Safer Recruitment in Dental Practices: What CQC Expects Under Regulation 19
Updated: 6 hours ago
A safer recruitment dental practice process is one of the first things I look at when I review a practice, because staff files tell you very quickly whether a provider's systems actually work. When I was a CQC inspector, recruitment records were among the most common reasons a dental practice was found in breach of the regulations. The good news is that the requirements are clear and, with a little organisation, very achievable.
What Regulation 19 requires
Regulation 19: Fit and proper persons employed says that everyone employed to carry on a regulated activity must be of good character, have the qualifications, competence, skills and experience needed for their role, and be able, after reasonable adjustments, to perform the tasks intrinsic to their work. Providers must operate recruitment procedures effectively to make sure this happens.
Two points from CQC's guidance often surprise practice owners:
"Person employed" includes volunteers, contractors, agency and bank staff, not just people on your payroll. Self-employed associates and visiting clinicians are in scope.
The Schedule 3 information must be confirmed before someone starts work, and CQC must refuse registration if a provider cannot show it will comply.
The Schedule 3 information you must hold
Schedule 3 of the Regulated Activities Regulations 2014 lists the information you must have for each person employed. In plain terms:
Proof of identity, including a recent photograph.
A criminal record certificate at the appropriate level, where the role is eligible.
Satisfactory evidence of conduct in previous employment in health or social care, or with children or vulnerable adults.
Where someone has worked with children or vulnerable adults, verification, so far as reasonably practicable, of why that employment ended.
Documentary evidence of relevant qualifications.
A full employment history, with a satisfactory written explanation of any gaps.
Satisfactory information about any physical or mental health conditions relevant to the person's ability to do the job, after reasonable adjustments.
CQC's Dental mythbuster 19: Staff recruitment confirms that inspectors ask about your procedures and check a sample of staff records. Records should be easy to access and kept securely.
DBS checks: who needs what
Dental mythbuster 19 states that all clinical staff need a DBS check, including dentists, hygienists, therapists and dental nurses. For non-clinical staff, it depends on their duties. A receptionist with access to records but no patient contact may not need one, but staff who chaperone, or who supervise a child while a parent is treated, will.
CQC does not decide eligibility for you. Use the NHS Employers DBS eligibility tool or the government DBS eligibility guidance, and record your reasoning. If you decide not to check a non-clinical role, write down a clear rationale and a risk assessment.
Inspectors would not usually expect someone to start work before their DBS result is back. If you do allow it, you need a documented risk assessment and supervision arrangements. For NHS performers, you can sometimes rely on Performers List checks, but you must hold assurance from NHS England and a risk assessment. The DBS Update Service can make portability and ongoing checks much easier.
References and conduct in previous employment
I regularly see files with a single generic reference from a friend or a colleague of equal grade. That is not what Schedule 3 asks for. You need satisfactory evidence of conduct from previous employers in health or social care, and verification of why the person left roles involving children or vulnerable adults.
In practice, I advise:
at least two references, including the most recent employer
references requested directly from the referee, not handed in by the candidate
verbal confirmation of any reference that is vague, then a note of the call
a written explanation for every gap in employment history, signed and dated
GDC registration and indemnity
Regulation 19(4) requires staff to be registered with the relevant professional body. For dental professionals that is the General Dental Council. Check the GDC online register before the start date, save a dated copy, and recheck at each annual renewal. Dental mythbuster 19 expects documentary evidence of registration.
Indemnity is a legal requirement too. The GDC's indemnity guidance says dental professionals must have appropriate indemnity or insurance before they practise, covering their full scope of practice. Hold a current copy of each clinician's certificate, or confirm in writing what your practice policy covers, and diarise renewal dates.
Hepatitis B immunity
For clinical staff, Dental mythbuster 19 expects evidence of hepatitis B immunisation including the level of response, the titre. Where someone has not responded, or evidence is unavailable, there must be a risk assessment.
The Green Book, chapter 18 explains that an anti-HBs level of 10mIU/ml or more is generally accepted as protective, and that healthcare workers who are non-responders should be managed under the national guidance on bloodborne viruses in healthcare workers. Dental clinicians perform exposure-prone procedures, so occupational health clearance matters. A vaccination card without a titre result is a gap I still find on mock inspections.
Health, competence and induction
You must have satisfactory information about health conditions relevant to the role, but CQC says it does not expect to see a health certificate stating the person is fit for work. A short health questionnaire reviewed by occupational health is usually proportionate.
Competence is part of Regulation 19 too. Record the induction, supervision until someone is assessed as competent, and the training they arrive with. My guide to mandatory training in a dental practice sets out what CQC expects to see.
A safer recruitment dental practice checklist
Before anyone starts, I would expect each file to contain:
photo ID and right to work evidence
an application form or CV with full employment history and explained gaps
at least two satisfactory references, including the most recent employer
a DBS certificate at the correct level, or a recorded eligibility decision and risk assessment
qualification certificates
a dated GDC register check, where applicable
current indemnity evidence for clinicians
hepatitis B immunity evidence with titre levels, or a risk assessment
a health questionnaire outcome
signed induction records
Your recruitment policy should describe this process, and you should follow it every time. Your registered manager is accountable for this, which I cover in my guide to dental registered manager responsibilities. It also links closely to your wider governance policy.
How I can help
If you are registering a new dental practice, CQC will want to see a recruitment policy that shows how you will meet Regulation 19, and its recruitment policy guidance sets out what to include. I write and review recruitment policies, audit staff files against Schedule 3 and prepare practices for inspection. Find out more about my CQC registration application support.
If you want an independent check of your practice, a dental CQC mock inspection can help you spot gaps before CQC does.
If you want your recruitment files and wider compliance evidence reviewed, see my CQC compliance support.
Sources
Want to talk it through? Book a free 15-minute call
Comments