Practice Managers need broad shoulders. The days of a PM being a receptionist who did the cashing up and staff rotas are over. Today’s successful dental practice needs a dedicated team with an effective PM at the heart of it. But what are the major issues that are landing on PMs desks across the UK? Having surveyed the ADAM membership, here are our Top Five:
1. CQC/Regulation
Far and away the dominant issue affecting PMs and their practices today. Quotes included:
“Definitely the ever changing and increasing regulations; whilst there are compliance packages available, we shouldn’t need to be buying in further help. Some of the compliance companies are also fuelling the system by adding in all sorts of unnecessary policies and protocols. It is becoming very difficult to know what is actually required, and what is totally OTT. One CQC inspector will interpret things one way, and another will have a different opinion. I understand that they are trying to be more standardised in how they inspect, but there are still far too many variants out there for anyone to tick all the boxes.”
“It’s hard to keep up with changes and regulation; there are not enough hours in the day. You tend to be buried in paperwork, when you should be available to deal with staff and patients and to let them know you are there for them.
The other problem is the new CQC inspections on the KLOEs – is the practice well led – To an extent yes, it is as all governance, health and safety, information governance to name just a few are complete, but as the Principal is the registered manager and doesn’t invest in the practice or staff, this affects the outcomes of some of the CQC requirements. Whereas I can identify the learning needs of the staff, the Principal will not pay for any training other than CPR/medical emergencies. So I am not in a position to support the staff to meet the requirements of the registration.”
“…keeping up with regulations and CQC requirement is quite stressful.”
2. Staff – recruitment of the right team members
“I think the biggest concern at the moment is the lack of qualified and experienced dentists and nurses who want to work in an NHS practice that is open 8-8, which is how our site operates. Even though we offer modern facilities and have a very good, qualified support team, if someone leaves, we have been finding it extremely difficult to recruit these two key roles for about 2 years now. Even securing a locum dentist who wants to work these hours has proved almost impossible.
I hear anecdotally from colleagues that many dentists are choosing to work outside the NHS, even after completing their VT, which makes one concerned for the long-term future of NHS dentistry.”
“Recruiting qualified nurses is becoming harder. I have been advertising for months and no interviews.”
“Recruiting experienced dentists is a constant struggle – there are very few applying for jobs. My worry is after Brexit this will become even more difficult as most of our dentists are Europeans.”
“While I understand the need for employing a qualified nurse, the current system does not cater for those people who want “just a job”. Many good nurses are lost because it is expensive for them to stay registered (GDC & INS). It is an added cost for employers to take on and the CPD requirements are an added burden to many. One recently told me that with all the compliance issues etc the fun has gone out of the job. Recruiting and maintaining staff is a big issue.”
3. Tendering and LATs
“The subject of tendering has now come up as although we are told by our health board it will just be reviewed like the end of previous contract times, we cannot assume – this may change and we may have to tender for our large orthodontic contract. We have sought advice from an independent company but just by looking at the forms I can see I have a lot of work ahead of me!”
“E-referral systems are being set up now throughout England for Minor Oral Surgery and orthodontics with us in September 2017. We are an orthodontic practice but we also have a paper referral waiting list. The Local Area Team (LAT) are asking us to add all of these onto the e-referral system as well as still using our own software – double the work and to what end? The LAT don’t really know yet. The LAT get audit figures from the BSA already. All very annoying!!”
4. The Economy.
This was a particular worry of those who had a small or no NHS commitment.
“We are an independent non NHS practice in a market town. If the economy does worsen that will have an effect on our patient’s ability to pay for treatment; recruiting new patients is always something which we worry about.”
5. Staff – retaining the right team members.
“My current challenges are retaining staff and keeping them motivated. With the cost of GDC, Indemnity and DBS (which staff have to pay themselves) staff are now starting to leave and go into jobs in supermarkets etc as the pay is higher and there are no outgoing costs involved in doing your job and no outside bodies coming in and inspecting the way things are done.”
“In the 30 years we have been in dentistry, getting the right team together is the biggest issue. Finding that special person has always been a challenge! You do get what you PAY FOR!”