Clinical Audit (Quality Improvement) Activity Update – October 2017

As you will have noted in the recent circular (NHS: PCA(D)(2017)4 – Amendment No. 135 to the Statement of Dental Remuneration) sent to you by your Health Board, with effect from the 26th October 2017, within the SDR and within the regulations, the term “Clinical Audit Activity” is being replaced by “Quality Improvement Activity”. Scottish Government intend to issue further information about this change in due course. However, in the meantime, they have given me permission to write to you, to advise you of immediate actions you must take in relation to current clinical audit activity projects.

Draft projects

If you have started any applications for Audit, eSEA or Peer Review projects and have not yet submitted these to NES for review and approval, you MUST complete the application process and submit these by 11:59pm on the 25th October. N.B. All projects with a status of ‘draft’ will be automatically marked incomplete after this deadline and will no longer be accessible. You can check the status of your projects in the ‘Your Audits’ section of Portal. You can also delete any duplicate projects or projects you no longer plan to undertake in this section.

Current ‘live’ projects

All projects submitted by the deadline above, will be reviewed and if approved, can continue to be undertaken under the existing regulations. Final reports and supporting documentation for these must be submitted by the end date of these projects, which is stated in each standard confirmation email, sent when the project is approved. The existing system will remain live until such time as all projects approved on or before the 25th October have been concluded.

National Audit Projects

Due to limited notice given to NES of the changes and the need to create a new system to allow the submission of quality improvement activity projects, it will not be possible to join national projects after the 25th October, until around early January. We will send a further update when the development work has been completed and when it is once again possible to join national projects.

If you wish to join any of the three existing national projects, i.e.:
• An Audit of Radiological Compliance
• Single round maintenance audit – Radiographic Quality Assurance
• An Audit of Record Keeping Including Medical Histories

you should do so, on or before the 25th October. Please ensure you complete all three stages of the joining process and that you press the ‘submit’ button. If you do not receive an email confirming approval and stating the end date for the project, you have not completed the joining process.

New Application Process for QI Activity Projects

From the 26th October, a “Getting Started” guidance document will be available in the NES Portal at iBooklet/Dental QI Projects/Guidance.

This will be your guide to how the new system and processes will work and I would strongly recommend that you download and read this, before attempting to submit any new projects, or in time, to join any national audit projects. The new process is very similar to what you will be familiar with if you have submitted an eSEA project and has been designed to be more generic and to make it easier for you to access a broader range of QI Activities.

Enhanced Significant Event Analysis (eSEA) projects

As you will recall, at the start of April 2017, we moved to a new way of reporting and learning from Significant Events – enhanced SEA projects. The enhanced SEA process has a different focus. Using this approach will help individual dentists and their teams to openly, honestly and objectively analyse events. It helps to ‘de-personalise’ the incident and consider systems-based reasons why the significant event happened. In this way, a more constructive approach to learning can take place and more meaningful improvement can be implemented to minimise the risks of the event happening again. This involves considering ‘Human Factors’ related to the event with a focus on avoiding blame.

For more information on enhanced SEA and Human Factors, see:

A review of the eSEAs submitted since April has found that in a large proportion of the projects, the analysis and the action planning is quite limited, and there has been too little consideration of the human factors. As a result, the reviewers do not feel that these projects can be awarded the higher number of hours that are possible, with many being awarded two or three hours for the Lead dentist and zero or one hour for other participants. Undertaking the short eLearning programme, and reading the background material, as well as spending the time on the analysis and action planning stages, can lead to the awarding of the higher hours, as already given to some projects.

If you have any queries about the content of this update, please email:
Tony Anderson
Director of Postgraduate GDP Education
National Lead for the CPD Workstream
(CPD, Clinical Audit, TRaMS, RTW, Mandatory Training)