►
Description
Hear from Dr Rosie Benneyworth, Chief Inspector of Primary Medical Services and Integrated Care and John Milne, Senior National Dental Advisor at CQC as they discuss our transitional regulatory approach and the latest on our emerging strategy for 2021 and what this means for those working in dental services.
A
So
if
I
could
go
to
the
next
slightly
steph
just.
Firstly,
we
have
a
little
team
of
people
behind
the
scenes.
Here
we
will
try
and
make
sure
everything
goes
as
smoothly
as
possible,
we're
all
managing
reasonably
well
with
the
technology
and
we're
used
to
teams,
but
clearly
sometimes
there's
some
technical
hitches
that
we've
got
so
bear
with
us.
A
We've
also
got
some
of
our
dental
team
here,
janet
williams
and
our
deputy
chief
inspector
of
primary
medical
services
and
sam
banger
who's
our
head
of
inspection,
and
they
will
be
answering
some
of
your
questions
as
well.
In
the
chat
as
we
go
through
so
just
on
to
the
next
slide,
our
main
purpose
today
is
to
talk
about
our
transitional
approach
and
also
our
future
strategy,
and
we
want
this
to
be
a
productive
session
that
you
find
useful.
A
So
we
will
do
our
best
to
stick
to
time
and
we
also
want
to
hear
from
you
as
much
as
possible.
So
although
this
is
set
up,
so
you
can't
directly
speak,
we
can
answer
questions,
and
so
please,
during
the
time
we're
talking
put
all
of
your
questions
in
the
chat
function
that's
available
and
we
will
endeavor
to
answer
as
many
as
possible
that
we
can.
A
A
So
the
next
slide,
please
steph
just
wanted
to
iterate
that
our
role
and
purpose
has
not
changed.
We
are
the
independent
regulator
of
all
health
and
adult
social
care
services
in
england,
and
we
absolutely
make
sure
that
health
and
social
care
services
provide
people
with
safe,
effective,
compassionate
high
quality
care.
A
I
think
regulation
has
been
played
a
role
in
making
sure
that
services
continue
to
deliver
high
quality
care
for
people
who
use
them
so
going
on
to
the
next
slide.
We
know
that
an
awful
lot
is
changing
it
pre-covered.
There
is
massive
changes
across
the
health
and
care
landscape,
new
models
of
care,
integrated
care
and
primary
care
networks
being
developed
and
technology
being
used
in
many
different
ways,
and
we've
seen
over
the
last
few
months
with
covered
how
that
has
really
accelerated
even
further,
and
that
has
really
solidified
for
us.
A
The
importance
in
the
fact
that
we
need
to
change
as
well
if
we're
going
to
continue
to
deliver
our
purpose
and
enable
improvement
across
the
system
enable
new
models
of
care,
new
innovations
to
happen.
We
need
to
enable
we
need
to
change
to
do
that.
We
don't
want
to
be
a
barrier
to
innovations.
We
absolutely
want
to
encourage
them
and
we
want
to
encourage
that
improvement.
A
We
want
the
way
we
regulate
to
be
simple,
based
on
strong,
open
relationships
with
providers
and
to
be
more
effective.
We
want
to
focus
our
actions
on
areas
that
can
have
the
biggest
impact
on
people's
experiences
of
care.
We
want
to
add
as
much
value
as
a
regulator
as
possible,
so
if
we
could
move
on
to
the
next
slide
and
just
so
people
are
aware,
we
started
our
transformation
of
the
cqc.
So
much
of
our
thinking
started
back
in
the
summer
of
last
year.
A
A
B
So
during
the
months
from
april
to
september,
as
many
of
you
know,
we
developed
our
emergency
support
framework
and
that
was
a
telephone
call
which
lasted
roughly
an
hour.
It
was
intended
to
be
supportive
in
nature.
We
were
inquiring,
how
practices
were
getting
on
we're,
asking
what
changes
practices
were,
making
to
keep
people
safe
and
to
keep
their
staff
safe.
B
B
We
talked
with
over
400
dental
practices
and
by
and
large,
the
the
feedback
we've
received
from
those
emergency
support
framework
calls
has
been
very
positive,
and
so
we've
taken
that
positivity
as
as
part
of
the
process
in
moving
to
our
transitional
methodology,
which
we're
which
we're
beginning
from
now.
So
if
we
could
change
the
slide
again,
please.
B
So
our
transitional
regulation
approach
is
bringing
together.
Elements
of
our
existing
methodology
are
learning
from
how
people
have
got
on
with
the
covid
response,
and
our
overarching
aim
is
to
continually
monitor
how
services
can
be
keep
people
safe
and
respond
to
changes
with
a
light.
