The Dentist Magazine.

GDC consultation launched

Published: 26/01/2017

The General Dental Council (GDC) has published plans for how its approach to regulating dental professionals will be reformed to put public safety firmly at its heart.

Proposals outlined today show how the GDC will focus on the prevention of harm. The GDC will make more active use of education and learning to support dental professionals throughout their career.

Patients will be supported to raise their concerns in the most effective way; better relationships will be built with partners and the regulator will be clearer to the public and professionals in what circumstances its enforcement powers will be used.

The changes are focused on securing patient protection, public confidence in dental services and a fairer regulatory system for professionals, which will be more agile, graduated and proportionate.  Making these changes work will require the dental profession, regulators, educators and the many organisations and individuals involved in the sector to play an active role.

Commenting on the proposals, William Moyes, chair of the General Dental Council, said, “Today’s plans present a significant shift in how we will regulate dental professionals in the future.

“At present, we deal with harm after things have gone wrong, investigating the resultant complaints and where necessary, applying sanctions.

“For the future, we want to give much more emphasis to preventing patients being harmed in the first place and ensuring lessons are learned from the cases that come to the GDC. This is better for patients and for dental professionals, and for the reputation of the entire dental team.”

Ian Brack, chief Executive of the GDC, said: “This is our most significant proposal in a generation and I encourage anyone involved with dental services, whether as a dental professional, employer, educator, policy maker, indemnifier, professional association or patient, to engage with our plans.

“We have made it clear from the outset that we cannot do this alone – the proposals require  fundamentally better collaboration with others than we have achieved in the past.

“I am confident that our proposals can make the system better for patients and fairer for dental professionals and strengthen public confidence in dental services.”

Broadly set out under four areas of work Shifting the balance: a better, fairer system of dental regulation will see the GDC:

  • Support and empower the profession through a range of education, learning and development activities such as embedding the ‘Standards for the dental team’, making sure students and trainees are equipped with the right skills from the beginning of their careers and making sure that those skills are maintained and improved through measures such as continuing professional development. The intention is for the regulatory system to help to reduce the likelihood of things from going wrong, rather than to respond to harm once it has taken place.
  • Support patients to feel confident their concerns are appropriately raised and resolved by the right body at the right time. Patients raise many issues, concerns, complaints and feedback about dental services with the GDC which fitness to practise (FtP) powers are not well suited to address. The GDC wants to see the ability of the sector to deal with complaints enhanced and strengthened so issues raised by patients are dealt with appropriately, which is very often in the first instance by the dental practice.
  • Continue its commitment to work better with partners to improve the regulation of dentistry in the UK. It wants to strengthen its relationships with systems regulators and the NHS in the four nations, as well as professional associations, indemnity providers and employers, including corporate providers of dental services. The GDC cannot bring about real improvement without the support of the profession and its partners.
  • Make it clear how and when it will use its formal FtP enforcement powers to manage serious risk to patients. Enforcement action is sometimes necessary, but the GDC’s aim is to use it when dental professionals put patients at serious risk or their actions damage public confidence in dental services. We have already widened the range of enforcement options available to us such as voluntary undertakings and anticipate accessing a range of tools across the regulatory system by better collaboration with other organisations and the profession. The proposals will be much clearer about when FtP powers are likely to offer the most appropriate solution and to help patients navigate the alternatives.

 

The GDC is seeking views on the proposals. The discussion document will be live for three months and closes on April 26, 2017. You can take part on the GDC website and join the conversation online using #shiftingthebalance

Reactions

The BDA has announced that it will canvass members’ views to inform its response to the General Dental Council’s (GDC’s) long awaited consultation on improving dental regulation, which was launched today.

The association will also scrutinise Shifting the balance: a better, fairer system of dental regulation to see if the GDC’s plans are likely to achieve regulation that’s better for patients and fairer for dental professionals, as the regulator purports.

The dentists’ body believes that the current model of regulation is outdated, cumbersome and inefficient, a view that has recently been acknowledged by Bill Moyes, the chair of the GDC.

Mick Armstrong, chair of the BDA, said, “The GDC seems to be making the right noises in advance of launching their much hyped plans to improve regulation but, as ever, the devil is in the detail.

