Streamline Your Hourly-Pay Procedures

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Practice Managers spend a lot of time collating, checking and agreeing the number of hours worked by members of the team ahead of the monthly pay run.
This is another quick win where technology can take the strain and do all the hard work for you.
Deputy Staff Management collates all the hours worked either directly from the on-line work roster provided or using a great tablet-based check-in system called “Kiosk” to accurately log actual start and finish times.
With hourly rates loaded for each member of the team you can track staff costs in real time.
Deputy is successfully established and running in several of my client practices, with more coming on board each week.
If this sounds interesting, you can set up a 30 day free-trial here and Your Dental Manager will make sure you are set up and running to make best use of your trial month.

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Streamline Your Hourly-Pay Procedures

CQC Hotspots – November 2017

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Reviewing a further sample of 107 CQC dental inspection reports published in November highlighted a number of compliance breaches and warnings which can easily be avoided, but which are still catching out some practices.

Of the 107 practices sampled, only 7 practices were issued with breach notifications, which is a big improvement on previous samples. Clearly the majority of practices are getting things right, which is great news. All notices reviewed this month were again issued for breaches within the “Well Led” standard, with just one other issued in respect of “Safe”.

It is very clear from this, and several previous samples, that the “Well Led” standards are still causing problems for many practices, despite most being fully compliant in the many other aspects of good practice management.

The “Well Led” standard is inspected under the following broad areas:

  • Governance Arrangements (management structure and responsibilities/delegation)
  • Leadership, Openness and Transparency
  • Learning & Development/Continuous Improvement
  • Seek and Act on Feedback from staff and the public/patients

In the spirit of continuous improvement and to try and help 100% of practices achieve a clean pass, here are some of the key-findings and recommendations from these very recent inspections, which might just keep another practice out of trouble.

Interesting to note that a number of the issues picked up by inspectors in recent reports have been flagged up in previous bulletins and all are easily resolved once identified.

  • Don’t let the basic Infection Control procedures slip – remember that your Infection Control Audits and HTM01-05  should be at the forefront of everyone’s mind.
  • Inspectors are still picking up evidence of audits being undertaken and filed with no subsequent action planning or attempt to resolve identified issues. Remember that once you have identified a risk, the practice is responsible for pro-actively resolving and/or reducing the risk to an acceptable level. Always document timescales, responsibility and follow-up plans.
  • Medical Emergency procedures have caused problems for some practices. Remember to rehearse these regularly (keeping records), involve all staff, check that you have the essential drugs/equipment readily available as recommended by Resuscitation UK, British National Formulary, GDC and make sure that nothing in your emergency kit goes out of date.
  • As with all policies and procedures, Safe-Guarding and Whistle-blowing procedures must be personalised to your own practice and reflect local contacts and procedures. Inspectors still find many examples of generic policies/procedures which bear no resemblance to what actually happens locally,
  • Practices are still being picked up for inadequate recruitment procedures. Always follow simple, readily available checklists and procedures to demonstrate that you are doing things correctly and keep records readily available in staff files. This includes employment references, DBS certificate numbers, qualification certificates, photo i.d. and proof of residency/home address.
  • Ensure you are receiving, checking and taking action on relevant MHRA/CAS patient safety alerts. Dental practices don’t receive many but there must be a robust system in place to show that you identify and respond to any that are published.
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  • Management of sharp injuries are regularly checked. Ensure procedures are in place and communicated to all the team. Endo files need to be risk assessed if used.
  • Incident/Accident Reporting records must be updated for any significant events, including Sharps injuries..
  • COSHH records not held or maintained/reviewed. Practices work with a lot of high-risk substances. Essential that you have information sheets and risk summaries for all, including routine cleaning materials. Immediate access to this information will be vital in the event of an accident. Also make sure that anything within your COSHH records is safely and securely stored to reflect the increased risk. Don’t forget to log and register  those new materials you keep trying out if they are a COSHH risk.
  • Make sure your clinical and domestic waste records are fully up to date and that appropriate waste audits have been completed accurately by yourself and your waste handlers.
  • Check your drugs and materials for storage guidelines, ensure refrigerated where required and regularly check for out-of-date supplies.
  • Make sure that your clinical team have up to date Hep B immunity records confirmed and available for checking, before working in risk areas. Take care to ensure all impacted staff have reached the minimum level of vaccine effectiveness.
  • Inspectors continue to come across missing or partially-completed, mandatory risk assessments including Legionella, Sharps, Clinical Waste and COSHH. Make sure that any actions required to minimise risks are documented and implemented.
  • Staff reviews/appraisals must be available to show evidence of performance, learning needs, “general well-being” and future training/development plans. Something is better than nothing, so don’t delay or wait for “perfection”.  So often, inspectors are told that appraisals “are in hand” but not yet done.
  • Interpretation services must be made available for patients who do not speak English, either in house or through an external third party service.
  • Don’t forget to have an up to date Disability Discrimination Audit available along with plans for improvements or reasons why changes cannot reasonably be made.
  • More practices are now making use of CCTV – make sure this is documented in your Data Protection records and that both staff and patients are given adequate notice of why CCTV is being used and that they have a right to view footage.
  • Take care with “Off the Shelf” or “In a Box” Policy and Procedure packs. They are an essential and valuable source of material for many practices, but each policy/procedure must be reviewed and personalised to the practice and the way you work.