Regulatory
action.
B
We're
also
exploring
our
emerging
strategic
themes
and
part
of
that
is
discussing
how
we
will
operate
in
terms
of
our
future
strategy
with
cqc,
and
some
of
you
may
already
have
seen.
There's
a
draft
strategy
document
from
cqc
out
there
and
during
this
regula
during
this
transitional
phase
that
we're
in
at
the
moment
we're
absolutely
interested
to
hear
what
you've
got
to
say.
So
could
you
change
the
slide
again?
Please.
B
B
Looking
at
areas
such
as
infection,
prevention
and
control,
of
course,
we're
all
aware
that
the
coronavirus
is
still
lurking
within
our
population
and
there
will
be
people
attending
our
services
who
may
be
carrying
the
infection
and
don't
actually
know
it.
So
it's
really
important
that
we
build
and
maintain
our
strong
relationships
with
providers
and
the
way
that
we're
going
to
do
that
is
through
the
regular
calls
from
the
transitional
monitoring
process.
Could
we
change
the
slide
again?
Please.
B
Other
things
have
been
how
well
sectors
such
as
the
care
home
have
been
able
to
access
urgent
dental
care
when
they've
needed
it,
and
also
the
effect
on
our
hospital
referrals
and
the
like,
and
so
we'll
we'll
be
continuing
that
provider.
Collaboration
work
we'll
be
looking
at
urgent
and
emergency
services
in
the
next
few
weeks,
and
also
following
on
from
that
we'll
be
looking
at
cancer
services,
including
how
oral
cancer
is
is
dealt
with
with
dental
services.
B
So
using
our
transitional
methodology,
we'll
be
looking
at
about
1500
practices,
there'll
be
a
call
of
some
sort
which
will
last
between
one
and
one
and
a
half
hours.
That's
the
basis
of
our
approach,
and
also
clear
in
our
understanding,
is
how
those
1500
practices
are
prioritized
and
so
we'll
be
using
information
that
we've
got
already
we'll
also
be
taking
account
of
information,
that's
given
to
us
by
other
services,
but
what
probably
one
of
the
largest
elements
as
to
which
practices
get.
B
The
other
thing
that
we'll
be
doing
at
the
moment
is
trying
to
understand
about
people's
experiences
of
care,
and
we've
been
getting
information
at
the
moment
from
healthwatch
that
people
are
having
difficulty
in
getting
access
to
dental
care,
so
we'll
be
interested
in
hearing
people's
experience,
we'll
be
talking
with
healthwatch
about
that,
and
probably
in
in
in
the
next
few
weeks,
with
the
calls
that
we'll
be
making
to
practices,
we
will
be
asking
the
practices
we
contact.
What's
access
like
for
their
patients,
are
they,
but
are
they
able
to
deliver
urgent
care
where
it's
needed?
B
We
have
been
receiving
a
lot
of
whistleblowing
in
cqc
from
dental
practices,
where
concerns
have
been
raised
about
how
practices
are
able
to
keep
up
with
the
keep
up
with
the
guidance
and
protocols
for
infection,
prevention
and
control
and
stuff
like
that,
so
we're
keeping
our
ears
open.
Can
you
change
the
slide
please
before
we
before
we
go
on
to
the
questions
from
you?
The
monitoring
questions
for
dental
providers
are
on
our
website.
B
They
follow
the
five
key
questions
and
the
key
lines
of
inquiry,
and
also
one
of
the
things
that
we
will
be
doing
is
exploring
the
use
of
technology
on
our
calls.
So
when,
when
the
inspector
calls
you
to
say
to
fix
an
appointment
for
one
of
these
transitional
course,
they
might
ask
you
whether
you
you
want
to
participate
using
teams
or
zoom,
or
things
like
that,
so
that
you
can
have
a
face-to-face
conversation
which
is
a
little
bit
more,
perhaps
a
bit
more
meaningful.
C
Thanks
john,
yes,
we've
got
a
got
a
few
questions
coming
in,
so
thanks
for
everyone
for
submitting
those
and
please
do
carry
on
dropping
them
into
the
chat.
So
one
of
the
questions
we've
got
john
is
is
asking
a
bit
more
about
the
the
chloe's
we're
using
at
the
moment
during
our
transitional
period.
Could
we
say
a
bit
more
about
what
we're
focusing
on
and
why
we've
picked
those
okay.
B
The
we're
focusing
particularly
on
on
safety
and
as
part
of
safety
will
be
ful
will
be
taking
a
keen
interest
in
infection
prevention
and
control.
