While this is a notion many would welcome, its success relies on big changes being made across the healthcare system as the GDC admit “there are limited processes in place to reroute these matters to a more appropriate body.”
Building partnerships and education The success of the regulator’s vision relies on improving links with major UK partners like the NHS, professional associations and systems regulators. The GDC hopes these partners will help “embed standards within practice” and “increase our intelligence picture”, for example by sharing data showing which standards commonly cause dentists difficulty. The GDC hope to develop methods to link standards to performance management and appraisal. Partner organisations would also hopefully facilitate local complaints resolution, thus lightening the GDC’s workload. Improved education is also an important part of the GDC’s future vision, including plans for more meaningful CPD. Research they commissioned in 2011 found “there was very little evidence to suggest that current models of CPD have an impact on the quality of care delivered, performance or competence”. An enhanced CPD (ECPD) model aims to encourage professionals to
“take a cyclical approach to their CPD, involving planning, undertaking and reflection, using a personal development plan”, all within the same five-year cycle. Under this scheme non-verifiable CPD would be removed and the number of required hours would be cut to 100 for dentists and 75 for most dental care professionals. The GDC is keen to encourage “professional ownership” of CPD, with
their role being a supportive one, “providing data, intelligence and information to assist professionals in determining their development needs.” Implementation is not expected before January 2018. This “professional ownership” idea has broad support amongst the
profession according to the May 2017 Shifting the balance response document, but with some concerns over practicalities for independent practitioners and dental nurses. Similar support was also reported for the suggestion of peer review processes and interactive CPD which would see greater collaboration amongst registrants.
Fitness to practise Improving the fitness to practise process is a priority for many dentists, as reflected in a recent British Dental Association survey which found 71 per cent of respondents wanted the process to be made “fit for purpose”. The way the GDC manage their processes has undergone what they
describe as “transformational improvements” in recent years, but they admit they are still tied by “some legal constraints”. One improvement measure was the introduction of case examiners in
November 2016. They have the power to agree undertakings with practitioners with the aim of reducing the number of cases that proceed to investigation. It is too early to say whether the promised £2 million annual savings will be achieved. The response report also highlights strong support for an effective
self-triage mechanism to help filter complaints submitted via their website, as well as improved education for the public about the regulator’s role. Shifting the balance states: “Patients raise many issues, concerns, complaints and feedback about dental services for which our fitness to practise powers are not well suited. We need, working with the profession and partners, to develop ways of ensuring that these concerns can be appropriately raised and resolved, by the right body, at the right time and at the right cost.” The GDC also hope to refocus their processes by tightening up their
definition of “serious misconduct” and linking impaired fitness to practise more closely to patient risk and public confidence in dental services. They also plan to carry out an “end-to-end review of the fitness to practise process”.
Potential benefits In addition to financial savings and an increased focus on safety, it is hoped the GDC’s plan could reduce practitioners’ stress levels. Indeed, MDDUS CEO Chris Kenny believes fitness to practise reform
plays a vital role in this. In a statement following the launch of Shifting the balance, he welcomed the “ambitious and radical plan” and urged the GDC to implement it swiftly, fairly and consistently. He said: “The often unjustified threat of regulatory action can destroy careers and reputations and lessen public confidence. That serves neither patient nor dentist. We support all steps that will make the complaints and regulatory processes less stressful for dentists and reduce the number of unjustified final hearings.” The potential benefits of the GDC’s plan are many and it can only be
hoped they find enough support to deliver a regulatory system that better serves dentists and patients alike.
Joanne Curran is an associate editor of SoundBite
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