A dentist called me recently and asked, 'What makes a good practice?' I was lost for words. I found myself reciting my enthusiastic sales patter about the BDA Good Practice Scheme, how the Scheme recognises good practice and how it is a team commitment to working to the standards laid down by our own professional association, but all the while I knew that this was not the question the caller had asked me.

The dentist wanted to arrange some team training; she was looking for a speaker for a meeting, who would presumably provide the Holy Grail, the secret of how to become a good practice. Was I the speaker with the answers? As the BDA Good Practice Scheme manager I was not sure.

The BDA Good Practice Scheme

The BDA's Good Practice Scheme can help facilitate good practice, but it's the team's desire to develop that makes the difference, says BDA Good Practice Manager ANNE BENDER

The Good Practice Scheme recognises 'good practice' and is a way that practices can communicate to professionals and patients that a practice is committed to working to the standards set by the profession's own national association.

Within the Scheme there are 96 standards, which relate to every aspect of running a dental practice. The self assessment audit that practices commit too takes the team on a journey by establishing consistent working relationships through employment contracts and detailed job descriptions, to ensuring that patients have accurate information about the services on offer at the practice, through to the systems and protocols needed to satisfy current health and safety requirements. A final section looking at training and personal development for all members of the dental team completes the Scheme audit.

Validation for membership of the Scheme

When a dental team is sure that they satisfy the standards detailed in the Good Practice Scheme the practice applies for membership. The application process is such that if a practice has worked through the Scheme thoroughly then an application should not fail. In order to validate a member practice the BDA randomly selects ten pieces of evidence from the Scheme audit to be supplied within seven days. The evidence is examined to see if it meets with the Scheme requirements and if it meets the standard then the practice is approved. Member practices receive a plaque for display in the waiting room as well as exclusive use of the Good Practice Scheme logo. All 'good practices' are named in the January edition of BDA News.

The Scheme is two years old in October 2003 and already has nearly 300 member practices with a further 1,000 working towards recognition. As the manager of the Scheme I spend my working days encouraging dental teams through the Scheme audit; perhaps these practices have the answer to what makes a practice special, what makes it shine, to the question of what is a good practice?

Lewes tides

North Street Dental Practice in Lewes East Sussex achieved recognition on the Good Practice Scheme in March 2003. This practice had been rebuilt having risen from the silt of a series of extraordinarily high spring tides the previous winter. The team of six dentists and twelve PCDs had pulled together, relocated and reinvented a new and improved North Street Dental Practice.

North Street (pictured top right) is a mixed private and NHS expense sharing partnership and Sue advised me the team wanted to be part of the Scheme to “assure patients that they are doing all that is possible to give the best possible service” The additional benefit is that the Scheme ensured that the practice was meeting all its clinical governance requirements.

A tool for clinical governance

The 10 commitments at the heart of the Scheme (right) mirror the clinical governance requirements that form part of the GDS terms of service. The regulations say that every principal dentist must have:

  • A quality assurance system in their practice with a named person who is responsible for operating the system.

  • A written practice quality policy displayed in the practice

The 10 commitments at the heart of the Scheme mirror the clinical governance requirements that form part of the GDS terms of service.

An annual report on the quality assurance system to the health authority.

Quality management and clinical governance can appear a challenge for even the most progressive dental team but the benefits of establishing reliable systems in a practice are worthy of the investment. Put quite simply, quality management, clinical governance or good practice really just translates into 'everyone knowing what is supposed to happen and making sure it does.' In this context 'everyone' means the trinity of dentists, PCDs and patients. Establishing clearly defined practice systems where 'everyone' is working to a common goal creates good working relationships and reduces the risk of accidents and misunderstandings.

Clinical governance allows teams to be reflective about their work and creates an environment where practices can evolve and develop, setting themselves higher and higher goals. Quality assurance emerges out of clinical governance systems, as practices are able to demonstrate their commitment to assuring consistency in their care of patients.

The Good Practice Scheme is a good tool for assuring consistency and meeting clinical governance requirements.

North Street used the Scheme as a tool for rebuilding the practice and to introduce quality assurance into its systems. The scheme provided the structure that the practice needed to rebuild and develop. There is a definite sense at North Street that the practice team and not just the dentist have achieved recognition as a Good Practice.

Jeremy Peak from the Crescent Specialist Dental Centre in Plymouth (pictured top left) also found the Good Practice Scheme 'an excellent basis for clinical governance... and being one of the first practices to achieve the standard generated some excellent PR.'

The more I talk to practices the more I realise that perhaps a 'good' practice is one that encourages and facilitates a team's desire to develop and to shine. Becoming part of the Good Practice Scheme can help do this because it recognises good practice.

It can not create it.