As
I
said
a
few
moments
ago,
that's
been
the
area
where
we've
had
concerns
raised
with
us,
both
by
a
small
number
of
patients,
but
also
by
members
of
the
dental
team,
who
are
not
at
all
comfortable
about
some
of
the
circumstances
in
which
they're
working,
often
that
comes
from
perhaps
not
having
having
seen
or
understood
the
most
relevant
guidance.
B
That's
out
there
and
practices
need
to
know
that
public
health
england
have
just
recently
issued
an
appendix
specifically
for
dentistry
on
infection
prevention
and
control
during
the
pandemic.
So,
in
our
questions,
we'll
be
we'll
be
focusing
on
the
five
key
questions
whether
cares
safe,
safe,
effective
caring,
responsive
and
well
led.
I
imagine
that
the
the
questions
we
will
be
asking
more
of
will
be
to
do
with
safety
mostly
to
do
with
cross
infection.
B
Prevention
and
control
of
I'd
said
also
we'll
be
measuring
on
leadership
in
terms
of
how
we'll
organize
the
practices,
how
well
able
people
who
are
working
in
practices,
how
they
understand?
What's
expected
of
them
in
these
in
these
difficult
times,
and
things
happen
all
the
time,
don't
they
just
within
the
just
within
the
practice?
Where
I
work
we
were
asked,
we
were
asked
today
about
a
patient
who
saw
us
yesterday
and
has
come
up
with
a
positive,
a
positive
test.
B
Today,
there's
lots
of
information
around
about
what
to
do
in
that
circumstance,
but
thinking
you
know
it
and
then
putting
it
into
practice
is
a
difficult
thing.
So
we've
had
to
you
know
we
had
to
take
a
look
quickly
at
what
public
health
england
that
we're
advising
so
that
we
could
take
the
correct
action.
C
B
Okay,
I'm
not
absolutely
sure
on
the
number
of
days
or
weeks
the
notice
will
be,
but
I
know
what
will
happen
is
that
an
inspector
will
call
the
practice
and
we'll
discuss
with
you
in
the
practice.
What
the
most
appropriate
and
convenient
time
is
we're
not
in
the
place
where
we
had
two
weeks
notice,
as
we
had
had
with
the
face-to-face
inspections,
I'm
hoping
that
somewhere
in
the
chat.
One
of
my
colleagues
is
going
to
give
a
more
definitive
answer.
But
as
far
as
I'm
aware,
what
we're
expecting
to
do
is
he'll.
B
Have
a
conversation.
It'll
be
a
mutually
convenient
time
with
our
inspector
and
you
in
the
practice,
and
also
you'll
have
the
opportunity
to
decide
who
within
the
practice
is
going
to
come
on
that
call.
It
may
be,
it
may
be
the
registered
manager
and
it
may
be
there'll,
be
one
or
two
other
staff
members
that
you
want
to
participate
in.
That
call
at
the
appropriate
time.
A
C
Thanks
both
just
building
on
what
you
were
talking
about
earlier,
john
about
providers
working
together
in
a
system,
we've
got
a
question
about
dental
services,
interacting
with
adult
social
care
services
and
just
asking.
If
we've
got
any
plans
to
encourage
dental
support
to
still
be
available
to
adult
social
care
and
and
to
talk
a
bit
about
the
work
we
do
in
that.
B
Okay,
thank
you.
Well,
as
many
of
you
know,
last
year
we
produced
a
report
called
smiling
matters,
and
that
was
to
do
with
oral
health
in
the
care
home.
Setting.
Many
of
us
in
the
dental
profession
are
aware
that
when
people
enter
residential
care,
often
the
oral
health
can
deteriorate
for
for
all
sorts
of
reasons,
and
so
what
we
did
from
cqc
was
we.
B
We
said
that
from
our
side
in
terms
of
the
regulation
of
adult
social
care,
we
would
begin
asking
questions
within
the
care
home
environment
when
we
do
our
inspections
there.
What
providers
do
to
look
after
the
oral
health
of
people
that
they
look
after
and
and
in
itself,
that
was
quite
a
catalyst
for
change,
and
so
the
care
home
sector
has
been
has
been
seeking
training
opportunities
for
their
staff
and
also
trying
to
build
relationships
with
dental
practices.
B
But
we
don't
want
to
forget
the
good
work
that's
gone
on,
and
what
we're
aware
of
is
that
public
health,
england
are
producing
a
whole
suite
of
training
materials
for
care
homes
and
for
dental
staff.
We're
expecting
that
to
be
published
in
the
next
few
weeks,
and
we're
quite
excited
about
that,
because
it
looks,
looks
really
good
equally
well.
