The General Dental Council (GDC) has introduced some small but important changes to its fitness to practise processes. The changes aim to reduce the impacts on those subject to investigations, improve case progression, and make best use of limited resources in the absence of regulatory reform. It is now clear that full regulatory reform for the GDC is several years away following last week’s announcement by the Department of Health and Social Care (DHSC).

Fitness to practise can be a long and stressful experience for those involved. The latest improvements the GDC is making will reduce the impacts that long-standing or multiple investigations can have on those who are the subject to an investigation, and lead to improved performance.

The following changes have been made:

• The GDC will close cases that mirror an investigation being carried out by another authority, for example the NHS or Medicines and Healthcare products Regulatory Agency (MHRA) at the Registrar’s direction. Cases involving an ongoing police inquiry, interim order, or where there are other open fitness to practise investigations will not be closed.
• The GDC will not automatically open cases for matters referred from the NHS where the NHS is either investigating or managing the issues locally. Where there is a serious and immediate risk to public safety or confidence, the GDC will open an investigation (if, for example, the dental professional also practices privately) and, if appropriate, refer the matter to the Interim Orders Committee.
• The GDC is reviewing and closing some older cases, those where there is no realistic prospect of establishing that a dental professional’s fitness to practise is impaired, following review and approval of the Registrar.

John Cullinane, Executive Director, Fitness to Practise, said: “We are looking to reduce uncertainty where we can for those who are subject to a fitness to practise investigation, because we know it can be a long and stressful position to be in. We are constrained by our legislation, but there are small changes we can make that together with other changes we’ve made will progress improvements in our performance and reduce the impact on those involved.”

The GDC will be tracking the impact of these changes, and other improvements it has been making, through an updated set of key performance indicators and timeliness measures that provide a more detailed picture of case progression at each stage of the fitness to practise process.

Steps towards reform to the legislation that underpins the UK’s health and care professional regulators were taken this month, as the Department of Health and Social Care (DHSC) sets out the direction for future reforms. The General Dental Council (GDC) welcomes this important milestone but is extremely disappointed by the timetable.  

The Government first consulted on reforms to healthcare professional regulation back in 2017, and again in 2021 setting out proposals for a new consistent and modernised framework. The consultation outcomes released today recognise the need to update legislation that has not been significantly reformed for decades, but set out an approach which means the GDC will not see full reform of its legalisation for years to come.     

The GDC has long pushed for a flexible and modernised regulatory framework and is good to see that progress now being made, but the regulator is frustrated by the absence of any clear timetable for reform.  

Alongside the 2021 consultation results, the DHSC has today released proposals for regulations for the General Medical Council (GMC) that will apply to physician associates (PAs) and anaesthesia associates (AAs). These will be considered as a template for future reform for other regulators, including the GDC.  

The GDC urges stakeholders to review the outcomes to the 2021 consultation, and to consider the proposed framework for the two new associate titles to be regulated by the GMC. While it may be challenging to see how the proposal will apply to dentistry, close examination and views from stakeholders will help to shape future reform programme proposals for the GDC. 

In the absence of proposals for wider reforms, the GDC will be focused on changes to the international registration process and making performance improvements in fitness to practise, as set out in its Corporate Strategy 2023–2025.    

Stefan Czerniawski, GDC Executive Director, Strategy, said:  “We welcome the publication of the Government’s proposals for the next steps in regulatory reform. But we are extremely disappointed by the timetable set out by DHSC, as fundamental reform of our legislation still appears to be years away at best. The current legislative framework is a real barrier to efficient, effective and proportionate regulation and the need for reform is urgent.  

“We think the reform programme needs to go faster, in the interests of the public and patients, and of the dental professionals we regulate.” 

The General Dental Council (GDC) has launched a new consultation on Scope of Practice guidance dental professionals, workplaces and education providers.

The proposed changes aim to better support dental professionals to use their professional judgement in making decisions in the interest of their patients. The changes also aim to help professionals understand the boundaries of other roles within the dental team and to promote team-working so as to deliver the best possible patient care.

