Dentist Health Scare: Shocking but rare
The news that 22,000 people, patients of a Nottinghamshire dentist, are being contacted and offered testing to check for blood-borne diseases is truly shocking.
Every patient treated by Mr Desmond D’Mello over the last 3 decades is being urged to contact NHS England for testing as a result of concerns about the standard of clinical care at his Nottingham surgery, primarily in relation to infection control procedures.
It is reported that NHS England were contacted by a whistle-blower in June 2014 and as a result Mr D’Mello has been suspended. Covert filming apparently shows, among other things, a failure to properly sanitise equipment and the re-use of dirty gloves.
NHS England has assessed the risk of infection as low but the concern which his patients will be experiencing is fully understandable.
Dentists are subject to regulations which cover all aspects of clinical practice, including cleanliness and infection control. It is the responsibility of the Care Quality Commission (CQC) to inspect dentists such as Mr D’Mello and ensure that fundamental standards are being met.
According to the CQC, an inspection of his practice last year gave rise to no cause for concern. However, in light of the information received by NHS England, re-inspection identified failings in standards on cleanliness and infection control, in relation to the safety and suitability of equipment and monitoring of the quality of service.
No doubt questions will be asked in due course as to whether these failings could or should have been identified sooner. It is however worth placing this undoubtedly troubling case into context.
Earlier this year, I made a Freedom of Information Act request to the CQC in order to determine the level of enforcement action undertaken by the CQC in the dental sector. The response clearly demonstrated that the over whelming majority of dental practices are compliant with the regulations and the breaches which have come to light in this case are very much the exception to the rule.
As at April 2014 there were over 10,000 locations where dental services were provided. The CQC undertook 5720 inspections. This resulted in 34 warning notices being issued, which identified breaches of regulations and stipulated a time period for the provider to take the necessary steps to remedy the breach.
Whilst it is the case that the most common breach related to cleanliness and infection control, this amounted to 8 instances only (down from 20 the previous year) with a failure to assess and monitor the quality of service provision accounting for a further 7 notices.
In every case where a warning notice was issued the provider responded appropriately and addressed the breaches to ensure future compliance. As a consequence, the CQC took no further action.
The CQC have recently published their plan for how primary care dental services are to be regulated and inspected in the future.
One of their priorities is to develop an approach to inspection that protects the public from unsafe care. Whilst such an approach is to be welcomed, hopefully this troubling case will not detract from the fact that the majority of dental services are safe and that the quality of care is good.
For further information about any aspect of regulation concerning primary care dental services please contact Mark Quigley head of our Regulatory Department on 0191 226 4899 or firstname.lastname@example.org