B
We
understand
that,
under
the
guise
of
flexible
commissioning
nhs,
england
is
starting
to
think
about
whether
dental
practices
can
interact
in
a
more
meaningful
way
with
some
of
the
care
homes
on
their
patch.
We
think
it's
a
really
important
area
at
cqc,
we'll
be
we'll
be
following
it
up
over
over
the
next
year,
because
we
recognize
it's
important
that
oral
care
is
good
for
people
in
residential
care.
It
can
affect
the
quality
of
life,
it
can
affect
their
comfort
and
it
can
affect
their
dignity.
B
B
Okay,
that's
a
that's
a
really
interesting
question
and
I
think
if,
if,
if,
if
it
were
to
be
helpful,
we
would
be
happy
about
that
about
that
taking
place.
I
think
that
depends
on
the
discussion
between
the
inspector
on
the
day
and
you
in
the
practice.
It's
not
an
expectation
of
ours
that
people
will
be
necessarily
sharing
their
screens
and
sharing
patient
records
in
that
way.
But
if
it's
helpful,
we
we
we're
open
to
that
suggestion
and
certainly
going
forward
to
the
any
changes
in
methodology
from
from.
B
I
think
it's
around
about
may
next
year
we're
having
lots
of
consultation
with
dental
practices
at
the
moment,
and
one
of
the
questions
that
we're
asking
of
the
dental
profession
is
how
how
the
dental
profession
feels
about
whether
screen
sharing
examining
patient
records
in
this
sort
of
way
will
help
us
understand
how
effective
the
care
is.
That's
been
given
to
the
public.
So
for
us
at
the
moment,
it's
an
open
question.
B
Yeah
and
the
early,
the
early
feedback
we've
had
from
the
discussions
we've
had
with
several
groups
around
dentistry
at
the
moment,
have
been
positive.
I
think
what
what
people
have
been
saying
to
us
is
that
this.
This
will
enable
us
to
reduce
the
time
that
we
spend
in
practice.
If
we're
on
a
visit
and
provided
it's
done
safely
and
carefully
as
rosie's
just
been
saying,
it's
an
interesting
possibility
going
forwards.
B
Sometimes
something
might
be
out
to
be.
You
might
be
able
to
show
us
something
on
the
call
if
it
was
a
zoom
call
or
a
team
school,
but
that's
the
way.
That's
the
way
that
we're
thinking,
but
in
general
this
is
a
com.
This
is
most
likely
to
be
a
conversation
similar
to
the
esf,
calls
were
and
any
evidence
that's
needed.
One
way
or
another
needs
to
be
discussed
with
the
inspector.
C
It's
pretty
pretty
close,
john.
Yes,
thank
you
just
conscious
the
time
I
think.
Maybe
if
we,
if
we
take
one
more
question
now
and
then
we
can
pick
up
the
other
questions
in
the
second
q
a
session,
but
we've
got,
we've
got
one
here,
that's
asking
about
our
view
on
patient
access
to
dental
services
during
cobied
and
whether
this
is
something
we're
looking
at
and
we
have
any
information
about.
C
B
When
practices
eventually
opened
from
from
the
8th
of
june
onwards,
the
need
to
put
fairly
stringent
infection
prevention
control
measures
in
place
and
also
to
the
term
fallow
time
was
being
used
for
where
aerosol
generating
procedures
were
being
carried
out.
You
needed
to
let
the
surgery
rest
for
a
while
to
let
any
any
virus
particles
settle
and
then
for
the
surgery
to
be
thoroughly
cleaned.
B
Colleagues,
we're
thinking
about
that
access,
we're
going
to
discuss
those
issues
with
with
health
ministers
and
we're
going
to
think
we're
going
to
think
carefully
about
what
might
need
to
change
in
the
future
to
enable
the
public
to
get
access
to
the
care
that
they
need
access
hasn't
just
fallen
in
nhs
practice.
It's
fallen
in
private
practice
as
well,
and
so
it's
an
area
of
considerable
interest
to
us
and,
of
course
it's
it's
of
interest
to
the
population.
C
A
A
We
are
developing
our
future
strategy
and,
as
we
said
earlier,
this
is
looking
to
be
published
in
may
of
next
year
and
there's
going
to
be
four
key
themes
that
I
just
want
to
briefly
touch
on
this
afternoon.
So
one
is
around
people,
one
is
about
smarter
regulation.
One
is
about
safety
and
one
is
about
our
role
in
improvement,
and
I
think
what
fundamentally
underlies
our
new
strategy
is
the
fact
that
we
want
to
change
people's
lives
for
the
better
and
use
our
influence
and
our
regulation
to
be
able
to
do
that.
A
So,
if
we
could
go
on
to
the
next
slide,
please
steph.
