Audit

Practice Name
Auditor / Compliance Manager

Cluster Manager

PM Name

PM Assistant Name

Date of first visit
Date of update visit/next visit
Practice Appearance & Patient Journey

Disability access appropriate / free from blockages / pathway clear and even

Comments & Actions

Add media

Responsible

Date to be completed
Completed

NHS Charges posters clearly displayed and up to date

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Private fee scale clearly displayed

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Complaints procedure clearly displayed and up to date

Comments & Actions

Add media

Responsible

Date to be completed
Completed

NHS paperwork in use (FP17PR, FP17DC) and MH forms being updated rather than new for each patient

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Patient records available (duplicates not in use)

Comments & Actions

Add media

Responsible

Date to be completed
Completed
Staff

Uniform clean and presentable

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Name badges worn/identification of team role

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Emergency drugs checked daily along with AED before patients are seen (time/date and signatures -2 checks inc. one clinician)

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Check contents against list-all present /in date

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Oxygen cylinders full (gauge in green) checked daily before patients are seen

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Therapeutic/BVM masks available in adult/child sizes

Comments & Actions

Add media

Responsible

Date to be completed
Completed

DE Fib light green (Rescue Ready) or equivalent

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Pocket masks in each surgery and visible

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Training record of CPR with attendance list

Comments & Actions

Add media

Responsible

Date to be completed
Completed
Health & Safety - Radiation check

Signage

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Use of rectangular collimators

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Procedural checks - patient

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Panels seen during exposure

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Local rules and Risk Assessment

Comments & Actions

Add media

Responsible

Date to be completed
Completed
Health & Safety - Sharps Avoidance

Risk Assessment completed

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Use of re-sheathing device in absence of "safer sharp"

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Dentists managing sharps

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Occupational Health Advice notice clearly displayed

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Staff awareness of process

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Inoculation records seen

Comments & Actions

Add media

Responsible

Date to be completed
Completed
Fire Safety

Fire exits clear

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Fire doors unlocked

Comments & Actions

Add media

Responsible

Date to be completed
Completed
Practice Audits

IPS tool completed within last 6/12 (PM)

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Radiation audits seen at least 12/12 (Dentists)

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Record keeping audit in last 6/12 (PM)

Comments & Actions

Add media

Responsible

Date to be completed
Completed

DBOH audit by dentist within 12/12 and evidence of adoption of DBOH3 in practice

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Referral audit by PM within 6/12 (PM)

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Prescription audit by PM within 6/12 (PM)

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Recalls interval audit within 6/12 (Dentist)

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Waiting times audit 6/12 (PM)

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Missing Signage/ Certificates/ Leaflets

Cross Infection & Decontamination

Decon log books completed appropriately

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Observation of procedure

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Staff awareness of process

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Clinical waste appropriately stored

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Sharps disposal appropriate (container/contents/position)

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Special waste, appropriate use of containers and storage

Comments & Actions

Add media

Responsible

Date to be completed
Completed
Clinical Records checked against FGDP (UK) Gold Standard

Radiographs in line with FGDP (UK) guidelines

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Treatment planning and delivery meeting including choices

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Private treatment

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Claiming pattern

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Complaints

Comments & Actions

Add media

Responsible

Date to be completed
Completed

Communication

Comments & Actions

Add media

Responsible

Date to be completed
Completed
Summary

I fully understand the audit as completed the auditor.

Practice Manager / Asst Practice Manager
Auditor
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.