The proposals will not change the scope of practice of any of the dental professions. However, they will provide individual dental professionals with clear boundaries around their role while also enabling those who are trained, competent and indemnified to expand their personal scope of practice within those boundaries, safely and effectively.

The GDC states that it ‘continues to take steps to maintain and improve patient safety by moving dental regulation towards preventing harm rather than responding to the consequences of it’. A key part of this move is to foster a system that supports and encourages professionalism and decision-making that is centred on the best interests of patients.  

A review of the current guidance showed that it is no longer being used as originally intended and that it is being widely interpreted by the dental professions as a comprehensive, rather than indicative, list of tasks. This interpretation, the GDC has noted, can limit and restrict a professional’s practice and can impact patient care.

What became apparent, according to the GDC, during extensive stakeholder engagement was broad support for the guidance to be updated to make it less prescriptive and more adaptable.

The GDC encourages all interested and affected parties to share their feedback by 11 May when the consultation closes.

Stefan Czerniawski, GDC Executive Director, Strategy, said: “The GDC is pleased to be able to launch this consultation, which will better support dental professionals to use their professional judgement to make decisions in the interests and safety of patients. We have developed the updated Scope of Practice guidance after wide-ranging engagement with stakeholders and patients. We will continue this engagement during the consultation period, and we want to hear different views on the proposals. We think this is the right way forward and welcome suggestions for further improvement.”

More information is available on the GDC website: GDC launches consultation on Scope of Practice (gdc-uk.org)

Important changes have been made to the General Dental Council’s (GDC) legislation governing international routes to registration. 

The process for registering dental professionals who qualify outside the UK has been in need of modernisation for a long time. The reforms amend our legislation, replacing outdated and rigid rules governing the process for international registration. Those who qualify outside the UK represent a significant proportion of professionals on our register and make an important contribution to the provision of dental services.    

The updated legislation brings immediate changes affecting those who have been unable to sit the Overseas Registration Exam (ORE) due to the necessary suspension of the exam due to the pandemic, who will now have more time to sit the exam. The changes will also mean that only those who hold a relevant qualification as a dental care professional (DCP) can apply for registration as a DCP.  

The reforms provide the flexible framework and powers needed for the GDC to update and modernise processes for the registration of those who qualify outside of the UK. These will take some time to develop but provide an opportunity to create a new approach that meets the needs of applicants, the public and the sector. 

The GDC plans to consult on proposed ORE rules in the coming months.   

Stefan Czerniawski, GDC Executive Director, Strategy, said:  “This updated and more flexible legislation finally provides us with the framework we need to update our approach to international registration for those who qualify overseas and who meet our high standards for safe and effective care. It also aligns our overseas qualification requirements for dental care professionals with those for UK applicants. 

“The priority is to propose and consult on new rules for the ORE, because the current arrangements are not efficient or effective for the current number of applicants.   

“Removing the overly prescriptive constraints is an important first step to creating a more effective system. But the longer-term challenge will then be to develop new approaches which maintain the rigour of our standards while ensuring that there is sufficient capacity to meet demand.”

The General Dental Council (GDC) has today published its Corporate Strategy 2023-2025, setting out its priorities for the next three years.

The final strategy follows the GDC’s 2022 consultation on its plans, which saw three times the responses received on the regulator’s last strategy consultation. The feedback enhanced the GDC’s understanding of the current pressures on dental professionals and the difficulties people are facing in accessing NHS dental care.

While the GDC’s role in public protection remains unchanged, the plan recognises the need to modernise and for the regulator to improve its performance in certain areas, particularly international registration and fitness to practise.

The new strategy makes clear the GDC will continue to press for legislative reform, but also recognises that reform may not materialise, and will not resolve all existing issues. The plan, therefore, seeks to drive improvements within the regulator’s current legislative constraints while empowering the dental team to deliver safe and effective dental care, with high standards of professionalism.