So
in
terms
of
our
people
aspect,
we
feel
that
we
ought
to
regulate
through
the
eyes
of
people
who
use
services.
We
want
to
very
much
hear
from
people
who
use
services
get
feedback
on
the
great
care
they
receive
on
the
care.
That's
not
so
good
and
use
that
to
help
us
understand
what's
happening
within
services
and
also
families,
carers
of
people
who
use
services
as
well.
A
We
also
need
to
make
sure
that
we
have
the
tools
and
the
feedback
that
enables
us
to
truly
put
people
at
the
center
of
what
we
do
and
to
be
able
to
feed
back
to
them
once
we've
actually
done
something
with
the
information
that
they
tell
us.
So
that's
a
really
key
theme
of
our
future
strategy
that
we
want
to
get
people's
views
on
we're
very
worried.
At
the
moment,
we've
always
been
worried
about
inequalities.
A
I
think
we're
particularly
concerned
about
inequalities
and
widening
inequalities
at
the
moment
with
what's
happening
with
the
pandemic,
we
want
to
strengthen
our
work,
to
reduce
inequalities
and
do
everything
that
we
possibly
can
as
a
regulator
to
to
address
some
of
those
inequalities
in
the
health
and
care
system.
So
that's
going
to
be
a
key
focus
of
what
we
do
and
we
want
to
also
look
at
how
people's
experience
of
care,
how
how
that
happens
as
they
use
different
services
and
move
between
those
services.
A
So
if
we
could
move
to
the
next
slide,
which
is
about
smarter
regulation,
so
we've
heard
over
the
years
and
that
there's
been
concerns
about
consistency
in
our
ratings
and
that
our
current
approach
can
sometimes
mean
that
the
overall
rating
of
a
service
can
mask
concerns
in
individual
areas.
We've
heard
from
our
stakeholders
that
there's
strong
support
for
the
continued
use
of
inspection
in
our
regulatory
work,
but
with
a
clear
message
that
this
should
be
more
targeted.
A
So
we
are
developing
plans
to
look
at
how
we
evolve
our
ratings
program
across
all
of
the
sectors
to
make
sure
it's
up
to
date
meaningful
and
it
focus
most
most
on
what
matters
to
patients,
and
we
also
are
trying
to
detect
transitional
regulatory
approach.
That
john
has
just
talked
to
about
is
is
one
way
of
testing
a
much
more
targeted
approach,
specifically
in
dental
we're
intending
to
collect
and
share
information
digitally
where
possible.
A
We
want
to
reduce
the
time
on
site,
looking
at
policies
and
hope
to
do
this
more
remotely
during
the
pandemic.
We
will
remain
flexible
in
how
we
operate
to
minimize
any
impact
that
we
have
on
inspection
on
providers.
Whilst
we
continue
to
gain
assurance
of
services
that
they
are
being
provided
safely.
A
So
if
we
could
go
on
to
the
next
slide,
which
is
about
safety-
and
I
I
was
shocked
last
year
at
a
patient
safety
event,
although
probably
not
hugely
surprised-
that
unable
that
avoidable
harm
in
health
and
care
is
actually
one
of
the
top
10
killers
in
the
world.
Still
in
2020,
we've
still
got
massive
work
to
do
in
this
area
and
we
are
making
some
steps,
but
not
quickly
enough
in
in
our
mind,
in
terms
of
minimizing
avoidable
harm.
A
We
know
that
having
a
really
good
culture
and
an
organization
can
help
with
that.
So
how
are
people
able
to
speak
up
about
their
concerns?
How
do
they
talk
about
things
that
haven't
gone
well?
How
do
they
learn
from
those
things
that
haven't
gone
well
and
how
do
they
then
put
steps
in
place?
So
those
things
don't
happen
again
and
those
are
really
really
important
for
us.
A
And,
finally,
I
just
wanted
to
talk
about
improvement
and
look
at.
How
do
we
make
sure
if
we
could
go
on
to
the
next
slide?
Please
steph?
How
do
we
make
sure
that
people
get
a
consistent
improvement
offer
and
that
we
enable
all
all
parts
of
every
sector
to
improve
those
that
are
really
good
to
enable
them
to
continue
to
improve
and
drive
that
improvement
culture
that
that
continues
to
to
stretch
and
innovate
and
develop
services?
A
For
their
patients,
but
also
how
do
we
make
sure
that
those
providers
that
are
struggling
that
are
not
not
finding
it
more
difficult
that
are
starting
to
wobble
or
starting
to
deteriorate,
and
we
know
that
that
can
happen
very
quickly
for
a
whole
variety
of
reasons.