As always, remember that if something is not recorded or evidenced, in the eyes of the CQC and other external bodies such as the NHS, it didn’t happen, even though you may know full well that it did! This continues to catch practices out, leading to frustration and avoidable stress for all!

Findings from previous inspection reviews can be found here:  CQC Hotspots

There is plenty of help out there to plug any management gaps including Your Dental Manager, so please do get in touch if you have any concerns or want to further improve the overall management/efficiency of your practice: info@yourdentalmanager.co.uk or check our on-line calendar to book a complimentary chat.

CQC Hotspots – November 2017

CQC Hotspots – June 2017

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Reviewing a further sample of 67 CQC dental inspection reports published over recent weeks, highlighted a number of compliance breaches which can easily be avoided, but which are still catching out some practices.

Of the 67 practices sampled, 9 practices were issued with breach notifications. Clearly the majority of practices are still getting things right, which is great news. All notices reviewed this month were again issued for breaches within the “Well Led” standard, with just one other issued in respect of “Safe”.

It is very clear from this, and several previous samples, that the “Well Led” standards are still causing problems for many practices, despite most being fully compliant in the many other aspects of good practice management.

The “Well Led” standard is inspected under the following broad areas:

  • Governance Arrangements (management structure and responsibilities/delegation)
  • Leadership, Openness and Transparency
  • Learning & Development/Continuous Improvement
  • Seek and Act on Feedback from staff and the public/patients

In the spirit of continuous improvement and to try and help 100% of practices achieve a clean pass, here are some of the key-findings and recommendations from these very recent inspections, which might just keep another practice out of trouble.

Interesting to note that several of the issues picked up by inspectors have been flagged up in previous bulletins and are all easily resolved once identified.

