainder into the practice bank account. How would you overcome allocating the full amount due to the appropriate patient finance, bearing in mind their treatment plan will show a greater amount due than is actually received?

Answer:

We use SoE but perhaps it is similar? I invented a way to show this on the system, but don't know if it is right!

When I receive the finance company statement it tells me that £x is being paid into our bank account, which I then 'pay' on the patient's account and select BACS form of payment (normally you would select CC. visa etc or cash at the rec desk) and I put a note on the payment that it is a loan payment.

The statement also tells me the -£y amount that the finance company keep (your 'interest'). I have an item of service created called 'balancing payment to loan company' which I charge through on the course of treatment with the correct interest amount as a credit to the patient (a minus on our system). These two actions then make their account in credit with the full loan amount.

I don't know how this loan credit service item affects reports used to pay providers, as I don't deal with that myself, but it must show up somewhere to be taken into account.

Answer:

We use SoE Exact but this is what we do in our practice.

In the finance part of the patient file there is an option to input opening balance/ i am not familiar with R4 but if you have the option input (- the subsidy amount) it will at first put the patient in credit, then you input the monies received from the finance company. It should tally to the full amount of the treatment and it should show that the patient is in credit until the full course of treatment is charged.

Answer:

There is an easy way to process an IFC and I’ll tell you how it’s done in my practice.

You process the payment from your IFC company as (cheque for example, that’s how I do it), this will be the amount that your patient wishes to finance minus the cost of the IFC.

Then you credit note on R4 the IFC interest so you can put your patient in credit for the full amount.

Let’s say you patient wants to finance £2000 worth of treatment. The cost will be let’s say £200.00.

You will click Till then Payment and then Cheque and take £1800.00, you will be then £1800.00 IN CREDIT.

You will then credit note another £200.00(the IFC cost) to make the £2000 in credit.

You can then complete your treatment and money will balance.

Answer:

We do a balance adjustment and put comment “finance sub” in text so that it’s clear in the accounting why balance has been adjusted.

I would like to know if you insist that nurses take time off with their dentist, are made to keep some back for Christmas or maybe asked to space them out throughout the year.

Answer:

This year we have imposed their paid leave and said any other leave they require would be without pay. Legally you can do this. However, you may need this written into their contracts. Have you an organisation that can advise you on employment law? As you take on new staff it is a good opportunity to change their contracts. As we close between Christmas and New Year we 'give' these days as a bonus holiday. I don't think it unreasonable that they take their leave when a dentist is off as well.

Answer:

Our team have the 20 days (excluding bank holidays) split into, as follows;

5 days must be taken at the same time as one of the dentists,

5 days may be taken as odd one off days, birthdays etc or "sick days" if they've needed time off for sickness and want to be paid, (We do NOT pay sick pay only SSP)

2 weeks at any time having been previously agreed by the manager…. all holidays need written request and written confirmation

Answer:

We ask, wherever possible, that the dentists and nurses take their annual leave at the same time; if the dentist doesn't have any solid plans but the nurse does then we ask that the dentist take annual leave at the same time to accommodate their nurse and vice versa.

The dentists have more annual leave available to them compared to the nursing / reception staff which allows us to grant leave that doesn't tie in elsewhere.

Annual leave is granted on a first come first served basis.

We don't ask anyone to hold holidays for the Christmas period but it is understood that if the practice is to be closed and they have no AL remaining that the employees will be asked to take unpaid leave rather than being idle at work.

We suggest to all that the leave is spread throughout the year, with no longer than 3 weeks requested at any one time

Answer:

I do make nurses keep back time off for xmas, and also say at interviews that when possible can they take holiday when their dentist is off but it doesn’t always happen

Answer:

Holidays are always difficult. We find it very difficult in the first place to get the dentists to confirm too far in advance when they will be off! Some of them are never off! and some of them take long breaks at strange times – i.e 4 weeks in January !!

We don’t insist on the nurses taking the same time as their dentist, and sometimes they do, but we do try and ensure that one nurse is off when a dentist is off, this usually works quite well. We also try and ensure that they space their holidays over the year and not have too many left to take Nov/Dec time.

Answer:

I insist staff take 2 weeks when a dentist is off and save 3 days for Xmas. Most my staff realise the problems of taking holidays when dentist are in and work around that. As a thank you I always allow unpaid leave, so they take advantage of that.

Answer:

I have been managing a practice for 19 years and always run the same system. Staff must keep holidays to cover the time between Christmas and New Year, and after that staff are given priority in the order in which they were employed.

