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RQIA inspection, sedation and radiation guidance changes

We recently spoke with Stephen O’Connor from the Regulation and Quality Improvement Authority (RQIA) following a meeting between The Northern Ireland Dental Practice Committee (NIDPC) and the RQIA.

The meeting was to discuss what the change to bi-annual inspections and updates to sedation and radiation guidance will mean for dentists.

During the 2022/23 inspection year, RQIA undertook a total of 189 care inspections of dental practices:

  • 143 primary announced inspections
  • 22 pre-registration inspections
  • 22 variation inspections
  • 2 follow-up inspections

During this period, 86 post-inspection evaluations were completed and returned to RQIA. 32 of these included comments with only one negative comment in which the provider queried the inspector's knowledge. Two of the returns also commented on the inspection methodology.

At the meeting, our NIDPC RQIA sub-group queried the average length of inspection. During 2021/22, the average length was 2.5 hours but during 2022/23 it stood at 2.8 hours. Increasing the period of notice was also a subject of debate. Currently, notification of inspection is issued four weeks in advance of the inspection, previously it had been six weeks.

RQIA said it could in theory consider increasing the period of notice, however, careful consideration would be required as increasing the period of notice also means rescheduling inspections that have already been notified. The move from annual to biannual inspections, as passed by the Health Minister at the time, Robin Swann, was widely welcomed by the profession last year.

Legal context

On 1 May 2022, an amendment to the Regulation and Improvement Authority (Fees and Frequency of Inspections) Regulations (Northern Ireland) 2005 changed the minimum frequency of inspections to dental practices from once each year to once in every two years (where required RQIA may conduct additional inspections above the minimum frequency).

Those practices not inspected during this time will be inspected during the 2023-24 inspection year, the provider guidance for this year is available on the RQIA website. On 9 June 2022 Caroline Lappin, Chief Dental Office (CDO), issued a letter outlining the current position in Northern Ireland in relation to infection prevention and control (IPC) guidance. Each of the four countries within the United Kingdom transitioned to using the IPC manuals and the application of Standard Infection Prevention and Control Precautions (SICPs) and Transmission Based Precautions (TBPs) applicable in each region.

Conscious sedation

There have also been changes to the conscious sedation guidelines in the last 12 months. On 29 September 2022, the CDO issued a letter to all dental practitioners in Northern Ireland endorsing the SDCEP Conscious Sedation in Dentistry: Dental Clinical Guidance (Third Edition) with effect from 1 November 2022.

RQIA has also amended its inspection methodology to reflect the IPC manual and SDCEP guidance. Guidance in respect of the care component of the inspection; the maintenance and upkeep of the premises and the management of medicines are available on the RQIA website. These documents should be reviewed to ensure compliance with the minimum standards, regulations and legislation.

Accidental radiation exposure

This year has also brought updates to the accidental or unintended exposure to ionising radiation guidance. If there is any exposure, and the employer considers it is significant or clinically significant, it must be investigated and reported to the appropriate UK IR(ME)R enforcing authority (under Regulation 8(4) of The Ionising Radiation (Medical Exposure) Regulations (Northern Ireland) 2018.

Regulation 8 of IR(ME)R details the employer’s duties for making statutory notifications about accidental or unintended exposures. When accidental and unintended exposures are judged to be Significant Accidental and Unintended Exposures, they must be notified to the enforcing authority under Regulation 8(4).

The NIDPC sub-group will meet with RQIA again in December. If you have any questions or would like us to raise any matters directly with RQIA, please get in touch.

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