  • Team members will usually be asked about the “Duty of Candour” which relates to a culture of open and honest communication amongst the team and with patients. This includes apologising to patients when things go wrong and staff feeling comfortable with raising issues and concerns. There should be a “no-blame” culture clearly evident.
  • Inspectors are still picking up evidence of audits being undertaken and filed with no subsequent action planning or attempt to resolve identified issues. Remember that once you have identified a risk, the practice is responsible for pro-actively resolving and/or reducing the risk to an acceptable level. Always document timescales, responsibility and follow-up plans.
  • Policies and procedures not signed, reviewed, circulated or updated. Your policies and procedures are essential working documents, which your team must be familiar with.
  • Infection Control Audits, apparently completed, but not reflecting what is actually happening. Simple box-ticking is ineffective, a waste of everyone’s time and a real risk to the practice and patients. Remember that audits are intended to drive continuous improvement and change.
  • Staff indicating that certain actions have taken place or resolved, but with no documentary evidence. Always make sure your efforts and hard work are recognised by keeping notes and records of what you are doing to improve the practice.
  • Dental records (electronic or written) must be clear, concise and complete, with regular audits for each clinician. Feedback and monitor for improvements if necessary.
  • Practices are still being picked up for inadequate recruitment and staff induction procedures. Follow simple, readily available checklists and procedures to demonstrate that you are doing things correctly and keep records in staff files.
  • Ensure you are receiving, checking and taking action on relevant MHRA/CAS patient safety alerts. Dental practices don’t receive many but there must be a robust system in place to show that you identify and respond to any that are published.
  • Ensure that all sterilisation and clinical equipment is fully maintained in accordance with manufacturer guidelines, externally validated by professionals/suppliers and that recommended routine/daily/weekly checks are undertaken diligently. Even more important is to have evidence and documents to support your checks and maintenance!
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  • Prescription and controlled medicines/drugs must be locked away and closely monitored.
  • Management of sharp injuries are regularly checked. Ensure procedures are in place and communicated to all the team. Incident/Accident Reporting records must be updated for each event.
  • COSHH records not held or maintained/reviewed. Practices work with a lot of high-risk substances. Essential that you have information sheets and risk summaries for all, including routine cleaning materials. Immediate access to this information will be vital in the event of an accident.
  • Make sure that your clinical team have up to date Hep B immunity records confirmed and available for checking, before working in risk areas.
  • When appointing Fire Marshalls, First Aiders and other “appointed” roles, make sure that they are adequately trained and know that they have been appointed to the role! Inspectors have talked with staff who are unaware of their responsibilities.
  • Information Governance is becoming increasingly important, and high-profile as evidenced by recent events within the NHS. Make sure your team have been trained, with evidence, and are following your reviewed and updated IT security policies.
  • The practice Health & Safety risk assessment must be kept up to date and where new or changed risks are identified, actions put in place to resolve quickly. Don’t delay as once identified, you have a responsibility to correct.
  • Inspectors continue to come across missing or partially-completed, mandatory risk assessments including Sharps, Fire, Clinical Waste, COSHH and Manual Handling.
  • Remember to date and review all of your practice policies and procedures at least annually. If nothing has changed simply re-date to show that you have been there.
  • Don’t forget that associate dentists, therapists and hygienists should also have annual appraisals to review performance and identify training requirements.
  • Appraisals are generally expected to show evidence of performance, learning needs, “general well-being” and future training/development plans. Something is better than nothing, so don’t delay or wait for “perfection”.  So often, inspectors are told that appraisals “are in hand” but not yet done.
  • Collecting and responding to patient feedback and comments is essential. Even more important is to evidence what action has been taken in response to feedback. Inspectors will always ask for specific examples, so be prepared.
  • Take care with “Off the Shelf” or “In a Box” Policy and Procedure packs. They are an essential and valuable source of material for many practices, but each policy/procedure must be reviewed and personalised to the practice and the way you work.
  • Missing or out of date Accessibility Audits, which are required under the Equality Act 2010 along with action plans and explanations for not implementing best practice. One practice was picked up for not having a hearing loop on reception – something which can be reasonably implemented as required under equality legislation.
  • The practice is responsible for overseeing CPD training – make sure you keep records of where everyone is within their CPD training cycle.
  • For multi-site practices, make sure that their is a responsible person at each site – don’t just rely on a “roving” practice or compliance manager.
  • Don’t forget to book regular team meetings into the diary – ideally monthly – and keep records of agendas, minutes and action points from each. It is not enough for staff to say that everything is discussed and resolved informally during the working day. Also remember to keep absent staff (holidays, part-time or sickness) fully up to date with evidence.