Answer:

I co-ordinate all of our dental nurses annual leave in conjunction with dentists, it does not have to be their own dentist, I can rotate with the other dentists. But, to ensure smooth running efficiencies two weeks of a nurses leave has to be taken with a dentist (within reason).

We try and give fair holiday entitlement and also 8 days bank holiday a year, so that we can reserve some of their entitled leave for Christmas closedown.

We have a meeting each January and the staff all agreed they would like xmas closedown so were more than happy to reserve a few days for this.

Answer:

At our practice, we do a little of all.

1. Staff are required to keep a minimum of three days for the break between Christmas and New Year given that the practice closes during this time. (Actual amount of reserve may vary from year to year depending upon what days Christmas and New Year fall on).

2. It is our company policy that all staff must split their holiday leave pro-rata over the year. This is to prevent all leave being taken in the beginning of the year and then having nothing left and also to avoid storing holiday leave up and then taking a huge amount towards the end of the year and during busy times.

3. Whilst not compulsory, we do also request that wherever possible, staff should book their annual leave at the same time as the dentist.

Answer:

I think our practice has been very lenient over the years (possibly too much sometimes!) – nurses are encouraged to have time off with their dentists,
but it doesn't always happen! However, if a nurse is off whilst a different dentist is off, the original one just swaps shifts/surgeries and works for
the other dentist.

We don't always like it if a nurse and receptionist on the same shift have too much time off together, as it gets hard to cover both. Staff only have
to work one day at Xmas too, so they don't need to store lots of hol up either!

With 4 dentists working 2 shifts and 19 nurses and receptionists, working both shifts, to accommodate, it isn't always easy; but as most are part-time
and job-share, they tend to cover each other and I cover reception in the busy holiday period.

Answer:

Nurses take time off with their dentist preferable! (If the dentist takes two weeks then the nurse has to take the two weeks with him/her and then still have the option of her own choice of two weeks consecutive- this is then a win win situation for both.

School holidays/ nurses with children know that this will be their first choice but this time needs to be shared with the other nurses that need time in the summer holidays as well. (Plan ahead in the year and let them share one year IN /OUT)

Two weekscan be consecutive the remainder need to spaced out and what best suits the practice. (unless a nurse takes time with the Dentist)

Answer:

We do a sheet with a holiday request that the nurses fill in, then we check the schedule to see if it’s convenient for them to take leave then, we only allow one nurse or one receptionist off at any one time. Also we give a bonus if you take leave when the dentist is off i.e. if the dentist is off for a week and you take that week, it only cost you 3 days of your leave instead of 5 . It doesn't work for all the staff especially the ones with children as they need school holidays but most of our nurses like this. Yes you can say that they need to keep a proportion of their leave to cover the Christmas period.

Answer:

Most of our nurses take holidays when they want and we cover them with myself and a receptionist who is also training to be a nurse, however, we do try to encourage as many people take time off when the dentists take their holidays as it makes more sense, but we would not insist. Most of them take the time off anyway.

It is stated in our contracts though that there may be compulsory holidays throughout the year especially at Christmas, so it is there if we need it

Christmas we are only open for 3 hours each day in between Christmas and New Year so most people prefer to take it off as it can be quite boring.

Answer:

We are quite flexible with holidays and operate a 'half-rate' system which works that if a nurse takes time off when they are not needed (ie when a dentist is off) they get it at half-rate, ie two days taken off when they are surplus means only one day is deducted from their holiday allowance. This encourages nurses to take time off at a better time for the practice. More recently we have had to cap the amount of half-rate holiday taken to help distribute it more fairly. We've operated this system for 10 years now and it works well for us.

Answer:

Our nurses have 5 weeks holiday: 2 weeks have to be taken with dentist (dentist may have to fit in with nurse), then 3 weeks when there is availability. Our practice is not closed so we do not make them take time off near Christmas etc.

Answer:

Our Nurses do not necessary take the same holidays as there dentist, sometimes it works out. We have two rules 1. Only one nurse of at a time 2. They must keep holidays for Christmas break. Plus 6 weeks notice has to be given for holidays longer then a week, that way you have time to sort out any problems regards getting extra staff, any nurses working part time can re-arrange there work days.

Answer:

We ask all nursing and other (i.e. reception) staff to take their holidays at the same time as our two dentists and therapist (who also take their holidays at different times to ensure emergency cover) – usually nursing staff and dentists / therapists have discussions amongst themselves to agree mutually convenient times. So far I haven't encountered any problems with too many staff wanting to take holidays at the same time. I have also introduced a clause within contracts of employment that holidays will only be agreed with at least one months written notice and only if such a request is compatible with continuity of services – this makes it easier to refuse a holiday request if we have concerns regarding adequate staff cover. Also, staff are generally fairly sensible with regard to taking holiday over the twelve month period – I have never encountered anyone wanting to take all their holiday entitlement within a short period of time – they generally stagger it over the twelve months.

