Clinical governance

Two registered locations, fourteen clinicians, and a regulator that can inspect without warning

3 items need attention

An aesthetics clinic bolted onto a dental practice inherits two regulatory worlds at once. The dentistry is inspected and the clinicians are registered. The facial aesthetics side turns on who prescribed the product, whether that prescriber saw the patient, and whether the practitioner is working inside their competence. Those are different questions with different answers, and one spreadsheet covering both is how a practice ends up unable to answer either.

Needs attention

1 lapsed

Clinicians registered

14 of 14

Checked weekly against the register

Audits due this quarter

2 not started

Complaints, 12 months

5 closed · 1 open, 9 days

Clinician register

Registration, indemnity, training and continuing development — the four that stop somebody working. Registration is checked against the public register weekly, not read off a certificate

Clinician	Role	Registration	Indemnity	CPD	Medical emergencies	Standing
Dr Aruna Mehta	Principal dentist	To 31 Jul 27	To 1 Apr 27	28 of 30 h	14 Feb 26	Clear
Dr Marcus Vane	Implants & cosmetic	To 31 Jul 27	To 12 Sep 26	31 of 30 h	14 Feb 26	Indemnity 18 d
Dr Callum Reith	Associate	To 31 Jul 27	To 3 Mar 27	11 of 30 h	Aug 25 — lapsed	Cannot treat
Dr Priya Sandhu	Associate	To 31 Jul 27	To 19 Nov 26	22 of 30 h	14 Feb 26	Clear
Ffion Llewellyn	Hygienist–therapist	To 31 Jul 27	To 8 Jun 27	19 of 30 h	14 Feb 26	Clear
Rosa Bellini	Aesthetic nurse prescriber	To 30 Apr 27	To 22 Jan 27	26 of 35 h	14 Feb 26	Clear

Showing 6 of 14.

Dr Reith's medical emergencies training lapsed in August and he has treated patients on eleven days since. It is annual, mandatory, and the first thing an inspector asks for. Nobody knew, because the certificate is a PDF in a shared folder and the date was in nobody's diary — which is the same failure this practice has with treatment plans, wearing a different hat.

Practice obligations

Both registered locations

Obligation	Applies to	Last done	Next due	Days	Owner	Status
Regulator registration	Both locations	4 Apr 2026	4 Apr 2027	222	D. Achara	Current
Radiography — equipment test	4 units	18 Mar 2026	18 Mar 2027	205	D. Achara	Current
Radiography — image quality audit	Both locations	2 Sep 2025	2 Sep 2026	8	Dr Mehta	Not started
Decontamination audit	Both locations	14 May 2026	14 Nov 2026	81	D. Achara	Current
Infection control audit	Both locations	14 May 2026	14 Nov 2026	81	D. Achara	Current
Emergency drugs & equipment	Both locations	1 Aug 2026	1 Sep 2026	7	F. Llewellyn	Monthly
Record-keeping audit	Sample of 20	11 Feb 2026	11 Aug 2026	−14	Dr Mehta	Overdue
Legionella risk assessment	Both locations	7 Jan 2026	7 Jan 2028	500	D. Achara	Current

Two audits are owned by the principal dentist, who is in a surgery forty hours a week. Both are the overdue ones. That is a scheduling problem, not a diligence problem.

Complication protocol

The one route into the practice that is never allowed to queue

Trigger	Route	Goes to	Target
Pain, blanching or colour change after filler	Portal, SMS or phone	Clinical lead, then on-call	Immediate
Vision change after any facial injection	Any route	Clinical lead, then on-call	Immediate
Swelling or infection after a dental procedure	Portal or phone	Treating clinician	Same day
Anything else, within 14 days of aesthetics	Portal	Treating clinician	Same day

A patient describing pain and a colour change after dermal filler is a time-critical event, and the practice has one route where that message could sit in a shared inbox until Monday. This is the rule that takes it out of the queue: the message is classified on the way in, the clinical lead is paged, and the log exists whether or not it turned out to be anything.

Aesthetics governance

Different questions from the dentistry, asked of every single treatment

Requirement	Applies	Treatments checked	Compliant	Status
Prescriber saw the patient	Prescription-only products	412	412	100%
Prescription on file, in date	Every POM treatment	412	408	4 missing
Written consent, treatment-specific	All treatments	1,184	1,171	13 missing
Cooling-off period offered	First-time patients	284	284	100%
Practitioner within competence	All treatments	1,184	1,184	100%
Before-and-after photographs	All treatments	1,184	1,042	142 missing
Adverse event log	Ongoing	7	7	All recorded
Complication protocol acknowledged	All patients	1,184	1,184	100%

Four treatments have no prescription on file. Those four are the ones that matter — everything else on this list is tidy by comparison.

Photographs are the weak point

Treatments without before-and-after142

Of which had a complication2

Complaints where photos were requested3

Photos available for those 31 of 3

Photographs are boring right up until somebody complains. Two of the three complaints involving aesthetics last year turned on what the patient looked like beforehand, and in two of them Bramfield could not produce it. The treatment cannot be marked complete without them.

Open complaint

Received
16 Aug 2026 · in writing · dermal filler asymmetry
Acknowledged
18 Aug · within the practice's 3-day standard
Clinical review
Due 30 Aug · before-and-after photographs available
Written response
Due 6 Sep · 21 days from receipt
Indemnity notified
Not yet required

Every complaint has a clock on it and a deadline that is the practice's own published standard. Missing your own standard is worse than not having one.