Insights from Our Inspections: Key Themes in Dental Practices

While our inspections show that most dental practices manage clinical care well, there are recurring issues in non-clinical areas that require attention. These areas, though sometimes overlooked, are essential to maintaining patient safety and ensuring regulatory compliance and delivering a positive patient experience.

Our inspections have revealed several recurring themes, and we ask dental practices to reflect on these issues and consider how they might apply this learning to their own services.

Inadequate Recruitment and Safeguarding Checks

A number of practices fail to carry out or record essential pre-employment checks. This includes missing reference checks, gaps in verifying employment history, and failure to conduct Disclosure and Barring Service (DBS) checks. Robust safeguarding measures must be in place to ensure that all staff are appropriately vetted and fit to work in dental practices.

Poor Oversight of Mandatory Training

Some practice managers often lack robust systems to monitor staff compliance with mandatory training. In some cases, training records are incomplete or outdated, posing risks to patient safety and staff competence. Practices should implement reliable tracking systems to ensure all staff maintain up-to-date training in key areas such as infection control, safeguarding, and radiography and radiation protection.

Generic Policies and Procedures

We frequently find that practices use generic policies that are not tailored to their specific services. This can lead to confusion among staff and inconsistent application of procedures. Policies should be relevant, regularly reviewed, and reflect the unique context of each practice.

Inaccessible Patient Information

Patient information is not always offered in alternative formats such as large print, Welsh language, or easy-read versions. This limits accessibility and fails to meet the needs of all patients, particularly those with additional communication requirements. Practices must ensure that information is inclusive and accessible to all.

Poor Document Control

We often see a lack of version control in policies and procedures. Without clear tracking of updates, staff may unknowingly follow outdated guidance, which can compromise safety, consistency, and compliance. Practices should implement systems to ensure all documents are regularly reviewed, updated, and clearly marked with version history to support effective governance.

Lack of Active Offer and Language Needs

Many practices overlook the “Active Offer” principle—providing services in Welsh without patients needing to ask. To deliver inclusive care, practices should routinely offer Welsh-language services and ensure patient information is available in Welsh.

We have also found several instances where the language preference of patients has not been asked and recorded within patient records. Embedding this into everyday processes helps ensure patients receive care in a format and language that meets their needs.

HIW will take enforcement action where we find that standards are not being met to protect patients and maintain the quality and safety of care. Unfortunately, since our previous Learning and Insight dental update issued in 2022, we have issued 25 non-compliance notices to practices requiring immediate improvements. In one serious case, HIW cancelled the registration of a dental practice, and it is no longer operating. This demonstrates our ongoing commitment to taking decisive action where necessary to protect patients and uphold the quality of care.

Private Dental Practices: Registration Reminder with HIW

Healthcare Inspectorate Wales (HIW) recently reminded private dental practices in Wales that they must be registered with HIW if they intend to:

• Use Class 3B or Class 4 lasers or Intense Pulsed Light (IPL) devices for treatment.
• Undertake conscious sedation procedures.

Those dental practices providing such services must submit an application form and supporting documentation to ensure HIW registration certificates accurately reflect the services provided. Further information can be found in our recent article. Alternatively, please email HIW.Registration@gov.wales if you require any further guidance.

Additional Information Requirements for HIW-Registered Private Dental Practices