GDC Chair, Lord Toby Harris, said: “We know dental professionals have been providing patient care under exceptionally difficult circumstances. This strategic plan describes how effective professional regulation can support the ongoing recovery of dental services from Covid-19 for the benefit of dental professionals, patients and the public. The plan also sets out our further steps to continue to move the balance of our effort towards prevention, an ambition we have been working towards since 2017. I’d like to thank everyone who took the time to consider our plans last year and respond to the consultation.”

The GDC’s corporate strategy does not set the level of the annual retention fee (ARF). Nevertheless, the activity described within the plan has a significant bearing on what dental professionals pay for their ongoing registration. In October last year, the GDC announced the ARF levels for 2023. Due to the ongoing inflationary pressures and economic volatility in the UK, the regulator made clear then that the fee levels may need to be reviewed again in 2023 and 2024. The GDC also committed, however, that any increase would be kept – at most – in line with the rate of inflation at the time, unless further exceptional circumstances arise.

The GDC’s Corporate Strategy is available to read in full on the GDC’s website.

One of the ways the General Dental Council (GDC) fulfils its primary purpose of maintaining public safety and confidence in dental professionals is through its quality assurance of education and training programmes which lead to registration as a dental professional. The GDC has today published its review of that quality assurance activity for the academic year 2021-2022 (August 2021 – July 2022).

Over this period, the GDC:

• granted approval to four new programmes (one dental hygiene, one dental therapy, two dental nursing)
• quality assured six dental care professional education providers and six awarding organisations through monitoring
• completed the targeted monitoring of 15 bachelor of dentistry and 15 dental hygiene and therapy programmes, which were the outcome of a temporary process introduced to focus on education requirements at greatest risk during the pandemic
• progressed work with the royal colleges’ specialty advisory committees to produce 13 updated specialist curricula, due for publication in March 2023
• appointed 57 education inspectors to provide expertise in delivering our quality assurance function.

GDC Head of Education and Quality Assurance, Gail Fleming, said: “The results of our education and quality assurance activity in this period highlight the high standard of education in dentistry. This has remained a challenging period for dental education and training, as the sector continues to recover from the effects of the pandemic. Those challenges required both our own team and education and training providers to be flexible while also remaining focused on meeting the required standards, and I’d like to express my thanks to everyone involved.”

The full Review of Education 2021-2022 is available on the GDC’s website.

Independent qualitative research, commissioned by the General Dental Council to understand and learn from the experiences of 70 individuals involved with fitness to practise, was published today. The research, which looked at historical cases dating from 2015 – 2021, found that although outcomes were seen as largely fair and effective, there were often significant negative impacts reported on the mental health and wellbeing of participants and, as a result, this could have unintended consequences for professional behaviour and practice.

The GDC’s primary purpose is patient safety and one of the ways it fulfils this is by investigating the concerns it receives about the practise, conduct, or health of dental professionals. Investigations are often complex and, as a result, can take a long time. By its nature, the process can be difficult.

Much of this process is set by outdated and rigid legislation and, although the government has made commitments to reform, there is little prospect of change to the legal framework taking effect for some years to come. In the absence of that reform, the GDC is continuing its work to make changes within its existing legislation, and to address some of the issues identified by this research.

GDC Executive Director, Fitness to Practise, John Cullinane, said: “We know that fitness to practise investigations can be stressful and that many take too long to resolve, with some becoming complex and adversarial. Much in this report reinforces our view on where improvements are needed, and its findings have confirmed our thinking on the best way to go about effecting that change.

“This work will be challenging, but improvements have already been made. For instance, by always encouraging local complaint resolution, we’ve seen a reduction of almost 1,200 concerns being brought to us in the six years to 2021. We increased the capacity in our casework team at the beginning of the year and are now starting to see the benefits of that change, and earlier this year we launched the Dental Professionals Hearings Service to highlight the independence of panels and hearings from the GDC.

“Only reform of our legislation can bring the kind of wholesale change which is so clearly needed. But, in its absence, if we are to continue improving fitness to practise, we must go on making repeated incremental changes to improve the process and experiences of those involved, and this is very much our plan.”

The full research report, and further information from John Cullinane, are available on the GDC’s website.