Answer:

Our only request and we have it written into their contract – is that they take 50% of their holiday with their GDP.

Answer:

I have it in their contract that 2 of their 4 weeks must be taken at the same time as a dentist but not necessarily dentist they are allocated to work with. This gives a bit more flexibility. Priority is given to the nurse the dentist works with and then offered to others if nurse doesn't want that date.

Answer:

We close the practice Christmas week so everyone has to save holiday to accommodate this. We do not specify when other holidays must be taken, although as a single handed practice it is more convenient if staff take holiday when the dentist does. Holidays have to be agreed with us & I try to discourage everyone taking holiday the week after another staff member has been off.

Answer:

We try and encourage our nurses to take time of with their dentists, but don’t insist (a difficult one to deal with!), we do how ever ask them to keep holiday to take over Christmas but on some occasions have had to ask them to take unpaid as they have used up all their allocation.

Question:

We tend to fill our hygienist days but nearer the day, we can get quite a few cancellations and failed to attends. It does not always happen, but on some days we can have 2 or 3 gaps. Does this happen to everyone? Is it normal? Does anyone have any procedures in place to prevent it happening? The hygienist days seem to be much more affected by this than our other books!

Answer:

We have put together a leaflet on visiting the hygienist and add it to our recall letters, to inform people of the importance of the hygiene visits.

Answer:

Yes we also have this problem at our practice and we have started asking patients to pay for their hygiene visit in advance.   We seem to have a lot less last minute cancels and FTAs.

Answer:

We have a private hygienist – so our patients get referred by our NHS dentist – we take a £20.00 deposit on the day they book, the balance of £20.00 is paid on the day – if they FTA we then keep the £20.00 and that goes to the hygienist .

If they cancel on the day we keep the £20.00 deposit again for the hygienist – if they cancel a few days before the appointment – we re book and move the deposit to that day.

Answer:

We have also faced similar problems with our hygienist appointments in the past.

In the end we had to change our policy and put up a note saying that we will be taking advance deposit on hygienist appointment. This has ensured that patient turn up on the day of the appointment.  It has reduced the number of  fta and short notice cancellations. Amazingly majority of the patients have taken this new policy very well.  Also along with the change in payment policy we have also made our reminder system better.

Answer:

We have had a similar problem. We now book the check up appointment with the dentist and 15 mins later book the hygienist appointment so the patient sees both clinicians on the same day (this has made a huge difference in FTA/short notice cancellations). We also telephone all the remaining hygienist patients who do not have dual appointments the day before to remind them of their appointment time.

Answer:

This happens to us as well.  Our hygienist is usually booked up for quite a few weeks, so we have a cancellation list.  The receptionist phones people on the list, offering them the cancelled appointments. Also the nurses are made aware there are gaps, so that if they have a patient in who has been advised to see the Hygienist they can offer an appointment.

Answer:

We experience the same problem and we are confirming patients by telephone 2 days before their appointment and keep a very up to date standby list in case of any cancellations.

Answer:

We text our patients two days prior to their appointments, those without mobiles receive a reminder letter 1 week before. When I worked in a general practice we had a spate of this happening.  We decided instead of calling the day before to confirm hygienist appointments, we would call the week before and then if anyone had a problem we had a chance to fill the space.

Having listened to Chris Barrow last night and the importance of gaining patient loyalty, we are toying with the idea of offering patients who are present in the practice at the time of the hygienists free time a “spa” type mouth treatment. I’ve asked our hygienists to work on a 15 minute appointment idea where the patient gets some nice polishing, a bit of OHI, discussions on the benefits of hygiene or other dental treatments. The patient selected needs to be a regular patient of the practice and this service would be free to them.

Answer:

We tell the patients that the Hygienist is the most important person in the practice as without gums there is no point the Dentist doing his fab work – sounds good but we still get the failures, etc.

Answer:

We confirm all our hygiene appts the day before. We ask for 48 hrs notice for cancellation but charge the full cost of appt if pt does not come. You could try asking for a deposit prior to appt. This is not foolproof but it has helped us.

Answer:

All our hygiene patients have to pay for appointment in advance on booking. Then if they short notice cancel or FTA they forfeit the fee and have to pay again. May seem a bit harsh but then you sift out the time wasters.