How
do
we
make
sure
that
they
can
get
quick
access
to
help
and
support,
and
that's
something
that
we're
exploring
and
we're
looking
at,
how
we
can
develop
an
improvement
alliance
with
partner
organizations
and
look
at
how
we
can
then
directly
link
our
improvement
offer
to
this?
A
We're
really
keen
that
we
take
a
much
more
active
leadership
role
in
driving
improvement.
I
think
the
smiling
matters
work
that
john
referenced
earlier
was
a
great
example
of
how,
if
we
work
collaboratively
with
all
of
our
partners,
we
can
really
drive
improvement
right
across
the
sectors
and
how
we
can
how
we
can
change
things,
and
particularly
those
areas
that
have
been
neglected
or
not
talked
about.
How
do
we
really
shine
a
light
on
those
to
really
make
sure
that
things
move
forward
so
just
in
terms
of
the
next
slide?
A
This
webinar
is
part
of
that
process
and
our
intention
is
to
seek
and
hear
your
views
and
options
to
inform
the
more
formal
consultation
that
will
happen
in
the
new
year.
We
know
this
isn't
all
going
to
happen
overnight
and
we're
very
open
to
a
possibility
of
modifying
our
methodology.
So
please,
please
do
stay
in
touch
with
us
and
we'll
tell
you
how,
at
the
end
of
this,
at
the
end
of
this
webinar
and
finally,
just
just
moving
on
to
the
future.
A
C
Thanks
rosie,
so
we've
got
it.
We've
got
a
few
questions
about
fallow
time
in
the
chat,
so
one
about
what
we'll
be
looking
for
in
practice
is
what
we'd
expect
to
see
and
how
we'll
be
assessing
what
whether
what
practice
is
doing
is
appropriate
and
then
a
second
question
about
whether
we'd
expect
to
see
ventilation
systems
within
practices.
A
B
I
was
thinking
of
passing
that
one
on
to
rosie
no
only
teasing
yeah
fallow
time
it.
It
plays
a
huge
part
in
how
quickly
practices
are
able
to
return
to
something
even
approaching
normality,
and
we
do
understand
the
difficulties
that
have
been
there.
But
there's
been
a
lot
of
work
been
done
by
the
scottish
dental
clinical
effectiveness
programme
and
their
work
was
published
about
two
to
three
weeks
ago.
B
The
faculty
of
general
dental
practice
has
produced
some
guidance,
and
only
this
week,
public
health
england
produced
their
guidance
about
infection
prevention
control,
including
including
issues
around
fallow
time.
So
what
are
we
expecting
from
the
cqc?
I
think
the
first
thing
that
we're
expecting
is
that
we're
expecting
practices
to
think
about
the
issue
carefully.
B
The
way
that
I
phrased,
it
is,
if
you're,
the
next,
if
you're,
the
next
patient
in
the
room
following
on
from
a
patient
who
was
infectious,
but
you
didn't
know
it.
How
would
you
feel
if
you
were
that
patient
coming
into
the
room?
Think
about
that
in
terms
of
how
you,
how
you
develop
your
mechanisms
for
keeping
keeping
patients
safe?
So
the
guidance
that's
just
been
produced
talks
about
if
you've
got
various
things
in
play,
such
as
good
ventilation,
that
the
fallow
time
can
be
reduced
to
15
minutes
or
so
following.
B
If
you've
got,
I
think
six
to
ten
air
changes
per
hour,
so
we'd
expect
practices
to
be
thinking
about
the
air
changes
per
hour
in
their
surgery.
You
may
need
to
get
some
professional
advice
on
that
issue
and
I
think
what
we
would
be
expecting
is
you
to
have
thought
it
carefully
thought
through
it
carefully
taking
advice
and
moving
on
to
the
issue
about
ventilation.
B
It's
clear
from
the
guidance
that's
been
produced
that
there's
been
a
hierarchy
of
of
protections
and
good
ventilation
seems
to
be
to
the
forefront
in
in
diluting
the
number
of
viable
virus
particles.
Is
the
perhaps
the
best
way
that
I
can
describe
it
so
if
you've
got
good
ventilation,
it
quickly
dilutes
those
particles
that
might
be
in
the
air
and
reduce
the
risk
of
people
in
in
coming
into
the
surgery?
Next
inhaling
them.
B
We
do
recognize
that
it's
going
to
take
some
time
for
practices
to
install
ventilation
equipment
if
they
need
to
do
it.
Do
it
carefully
take
professional
advice.
The
british
dental
industry
association
will
be
able
to
help
you
and
there
are
all
sorts
of
regulations
around
building
and
electricians
and
the
like,
which
will
also
help
you
to
get
this
process,
get
this
process
right.