As always, remember that if something is not recorded or evidenced, in the eyes of the CQC and other external bodies such as the NHS, it didn’t happen, even though you may know full well that it did! This continues to catch practices out, leading to frustration and avoidable stress for all!

Findings from previous inspection reviews can be found here:  CQC Hotspots

There is plenty of help out there to plug any management gaps including Your Dental Manager, so please do get in touch if you have any concerns or want to further improve the overall management/efficiency of your practice: info@yourdentalmanager.co.uk or check our on-line calendar to book a complimentary chat.

CQC Hotspots – June 2017

JOB OPPORTUNITY – DENTAL HYGIENIST, OXFORD

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Self-employed Hygienist Required for Private Oxford Practice

2 days per week

One of my dental clients in Oxford has an excellent opportunity for an experienced and ambitious Hygienist to join a thriving practice.

This vibrant and successful, primarily private, dental practice operates from state of the art premises on the outskirts of Oxford being fully computerised with well-equipped, modern surgeries, digital x-rays and training facilities.

The practice has a strong preventive dentistry ethos and demand for hygiene services is increasing.

The successful applicant will enjoy excellent working conditions, competitive fee payments, access to an established patient list and the benefits of a strong and efficient management/support team.

You will need to have a minimum of 2 years post-qualification experience with excellent communication skills.

To apply for this opportunity or for more information please send your c.v. and a covering letter to oxford@yourdentalmanager.co.uk

JOB OPPORTUNITY – DENTAL HYGIENIST, OXFORD

Will Your New Recruit Fit Into the Team?

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With the prospect of new ideas, skills, renewed energy, enthusiasm  and hopefully a welcome breath of fresh air, recruitment of a new team member can and should be an exciting opportunity.

As many practice owners have learned the hard way, it can also be quite daunting and the “wrong” decision, can make life difficult for many months to come.

Common concerns I hear when recruiting new team members for client practices are:

  • “Will they fit in to the team?”
  • “Will they be disruptive?”
  • “Will they work well with the rest of the team?”
  • “Do they have the right attitude for the team and our patients?”
  • “How do I make sure they will make a difference?”

As with many things, a well structured and organised approach to recruitment will go a long way towards making the right decision.

Prepare Well

  • Don’t rush into making decisions – far better to wait and cover the role until you find the “right” person
  • Make sure you understand the role you are trying to fill – this can be a great opportunity to redefine a role and restructure responsibilities across the team to bring in new skills and fill knowledge gaps
  • Understand the type of person you need – all teams benefit from a range of personalities, experience, maturity and approaches to work
  • Understand the strengths of the remaining team and look to bridge any gaps or weaknesses through your new recruit
  • Is the time right to promote from within the team and bring in a more junior role to replace a more senior person?
  • Create a job profile outlining key responsibilities and requirements for the role
  • Create effective wording for your advertisement to attract the right candidates
    • Focus on the skills and requirements needed
    • Remember to “sell” your practice and the role using positive words like opportunity, “great team to work with”, successful, enthusiastic, “great location”, “good public transport links”, “coastal/rural/city centre location”
    • Take a look through my “News” page for several examples of proven recruitment advert wording
  • Always request a covering letter to support C.V.s, asking the applicant to explain why they are right for the role you have on offer and what they can bring to your team and practice

Each applicant will have a different range of skills and experience and one of the best ways to identify and short-list for interview is to “score” applicant C/V.s against your own prioritised criteria:

  • List 10-12 key aspects of the job and person that are important to you, such as
    • Years of experience
    • Qualifications
    • Specific skills needed for the role e.g. specialist nursing, decontamination, lead nurse, management , customer service, IT/software, teamwork, dealing with difficult situations, planning, communication
    • Always have an “Other” aspect for candidates who flag up special skills or particular reasons they could be right for you
  • Use the C.V. and covering letter to score each applicant against the criteria you have listed (0 = low/none, 5 = high/perfect!)
  • Allocate your own weighting or ranking to each of the aspects so that candidates with the most important skills score higher
    • If Lead Nurse skills are vital, weight this with a 5 – the best candidates would score a 5 from their C.V.  x your own weighting of 5 = 25
  • Short-list between 3 and 5 of the highest-scoring candidates for interview

