12 Oct 2018
By rick.craven

The CQC have now published their annual assessment of Health and Social Care in England within a report titled "The State of Healthcare and Adult Social Care in England".

This report has been based on CQC reports and findings over the period of 2017/18 throughout the healthcare sector.

What does the report share?

The state of healthcare and adult social care in England looks at trends, shares examples of good and outstanding care, and highlights where improvements are needed.

Within the report, it is stated that the CQC inspect 10% of primary dental care practices each year and between 2017/18, 1,336 practices within England were inspected.

What has the report highlighted within the primary care dental service sector? 

Following inspections, 90% of practices were meeting all of the regulations which means practices are: 

  • Safe
  • Effective
  • Caring
  • Well lead

Overall outcome for key questions asked

The outcomes of key questions asked resulted in:

  • 90% required no action
  • 9% required action
  • 1% required enforcement action

Of 1,336 inspected, enforcement action was taken against 17 practices.

The main triggers of enforcement action were from the below:

  • Poor leadership
  • Unwillingness or ability to take action
  • Failure to act when things had gone wrong

Importance of good leadership

The CQC stated "As with all services we find that leadership plays a key part in the quality of care, some inspection staff perceived that having an empowered practice manager who is not necessarily a clinician can be an advantage to a well-run practice, as they have more experience of management, rather than concentrating purely on clinical practice".

Inspection outcome by region

Reinspection report  

"Of the practices where enforcement action on the first inspection 80% had improved and no other action was needed.

Of the practices where requirement action on the first inspection 92% had improved and no further action was needed."


Why were these inspections triggered?

CQC stated "We published the results of 27 reinspections of practices whose first inspection resulted in no action. These reinspections will mostly have been triggered by concerns that inspectors received. The majority (21 practices) remained without actions on reinspection, but four practices had requirement actions applied on reinspection, and two had enforcement applied".

Patients Access to NHS Treatment

Within the report, the CQC stated that in the changing landscape of primary care, NHS dental practices are not fully involved in the developing models of integrated care. 

Within the dental sector itself, there is consolidation as the size and number of corporate providers grows. Because dental practices are also able to choose how they balance NHS and private provision of treatment, this may affect people’s access to NHS services in a local area.

In a recent 2018 GP patient survey this highlighted that patients requiring an appointment within a 2-year period 97% were successful in obtaining an appointment if they had visited the practice before, however, if they had not visited the practice previously only 77% were successful.

Younger adults and people in a minority ethnic groups also reported a lower success rate in obtaining appointments.

Oral Health in Children

Improvements had steadily increased over a number of years within 2007/2008, the average number of decayed, missing, or filled teeth in five year olds was 1.11 and by 2016/2017 it had reduced by 0.8.

There is a wide variation at regional and local authority level in both severity and prevalence of dental decay.

In a recent Public Health England’s Oral Health survey, it found that this appears to be linked with levels of deprivation within children.

Areas within England showed significant differences of % of decayed, missing, or filled teeth with 0.1 in Waverley, Surrey, compared with 2.3 in Pendle in Lancashire.

The survey also found that other factors such as ethnicity, exposure to water fluoridation, and geographic location are also independently associated with levels of dental decay in children.

Oral Health in Care Homes

Dentists have raised concerns with the CQC that there may be issues about the oral health of people in residential care homes. The CQC have advised they intend to carry out a review of this and expect to be able to report on this next year. 

Full report: The State of Healthcare and Adult Social Care in England 2017/2018 click here > 

All quotations and stats are taken from "The State of Healthcare and Adult Social Care in England" report.

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