I
think
my
my
best
advice
would
be
until
you're
certain
about
your
ventilation
or
any
other
measures.
You're
taking
to
reduce
risk
then
follow
the
follow.
B
I'll
take
off
and
then,
and
then
rosie
can
can
come
in
if
she
needs
to
the
dental
services
are
one
of
the
almost
the
only
service
ins
that
cqc
regulates
that
isn't
rated.
I
was
around
when
the
original
discussions
were
being
held
about
ratings
and
the
ratings
was
to
do
with
also
to
do
with
the
frequency
that
we
inspected
dental
practices
and
in
an
environment
where
currently,
we've
been
inspecting
only
10
percent
of
practices
per
year.
B
We're
also
asking
the
question
whether
there
might
be
a
benefit
of
rating
for
providers
in
terms
of
how
it
helps
them
work
through
an
improvement
process.
If
things
are,
if
things
are
not
so
good
or
equally
well,
if
they're
really
good,
a
rating
system
gives
credit
to
those
practices
which
which
is
useful
for
them,
as
well
as
giving
huge
confidence
to
the
patients
who
attend
those
services.
B
So
where
we
are
with
ratings
is
at
the
moment
we're
asking
the
question
we
haven't
made
our
mind
up
one
way
or
the
other
whether
to
introduce
ratings
in
dentistry,
there's
been
a
fair
amount
on
the
social
media
in
the
last
week
or
two
since
we've
opened
this
question
up
for
people's
opinions,
opinions
are
every
bit
as
varied
now
as
they
were
five
or
six
years
ago,
when
we
first
started
discussing
the
ratings
program,
so
we
haven't
made
our
mind
up
and
we
are
listening
rosie.
Do
you
want
to
comment.
A
Yes,
thank
you,
john
and
and
completely
agree.
This
is
something
that
is
work
in
progress.
We
want
to
hear
people's
views.
I
think
we
know
from
the
public
with
our
other
sectors
that
we
regulate,
that
they
do
find
value
in
the
ratings,
in
helping
them
choose
providers
and
helping
understand
the
quality
of
the
care,
and
I
think
one
of
the
considerations
that
we
need
to
think
about
is
when
we've
got
more
complex
providers
who
are
offering
a
multiple
of
different
services.
How
do
we?
How
do
we
manage
that?
A
If
some
parts
are
rated
and
dental
isn't,
but
I
think
the
that
there's
a
lot
of
pros
and
cons
either
way.
So
I
think
that
is
something
we
want
to
rate
and
want
to
work
out
over
the
next
few
months,
and
I
would
say
that
actually
part
of
our
transitional
regulatory
approach
in
our
other
sectors
is
looking
at
how
we
deal
with
ratings
over
the
next
few
months
during
the
pandemic.
So
it
is
something
we
are
actively
discussing.
B
Well,
I
think
the
I
think
the
first
thing
that
I
would
say
on
this
particular
subject
is
public
health.
England
have
got
loads
and
loads
of
guidance
of
the
appropriate
ppe
for
dental
practices
and
the
latest
stuff
that
was
produced
two
or
three
days
ago,
that
contains
that
advice,
the
faculty
of
general
dental
practice.
They
too
have
got
advice
as
as
of
the
bda,
and
these
are
all
credible
places
to
to
get
that
advice.
B
C
B
The
kobit
the
covet
pandemic,
first
of
all
brought
lots
of
challenges
for
for
the
dental
profession,
because
people
were
in
were
finding
it
difficult
to
access
urgent
care
and
the
profession
rallied
around
really
quickly
to
staff
the
urgent,
the
urgent
dental
care
centers,
sometimes
where
those
urgent
dental
care
centers
were
not
were
not
available.
Practices
made
themselves
avail
available
with
their
staff
to
treat
people
with
urgent
needs,
so
the
profession
has
worked
well,
a
good
number
of
people
within
the
dental
profession
threw
themselves
into
the
general
covid
process.
B
Some
were
working
in
helping
set
up
the
nightingale
centers.
Others
worked
in
a
e.
Others
worked
in
intensive
care
units,
the
dental
profession,
where
they
had
the
right
skills
were
able
to
offer
themselves
to
the
wider
health
community,
and
I
think
that
was
to
the
credit
of
credit
of
the
dental
profession.
Others
got
involved
in
intestine,
trace
things
and
and
stuff
like
that
in
in
terms
of
oral
health,
I
think
just
the
the
fact
that
care
was
big
became
rather
more
difficult
to
get
because
of
the
changes.
B
A
Yes,
I've
got
a
few
thoughts
as
well.