Get to Know Your Candidates Better

At this stage many of my clients make good use of Everything DiSC, a long-established and proven work-style preference profile, which short-listed candidates complete on-line in about 20 minutes. Workplace-Circle_thumb

Based around candidate responses to a wide-range of work-style/team scenario questions, a detailed profile on the candidate’s likely approach to work and their ability to work effectively alongside different types of people, including yourself as their manager or leader, is summarised and made available to you.

The profile helps to identify whether the candidate can fill “gaps” in your ideal team structure. Remember that no team can function effectively where everyone has the same attitude, approach and work-style.

You will also be able to identify the likely “motivators” and “stressors” for each candidate, which helps to structure the right questions for interview and is a great help for managing the successful candidate.

The profiles are self-explanatory, self-contained and available for just £75 per candidate. As an accredited trainer and provider of Everything DiSC tools, I can help you interpret and make full use of the information if required, including comparison reports where there is no one clear “winner”, even after interview.

You can find out more about Everything DiSC workplace profiles here.

Really Get to Know Your Candidates

At the interview use a similar score-card to the one above, update scores based on what you see and hear

Don’t take anything at face value – ask for examples of what has been done and what has been achieved. Challenge the C.V. and claims but most importantly of all, get to know the person and what makes them tick.

  • “Give me an example of when you resolved a patient complaint”
  • “Tell me about a time you felt under pressure at work and how you responded”
  • Give me an example of how you supported another member of the team”
  • “How would you deal with a patient complaint about . . . “
  • “How would you make sure the diary was kept full?”
  • “What part of the job do you find most and least satisfying?”
  • “Why is this role the right one for you?”

Some important additions to the C.V. score-card when used for interview candidates are:

  • Approach to handling of typical scenarios such as those above
  • Personality traits you are looking for such as confidence, outgoing, committed, hardworking, willingness to learn, flexibility
  • Specific questions and circumstances for individuals, which need clarification or investigation

We have focused this discussion on skills, attitude, ability and team structure. Don’t forget to use your practice recruitment procedures/checklist to make sure all the practicalities and legal requirements of recruiting the right person are also covered. A suitable probationary period of up to 6 months is also essential.

Go For It and Make Your Decision

Armed with information from the applicant’s C.V., covering letter, Everything DiSC workplace profile, candidate score-cards and an effective, frank and open interview, you will have all you need to confidently make the big decision.

There is plenty of help out there to plug any management gaps within your business, including Your Dental Manager, so please do get in touch if you have any concerns or want to further improve the overall management/efficiency of your practice: info@yourdentalmanager.co.uk or check our on-line calendar to book a complimentary chat.

 

 

 

Will Your New Recruit Fit Into the Team?

Boosting Your Patient Recalls

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Effective and reliable patient recalls are a critical part of your practice for many reasons:

  • Essential for ongoing patient care
  • Keep patients to recommended intervals and avoid slipping, often by many months
  • Minimise future pain and treatment through preventative care
  • Patient education
  • Relationship-building
  • Identification and discussion of patient needs, aspirations and future treatments
  • Practice cash-flow
  • Forward planning
  • Diary management
  • Minimise the time spent by back-office staff trying to fill white space

Here are some thoughts and suggestions to help improve and streamline your approach