Answer:

We have this problem too, we do charge for late cancellations and also offer a 10% discount to patients on the day if they take a cancellation appt. This does work in our practice

Answer:

We had the same problem, and introduced a 48 hour cancellation fee of the full amount if after this time, that is unless they can move to another gap that week and then we do not charge. The treatment plan which is given when the booking is made states that there is the full charge for missed appointments with less than 48 hours notice.

Question:

Please could you share how you charge your dentists for the hygiene patients? we are charging the associates a fee for referring patients to the hygienist and others a percentage. We want to offer an incentive for referring and not make the associate feel they are being 'out done by' for sending patients for a S/P. Please could you advise me how you all work out hyg figures for associates?

Answer:

We charge the patient £35. £15 each to practice and hygienist and £5 to referring dentist which is added to the private monies each month as a gross payment. ie the dentist received the whole £5. This seems to work very well.

Answer:

We pay the hygienist 40% and give the associates a fee of £4.00 per referral

Answer:

We give our patients a 15 min slot with our hygienists, the rate that is charged to each dentists is the Hygienists hourly rate divided by 4, i.e £28 per hour / by 4 = £7 per 15 min slot

Answer:

We charge the dentist the therapist hourly rate. ie if the therapist is paid £40 per hour, we would charge £10 per 15 min appt. if the dentist charges the patient £30 per 15min appt the net fee to the dentist is £20 per 15min appt, which should be an incentive. This is subject to the dentist percentage. ie everything would be at 50% including fees and payment.

Answer:

Our associate is paid 10% of what the patient pays us for each patient he refers. The hygienists keep daily tables of the number of patients seen and who the referrer is.

Answer:

Our associates pay 50% of the expenses (hyg included) and receive 50% of their income. This means we pay half of the hyg hours they use and they pay the other half.

Question:

Could anyone share with me how their practice pays an associate in respect of capitation patients. By this I mean what does the associate receive for their own capitation patients and those patients they see registered to another clinician in the practice.

Answer:

We make an "interschedule adjustment" the treating dentist charges the colleague normal private fees for work provided, we usually check with the dentist with whom the patient is registered before we make the payment. We also try whenever possible, never to book each others patients when on a capitation scheme. The amount paid to the practice is added to the dentists income and calculated as all other income at 45% or whatever the agreement %.

Question:

Our query is that with CQC coming into force, the title of Practice Manager is dispute. One of our Dentists has taken on the role of Manager of the CQC programme, but I will be continuing with my Practice Managers duties. CQC seem to have problems differentiating between Dental Practice Managers and Medical/Nursing Home Practice Managers. My Dentist is concerned as to what my title should be, would it be wrong in being called Practice Manager or is there another title to be used.

Answer:

You can be called what you like. I would suggest you stay Practice Manager and the dentist is Clinical Manager, or you could be Development Manager or similar while he is Operational Manager.

Question:

One of my dental nurses has been to see me. She has discoloured nails and this affects her confidence – she has them covered professionally with pink/white powder to disguise this. She has asked if she can continue with this to help with confidence issues. As I understand, the current guidance is that nails should be completely free from varnish, patterns / false nails. Does this mean I would need to ask her to stop having her nails coloured to ensure our compliance?

Answer:

This is one of my real bugbears – I think professionally manicured nails look so much better but the guidance is that nails should be short and uncoloured. However, it is guidance rather than legislation, so I think if you can argue the case then go ahead – that's my personal view.

Amelia Bray
BDPMA Chairman

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.

Nazia Hayat
Shared Services Officer
Customer Services – Correspondence Team
Care Quality Commission

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.

Nazia Hayat
Shared Services Officer
Customer Services – Correspondence Team
Care Quality Commission

Question:

I'm trying to get to the bottom of a possible scam, but am struggling to get anywhere! We were contacted by cold-call about a Music Licence by PRS. They said we required a music licence if we play the radio in reception and if any of our demo DVD's had background music on them (even if they're official licensed products?)

Answer:

PPL is a music entertainment service company licensing recorded music on behalf of over 3,500 record companies and 40,000 performers.

It was set up in 1934 by the record industry to grant licences for the broadcasting or playing of sound recordings such as CDs, tapes and records in public. Whenever recorded music is played in public, whether it’s on the radio, in a bar or club, a PPL licence is required.

When do I need a licence?

Under UK copyright law (the Copyright Designs and Patents Act 1988) a PPL licence is required when sound recordings subject to our control are played in public.  By ‘public’ we mean any event except a family or domestic gathering.  Many people ask, “If it’s my CD, why can’t I play it whenever and wherever I want?”  Owning a sound recording does not give you an automatic right to play it in public.

How much does a licence cost?