Actually
one
is
that
stating
the
office,
but
how
important
access
to
dental
services
of
I
think
we
we
all
heard
a
few
very
difficult
stories
about
people
who
couldn't
access
access,
dental
care
and
during
the
height
of
the
pandemic,
and
I
think
it
just
highlighted
to
all
of
us
how
important
good
access
is.
A
So
looking
at
a
broad
range
of
different
areas,
but
we
did
specifically
look
at
how
the
interactions
between
dental
teams
and
the
rest
of
the
health
and
care
system
were
going,
and
I
think
one
of
the
things
I
noticed
was
that
it
would
be
really
great
to
see
more
discussion
about
oral
health
at
the
integrated
care
system
boards
and
for
it
to
be
given
more
of
a
priority
through
those
systems.
I
know
when
we
spoke
to
many
system
leaders.
A
So
I
think
going
forward.
I
think
it's
a
really
interesting
area,
I'm
keen
to
think
about
how
do
we?
How
do
we
look
at
the
integrated
care
agenda
and
how
do
we
really
make
sure
that
oral
health
is?
Is
a
key
part
of
that?
Given
its
importance-
and
I
think
the
final
thing
just
to
mention
is
inequalities.
I
think
that
I
don't
think
we
fully
understand
the
impact
of
covid
as
yet
on
on
inequalities.
A
But
we
know
from
all
the
signals
that
we've
had
that
there
have
been
a
significant,
significant
cause
for
concern
around
those
widening
inequalities
and
and
access
to
care.
So
I
think
that's
something
that
I
think
we
do
need
to
to
work
on
and
to
look
at
and
make
sure
that
everyone
has
has
the
the
appropriate
care
that
they
need.
A
C
B
B
A
Well,
I
was
just
gonna
say
so.
The
five
key
questions
are
not
are
not
going
to
change,
so
we
we
think
the
safe,
effective
response
of
caring
and
well-led
are
important
for
us
to
look
like,
but
the
key
lines
of
inquiry
we're
trying
to
slim
down
so
that
we
can
really
focus
on
the
areas
that
are
important
and
they
will
be
very
available
on
our
website
for
people
to
see
john.
Do
you
want
to
add
to
that.
B
Yeah
we've
been
some
of
the
conversations
we've
been
having
already
with
representative
groups,
and
we've
been
asking
this
question,
and
safety
is
top
of
everybody's
priority,
not
just
because
of
the
pandemic
still
being
lurking
around
us.
The
the
other
one
that
people
are
really
interested
in
is
is
effective
care,
and
so
we'll
be
thinking
about
our
our
questions
around
effective
care
and
how
we
can,
through
our
inspection
process
or
through
our
regulatory
process.
B
However,
it
ends
up
in
the
in
in
the
next
year
how
we
can
look
at
whether
care
is
effective,
that
the
way
that
I
sometimes
articulate
this
in
in
in
conversation
is,
can
I
be
confident
that
my
mum
will
get
the
care
she
needs
to
improve
her
oral
health
and
maintain
her
oral
health
when
she
engages
with
the
dental
practice
that
she
might
go
to
and
that
that's
a
simplistic
way
of
putting
it.
But
we
think
it's
an
important
area
for
us
to
cover
at
cqc.
B
I'll
go
for
it,
I'll
go
for
it.
Okay,
let's
change
the
slide
over
brilliant,
so
I
hope
you've
understood
from
the
way
we've
been
talking
so
far
that
we
recognize
at
cqc
that
we
need
to
change.
We.
We
also
know
that
we
can't
just
change
and
do
things
to
you.
We
want
to
do
things
with
you,
and
so
it's
important
that
you
speak
with
us,
so
you
can
get
involved.
We've
got
digital
platform
called
citizen
lab.
B
We
send
you
our
provided
bulletins
and,
and
things
like
that,
you
can
sign
up
for
those
if
you
don't
already
get
them
and
we've
got
a
twitter
account
which
I
have
to
say
at
the
moment
I'm
not
engaged
with,
but
perhaps
there's
a
message
to
myself
there
and
also
we've
got
podcasts
and
things
like
that
on
cqc
connect.
There
are
lots
of
ways
in
getting
getting
in
touch
with
us.
We
hope
we'll
use
them.
B
We
hope
you
will
share
with
us
your
thoughts
about
how
cqc
develops
in
the
future,
because
we
think
that's
the
that's
the
best
way
for
a
regulator
to
work
and
for
a
regulator
to
be
one
in
which
the
public
have
got
confidence
in
us
and
our
judgments,
but
also
that
those
of
us
in
the
profession
also
share
that
confidence.
So
thanks
so
much
for
taking
part
in
today's
webinar.
Thank
you.