  • Always encourage patients to pre-book their next 3, 6 12 month appointment
    • Significantly reduces the volume of recalls to manage on a monthly basis
    • Allows patients to choose convenient appointments which may not be available to them nearer the time
    • Appointments can be changed as necessary subject to your 24/48 hour cancellation policy
    • Make good use of the automated reminder services within your practice software and use firm but friendly wording about the importance of attendance within the reminders
  • Replace the word “routine”  with “essential” or “vital”
  • Replace the phrase “check-up” with “comprehensive dental review” or “consultation”
  • Make full use of the automated recall systems within your practice software
    • This will take care of maybe 80% or more of your routine recalls
    • Typical recall schedule for a June recall is:
      • Automated reminder in May
      • Automated reminder in June for those still outstanding
      • Automated “Overdue” reminder in July, which is more detailed,
        • Highlights the importance of regular attendance
        • Benefits of ongoing, preventative care
        • List of the many aspects of oral health care covered during a recall
          • Create/make use of a 16 to 20 point bulleted Dental Health Review summary, based on all the checks undertaken
      • Automated reminder after 12 months, which is more of a reactivation approach
        • Details of what is included in the “essential” recall using your Dental Health Review summary mentioned earlier
        • Highlight importance of ongoing care
        • Ask for contact to enable records to be updated
        • Seek confirmation if no longer wishing to remain as a patient so that their place can be given to others on the waiting list
  • Review and personalise your automated recall letters carefully:
    • Firm but friendly letter which reflects your practice ethos/image/brand
    • Highlight benefits and importance of regular attendance
  • Practice staff focus their time and effort on contacting patients, by telephone, who have not responded or booked their next appointment after the third, “Overdue” automated reminder
    • In the above example, practice staff would be making phone calls in June to patients who are still overdue for a recall from April 2017 (2 months ago)
    • Phone call should be on a patient-care/concern over missed recall approach
    • Check that patient records/contact details are up to date
    • Build relationship with the patient and establish a good rapport
    • Understand patient preferences/needs
    • Respond to any questions or concerns
    • Update records and close off if patients have moved away or no longer wish to be a patient
    • Book an appointment
  • Keep your dental records up to date with each attempt at contact and with feedback or comments from patients so that you can follow up and pick up on previous discussions. This also avoids multiple contact to the same patient within a short period of time
  • Use your practice software “follow-up” lists to diarise patients who ask for a call-back, or more time
  • Use your practice software to help track and monitor progress with recalls. Most will now produce comprehensive, interactive and visual reports to help
  • Build regular “treatment blocks” into your diary to ensure days are not fully blocked with recalls, leaving no time for longer treatments

In summary:

  • Review your recall messages/letters and make them firm, friendly and compelling
  • Promote the benefits of regular attendance
  • Highlight and summarise the many checks completed during your “Comprehensive Dental Reviews”
  • Make good use of automation for the majority of recalls
  • Keep records of all contact
  • Plan out your diary and create treatment blocks
  • Focus on the much smaller list of patients who are still overdue after 2 months and speak with them
  • Follow-up and persevere
Boosting Your Patient Recalls

Job Opportunity – Associate Dentist Leeds

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Church View Dental Care, Crossgates, LEEDS

Self-employed Associate Dentist Required

2,000 UDA’s + good private opportunities

2 or 3 days per week including Fridays but some flexibility with other days

Due to continued growth, Church View Dental Care in Crossgates, Leeds, has an excellent job opportunity for an enthusiastic associate dentist to join a thriving practice in a busy high street location with great transport/road links.

This vibrant and successful mixed private/NHS dental practice operates from modern and spacious premises on the outskirts of Leeds being fully computerised with well-equipped surgeries and a committed, experienced team of dental professionals.

The successful applicant will enjoy excellent working conditions, competitive private fee payments/UDA rates, generous contribution to lab fees, access to an established NHS patient list, excellent private practice opportunities, strong peer/referral support and the benefits of a strong and efficient management/support team.

The right candidate will be an existing NHS performer with excellent communications, skills, a strong team player with a commitment to professional and personal development.

Practice website: www.churchviewdentalcare.co.uk

To apply for this opportunity or for more information please send your c.v. and a covering letter to Leeds@yourdentalmanager.co.uk

 

Job Opportunity – Associate Dentist Leeds