“We will be poring over the GDC’s plans to reform dental regulation in the days and weeks ahead to see whether the proposals are actually fair and proportionate as we’ve been led to believe.

“We’ll be asking our members what they think of key planks in the document that will have a significant impact on their working lives, for good or ill, so watch this space.

“The GDC has of late been emphasising the importance of partnership working; we will be holding it to that promise in our response to the consultation.” 

The Dental Defence Union (DDU) has welcomed today’s announcement. Commenting on the publication, Leo Briggs, deputy head of the DDU, said, “There are too many complaints going to the GDC that fall outside its powers and should be made more appropriately elsewhere. Even if the GDC closes the complaint at an early stage as it doesn’t meet the fitness to practise procedure, it is often devastating for dentists and other dental professionals. We welcome the GDC’s commitment to work with other bodies, such as the DDU, to explore a number of different ways of solving the problem and stemming the flow of inappropriate complaints.

“As the regulator for dental professionals, the GDC should only be involved where there are concerns about a registrant that suggest there may be a serious risk to patients or others. 

“As the GDC acknowledges, most patient complaints can be addressed by the practice in the first instance and there is no need for them to be referred to the regulator. The DDU is committed to working with members to help them to achieve these sorts of outcomes.

“We also welcome the recent joint statement on dental complaints, on which the GDC collaborated with other regulators and organisations, which should help to ensure NHS and private patients get clear and consistent messages about what to do if they have a problem. We welcome any moves to consistently signpost patients to the practice as the first port of call for any complaint.

“We will be scrutinising these proposals on behalf of our members to ensure they have the desired effect of making the regulatory process more efficient, proportionate and fairer for all involved.”

Dental Protection has announced that it believes it is important that only the most serious issues are escalated to the GDC. It says clarification from the regulator as to which cases may be investigated by them will also be beneficial.

Raj Rattan, dental director at Dental Protection, said, The procedures the GDC have already put in place to deal with cases at a local level, when there is no realistic prospect or likelihood of a finding of current impairment, are a positive step forward. However, reducing the number of unnecessary fitness to practise hearings is also vital and something Dental Protection has consistently called for.

“The Shifting the Balance consultation positively demonstrates that the regulator is working towards this and wants to make it clearer how and when it will use its formal fitness to practise. This is welcome news.  

“Dental professionals often work in high pressure and difficult situations. On the rare occasions when treatment might not go as planned, it is important that lessons are learnt to prevent recurrence. However, as the GDC has identified, many of these issues could be resolved at a lower level.

“While safeguarding the public is vital, it is also important that dental professionals are not put through stressful and preventable inquiries by the regulator. A review of dental regulation is necessary and we welcome the opportunity to join the debate.”

UK wide dental defence organisation MDDUS believes patients and dentists will benefit if reform proposals from the General Dental Council are implemented swiftly, fairly and consistently.

Following the launch Chris Kenny, chief executive at MDDUS, said, “The current dental complaints system is outdated and cumbersome. The often unjustified threat of regulatory action can destroy careers and reputations and lessen public confidence. That serves neither patient nor dentist.

“So we welcome the ambitious and radical plan from the GDC to shift the priority to upstream prevention from downstream punishment, to refocus fitness to practise work and to make the complaints process more transparent, consistent, fair and responsive.

“We look forward to continuing to work with the GDC to develop momentum in implementation and to make sure that detailed processes and procedures match the scale of ambition”

Aubrey Craig, head of dental division at MDDUS, added, “We support all steps that will make the complaints and regulatory processes less stressful for dentists and reduce the number of unjustified final hearings.

“Early local action is key to defuse complaints. In our experience, patient complaints that are dealt with quickly and efficiently between the patient and the practice are far more likely to be resolved.

“Wider reform is needed to achieve this. So we welcome work on a profession wide complaints handling initiative that strengthens first tier complaint resolution and the steps being taken to improve efficiency, transparency and decision making in the fitness to practise process. We believe focus should only be on the most serious allegations, usually where there is an apparent immediate risk of harm to the patients.

“We will continue to work with the GDC to help them deliver a regulatory system that better serves patients and dentists. Their challenge now is to turn aspiration into credible and effective action.”