The CQC has recently said it wants to recognise care which goes 'above and beyond the regulations', in order to promote learning and encourage improvement. 

CQC National Dental Adviser John Milne said in December 2015 that inspectors would now actively collect examples of notable practice that exceed CQC's fundamental standards. We advise practices to make the most of this opportunity to talk about the excellent care and service you provide to patients, including examples of how you have improved patient outcomes and experience and explain what makes your practice stand out from the crowd.

By April 2016, CQC inspected 10% of dental providers in England using its revised approach, which asks if the service is safe, effective, caring, responsive to people's needs and well-led. Encouragingly, after eight months of the new methodology John Milne reported that the safety and quality of dental care was generally high and that he was struck by the positive feedback from patients. 

However, Milne also noted two areas of concern in practices where inspectors had identified difficulties: 

• Leadership - in practices where leadership was weak and responsibilities were not clearly defined, there wasn't a strong culture of learning and reflecting. This in turn affected the safety and quality of care.
• Professional isolation - practices did not always know where they could go for support. This has been identified as a key priority for the profession in a new paper on the Future of Dental Service Regulation.

Team approach

The DDU recently emphasised the contribution that a team approach to learning can make to team building, morale and improved outcomes for patients. Our suggestions for incorporating team learning into everyday practice included:

• team meetings led by team members in turn
• peer review sessions
• sharing learning from courses attended by individuals
• practice study groups.

CQC requires dental providers to ensure that each member of staff is competent to carry out their role, from an induction programme and a learning and development needs analysis at the start of their employment to the need for training and regular updates to ensure that competence is maintained. 

This is consistent with Principle 6 of the GDC's Standards for the Dental Team which says dental professionals must: 'Work with colleagues in a way that is in patients' best interests'. Standard 6.6.5 elaborates: 'You must encourage, support and facilitate the continuing professional development (CPD) of your dental team.'

The DDU believes that team-based training can also help prevent some of problems that result in complaints to the practice and the GDC. If everyone in the team is properly trained in complaints-handling, they will be better able to identify and address situations where patients are dissatisfied, before this leads to a formal complaint.