The cost of a PPL licence depends on how the music is being used.  For example in a dental surgery waiting room/reception area, the cost is a flat rate fee of £91.02 per annum excluding VAT.

Who should take out the licence?

PPL usually licenses the occupier of the premises if the sound recordings and the equipment are not rented.  If you hire a music system, juke box and/or sound recordings from PPL-licensed operators to provide background music, the operator or supplier should obtain the licence on your behalf.  If you are holding any other events such as discos, you yourself may also need an extra licence direct from PPL.  In some cases we can also license the organiser of an event.  All the people involved have an equal responsibility under copyright law to get a licence.  If anyone has any doubts about who should apply for it, they should contact us.

Do I require a licence to show broadcast TV in my pub?

With effect from 31 October 2003, UK copyright law was changed so that a PPL licence is technically required when sound recordings are played in public via a radio or TV broadcast.  However, due to the statutory process that PPL has to follow, PPL has not yet been able to update its Waiting Rooms/Reception Areas tariff (which is the tariff that applies to background music played in dentists' surgeries).  If a dentists' surgery is only playing recorded music via a radio or TV broadcast, it therefore does not currently need to apply for a PPL licence, but should be aware that it will require one in due course.

The advice on the DCMS website relates to premises that are licensed under the Licensing Act 2003. Under the Licensing Act a premises, normally a pub or restaurant etc requires an additional licence if they have what is known as regulated entertainment (Discos live music karaoke etc) but if they only have a television or radio or background music they do not need this additional licence. This is why the DCMS site says they do not need a licence but what they mean is a licence under the Licensing Act. Irrespective of whether they need a licence under the Licensing Act they may still need a licence from PRS and PPL.

Question:

We have been concerned about our large consumables bills over the last couple of years and do have concerns regarding staff dishonesty. We are a very large 2 sited practice with a monthly spend well over £11,000. I am interested to know if anyone has had similar issues, especially after discovering the dental products that are available on eBay!

Answer:

This may not help as we are a one-sited practice with only 3 dentists and a hygienist. What we do is have a stock list of everything that is located in our main storage cupboard. Each nurse has to mark off what they have taken and our head nurse does a weekly check on how much we need to order. When stock comes in we mark this on the stock cupboard list so we have an up-to-date record of what we have and when new stock arrives. In our practice meetings we mention when the stock list does not marry up with the stock left in the cupboard. We have a maximum amount of consumables that each surgery can stock at anyone time (1 sleeve of plastic cups, 3 boxes of tissues, 3 bundles of c-fold towels, 3 bundles of stack-a-pack tissues, etc.

We also can quickly check on the stock list to see what we are ordering and when discrepancies can arise due to clinicians holiday, sickness, etc. if none of these, the discrepancies are looked at more closely.

If we have any discrepancies we discuss this in the practice meeting so that staff are aware that:-

1. We are seeing what is going on

2. They are aware of what things cost (so please do not waste)

3. That we make sure all support staff are accurate at recording things

We also have periods where the nurse has to record what consumables and materials she brings into that surgery – normally do it for 1 month and all surgeries do it at the same time this allows us to see and double check how much each individual surgery uses.

We found that since we adopted the system we have more consistency in consumable stock ordering which obviously allows us to plan.We keep the more expensive items in a separate cupboard (composites, burs, etch, etc) but still use the same type of stock system.

We only allow the Heads Nurse/Practice Manager or Principal to order stock, normally the PM then one person has hold of the situation.

Answer:

I have stock cupboards and sheets for stocks we use on a regular basis this shows what we are ordering each month also order numbers etc for quick ordering.

Answer:

My stock room is locked, each surgery has a stock book that they write down what stock is required each week, they only get stock once a week,
this enables us to see what stock is being used comparing it to what is booked appointment wise. No one but my principal or me have access to the room.

Question:

How do you sterilise appliances when they come back from the lab? We understand this is not compulsory but it is recommended but can't find any guidance on what to use, etc.

Answer:

We use UOGUARD from dental directory. Soak for 10 mins and rinse really well.

Answer:

We use ‘Perform’ the same cold disinfectant we use prior to sending appliances to the lab.

Answer:

We use sterilox in our impression baths, one clean: work from lab, one dirty: imps from the patient.

Answer:

We put them in a 'clean' Perform bath and rinse or spray with the anti bug cleaning spray we use to clean surfaces with.

Answer:

We soak in sterilux same as before going to lab.

If they are not working as a Dental Nurse then there is no need to be registered with the GDC. However, they must not be given the title 'nurse' as this can only be used by dental nurses who are registered with the GDC and will cause confusion.  Probably something like "Scrub Room Operative" is politically-correct enough.

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