3 February 2014
In this section:
The Care Quality Commission (CQC) came into effect on 1 April 2009. It was established by the Health and Social Care Act 2008 to regulate the quality of health and social care and look after the interests of people detained under the Mental Health Act. It brings together the work of the Commission for Social Care Inspection, the Healthcare Commission, and the Mental Health Act Commission.
The Healthcare Commission ceased to exist on 1 April 2009 with the CQC taking over some of its functions. However although the Healthcare Commission was the second stage of the NHS complaints procedure this is not now a function of the CQC. This function is now carried out by the Parliamentary and Health Service Ombudsman.
All healthcare organisations that provide regulated activities will need to register with the CQC. For primary care dental services registration was required from 1 April 2011.
Regulated activities include:
- Treatment of diseases, disorder or injury
- Diagnostic and screen procedures
- Surgical procedures.
In order to register, providers need to declare compliance with the all of the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and CQC’s Essential Standards of Quality and Safety that support the Regulations. After 1 April 2011 it is illegal and therefore a criminal offence for any primary care dental service to carry out any regulated activities unless it is registered with the CQC.
If the CQC believes a service is not meeting the Essential Standards of Quality and Safety and the requirements of the law, it can set improvement actions or compliance actions, and/or take enforcement action as it feels appropriate. After registration, providers will be monitored by the CQC and must comply with any conditions of registration.
The CQC shares information with other organisations and in particular has a Memorandum of understanding between the CQC and the GDC and a Memorandum of understanding with the Parliamentary and Health Service Ombudsman (PHSO).
I’m applying for registration
Who needs to register?
Under the Health and Social Care Act 2008, providers of primary dental care that provide regulated activities must be registered with the Care Quality Commission (CQC) from 1 April 2011. There is no regulated activity specific to ‘dentistry'. Providers of dental care will need to consider their services against the full range of regulated activities (such as, ‘treatment of disease, disorder or injury', ‘surgical procedures', ‘diagnostic and screening procedures', etc). All primary dental care providers that provide regulated activities, whether NHS or private, must be registered from April 2011. This includes those primary dental care providers who do a mixture of both NHS and independent work. Members are advised to read the CQC's document The scope of registration that sets out which regulated activities will need to be included in your registration, Guide to the application process: Guidance for new providers and The Care Quality Commission (Registration) Regulations 2009
It is the service ‘provider’ who must register. A provider may be:
- an individual
- a partnership
- an organisation.
Find the application form here
The process looks like this:
What you can be doing now to prepare for registration
To prepare for registration, providers of primary dental care can:
1) Review the key CQC guidance documents:
2) You will need to apply for a Disclosure and Barring Service (DBS) check. As part of your application, you will need to enclose a DBS (formerly CRB) disclosure number with your forms. Therefore, in order to complete the process as quickly as possible, obtaining a DBS check should be the first action you take. You will need to have obtained DBS disclosures for the providers of the service (where these are named partners or an individual) and the registered manager. Find out how to apply for a DBS check
3) You will need a Statement of Purpose. The information required is set out in the regulations but, in summary, statements of purpose must include the: provider’s aims and objectives; services provided; needs the service meets; service’s contact details; service’s legal status; locations where services are provided or provided from; ‘address(es) for service of documents’ for providers and any registered managers. The Statement of purpose guidance is here along with a template for providers
4) Check your own internal reporting and audit systems
5) Consider what evidence you already hold and what you need to create
6) Consider evidence on outcomes
Click here for CQC guidance on common errors in applying for registration
How is an application for registration assessed?
The CQC will assess each registration application using a judgement framework which has been developed to help it make decisions and reach judgements about the registration status of providers. The framework aims to improve consistency in the decisions and judgements made about a provider's registration, and should provide a transparent method that can be used to check the CQC's judgements.
It focuses on the 16 regulations and associated outcomes that most directly relate to the quality and safety of care.
The framework is split into four stages:
Stage 1: Determining whether there is enough evidence to make a judgement
Stage 2: Checking whether or not the evidence demonstrates compliance, or whether there are concerns about the provider's compliance with the regulations
Stage 3: If concerns are found, making a judgement about the impact on people using services and the likelihood of the impact occurring
Stage 4: Validating the judgement.
CQC state that a new application should take eight weeks to process. If CQC agrees to your registration, CQC will send you a Notice of Decision to confirm this.
If CQC decide not to register you in the way that you applied, or does not think it should register you, CQC will send you a Notice of Proposal to explain why.
Making a representation or appealing against CQC’s decision
If you do not agree with CQC’s proposal (including any conditions CQC apply), you have 28 calendar days in which to make representations to CQC. If you do not agree with CQC’s decision about how to register you, you have the right to appeal to the first-tier tribunal.
You can find out more in the guidance below or download the form you will need to make a representation:
ALERT! Fixed penalty notice - registered managers
Dental Protection is aware that CQC has issued a number of fixed penalty notices for £4,000 relating to the failure to comply with a 'Registered Manager' condition. Providers may find it helpful to review their own situation to ensure that they have a Registered Manager should this be required.