Frequently Asked Questions
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F. CARE QUALITY COMMISSION (CQC)
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1. Could you advise on available guidance related to the 'Statement of Purpose' required by CQC for practices introducing sedation services?
The 'Statement of Purpose' should be tailored to your sedation practice. It may include a description of the type of sedation provided, the environment in which it is offered, target patient demographics (e.g., age range, anxious patients, complex procedures), the drugs used (e.g., midazolam, nitrous oxide), and their intended purpose.
2. Do we need to inform CQC about providing sedation at the practice?
Yes, it is important to notify the CQC of your sedation services. They may enquire whether you provide sedation prior to scheduling a routine onsite visit. If there is no clear protocol for notification, it’s advisable to ensure they are informed.
3. What should I prepare for a CQC inspection related to IV sedation? We have a CQC inspection coming up in two weeks. It would be helpful to provide both clinical and non-clinical audits related to IV sedation.
While audits should be tailored to your specific practice, I have previously used the Safe Sedation Practice Scheme Checklist as a template for self-auditing. You can find more information on this in the document linked here: https://www.saad.org.uk/sedation-practice/practice-evaluations. Additionally, consider auditing patients' compliance with preoperative instructions or reviewing the clinical records of sedation cases.
4. I am a member of SAAD and we provide sedation services to private patients on a needs basis which can be about 3 or 4 cases a year. My purpose for this email was to find out whether we have to inform CQC and how to inform them.
Yes, if you are providing sedation for dental patients you need to update your CQC scope of practice and inform the CQC.
If it is only 3 or 4 cases per year and this is the only sedation the clinician is providing I would question whether this is sufficient to remain current and competent and would advise speaking to their indemnifier to seek further advice. If the sedation is provided by a visiting sedationist you would need to ensure they have the appropriate governance in place, and an SLA.
5 . Our practice has a CQC inspection next week and I was double checking everything was in place regarding sedation.
I started training a nurse in 2017 but as soon as she qualified she left the practice and so I decided to just stay as a dedicated-sedationist. For this, my understanding was that I didn’t need a sedation qualified nurse, just for the whole team involved with the sedation to be ILS trained. Basically, what I’m asking is if I have a dedicated sedationist treating the patient, is there a need for anyone else to have official sedation training?
My indemnity company (MDDUS) are now saying they won’t insure me for sedation unless my nurse is sedation-trained. I’ve tried to explain to them that I am a dedicated sedationist and not doing any of the dentistry, but I was wondering whether I could have your opinion on the matter so that I could forward that onto them?
You are correct: you do NOT need a sedation-trained nurse, and the dentist does not need sedation training either. Everyone must have ILS.
Below is information from IACSD. This was also agreed with CQC.
'I am intending to employ a doctor / dentist to provide sedation whilst I carry out the dental treatment. What training and experience must he / she have? Do I, and my dental nurse, also need to be trained in dental sedation?
The IACSD Standards apply to all doctors, dentists and DCPs. You must ensure that the sedationist has undertaken accredited knowledge / skills training and supervised clinical experience in line with these Standards. Although neither you nor your dental nurse need training in conscious sedation, it is recommended that you both have some knowledge about treating patients under conscious sedation. All members of the sedation team must have ILS / PILS training. (See FAQ 16).’