Tom reflected on his first 100 days as chief executive, discussing the GDC’s ambitions for 2025, including updates to Fitness to Practise (FtP) processes.
Tom’s speech
“It was five months last week since I took on this role – which is a little over 100 working days. Slightly over the 90 days the textbook gives you! Time has flown by, and I’m delighted to be here with you today.
My first day was June 3, 2024, and it has been a steep learning curve. But a good one.
When I had the opportunity to speak to you in week two, I talked about being outside in. Looking at ourselves from the point of view of the sector we regulate. Working in partnership. Recognising that in public leadership we have many common goals, that respectful of our different roles we must work together on the most pressing issues.
We have discussed two of those most pressing issues at the last meeting and this – wellbeing last time and workforce this time. That we will agree on far more than we disagree on. I want to be someone you can work with.
So, with those aims it has been a priority to get to know you, and the many people in the dental sector who we work with.
Thank you to all of you who have been so welcoming, for letting me join your events and discussions – to talk about my thoughts, and priorities, to hear your advice and feedback, and to hear about your work.
In some cases, you’ve let me visit you where you work too, that has been an opportunity for me to get to know our sector and for the GDC to learn too. It’s part of looking outside in.
It is important to me to connect with the profession we regulate. To talk about our role and how we work. To hear about how we can be better. And to understand where there are challenges in dentistry, in oral health – and how we alone or, more commonly together, can tackle them.
I’ve been doing a lot of visiting and listening in the GDC too – I’ve met every team. Every month I listen to the calls coming into our call centre.
And last week we gathered our teams together to talk about our purpose and role. Because it’s important to everyone at the GDC that we have one shared purpose, one strategy and a clear set of priorities in our plans for the year ahead.
I wanted to share some observations on what I have learned so far:
Firstly, it is clear to me that we need to be outwardly facing. Dentistry is a sector facing many challenges – it is not alone in that respect. We have a role to play in addressing those challenges that is sometimes just us, or more often in partnership with others. We may need to get others together to help. We run the exams that bring in overseas dentists. We have just restructured the routes for specialist list assessed applications. We have just for the first time gathered data on working patterns for dentists and dental care professionals – we have still got to work with, and in collaboration with the professions, to understand what that data is telling us and for it to inform what needs to be done.
My first visit was to a large dental lab – and I know many remain concerned about the dental technician workforce, education and training. It can only be resolved in partnership – many of us in this room.
Secondly, we have got to address the challenges arising from FtP. We have already made some important changes, all achievable within current legislation. We are getting quicker. We have done some excellent work on the quality of our decision making. We have run a very successful pilot on initial inquiries to speed up the assessment of mainly single patient clinical cases – which we have now adopted as a permanent move. But we need to do more on the impact of FtP and how we support the wellbeing of those involved. And we need to reduce the fear of us. Often on visits we have done, professionals have been afraid that the GDC are coming. But when we leave, they have (I hope) been left with a different impression. Fear and high standards can be closely related, but the balance has got to be right and the impact on public protection and the confidence of the public in the profession has got to be positive.
I have also heard that the GDC identifying learning from FtP– sharing it with the profession to make the profession stronger would be well received.
And thirdly – we need to look at what it is like to deal with us, our language, our processes and our use of technology. I am yet to meet someone who thinks we make the best use of digital.
The GDC’s priorities for 2025
Looking ahead to the GDC’s priorities for 2025, the theme of today is the dental workforce – asking the provocative question ‘How many dental professionals are enough?’.
I want to talk about some of our priorities for 2025 in relation to workforce – and when I started to put this together, it occurred to me that almost everything we do is for the benefit of the workforce – either the dental professions or the GDC’s workforce – but both are for the purpose of public protection and a profession the public can be confident in.
Working pattern data tells us about the workforce
We have wanted to play our part in supporting the sector to better understand the workforce challenges and illuminate the public debate on the dental workforce. We now know more about the working patterns of dental professionals than ever before. We want to work with you to encourage even more dental professionals to provide their data, so that picture continues to build.
The impact of FtP on the workforce
The impact on the health and wellbeing of dental professionals during what we know can be a difficult and stressful process is of deep concern to us.
For several years, we have commissioned and undertaken research because we knew there were issues with FtP which we needed to understand better so that we could address them more effectively.
Dental professionals who had participated in investigations or hearings perceived the outcome to be fair, but they also told us that the process itself had negatively impacted their health, wellbeing, behaviour and practice.
However, we also know that the ‘fear’ of regulation, driven specifically by experiences and perceptions of FtP, impacts on registrants’ decision making and practice, in a way that we are told contributes to what is known as defensive practice.
We are committed to making improvements, but delivering all the changes is likely to take some time.
We are prioritising work to ensure that dental professionals are supported appropriately during the process, and that the process is fair and proportionate to the issues raised.
- In 2025, we expect to make considerable progress towards being able to meet our PSA standard for FtP, improving processing time through all stages.
- There will be a major focus alongside this work for how we can reduce the impact on the mental health and wellbeing of registrants who find themselves within a FtP process. This includes reviewing our case management processes.
- We will improve practical support for registrants, informants and witnesses, through hearing support coordinators and considering other external support.
- We do not expect major legislative change to happen quickly and so we must look again at what further changes we can make within the current legislation.
We have announced that we are making a permanent change to how we assess single instance clinical practice concerns.
We have piloted a new process where our clinical dental advisers make an early request for the patient records and give their opinion, as dental professionals, about the seriousness of the concern.
One of our casework managers then reviews the case, and if the treatment is of an appropriate standard, can close it with no further action. These assessments are taking an average of 12 weeks rather than 30 weeks.
International registration
Our registration teams have achieved a remarkable thing in the past 18 months – reducing a backlog of 5,700 overseas registration applications to less than 400, which we expect to clear by mid-2025.
But demand for dentists particularly to register from overseas continues to grow.
On top of the additional capacity we have already put in place for our Overseas Registration Exam (ORE), we must complete the procurement of new contracts to run the ORE – and get them up and running with more exam spaces as quickly as possible.
We have many people who are wanting to register and a large number of people who have already registered, so these new contracts are a crucial step.
Standards impact professional practice
The GDC has an essential role in setting standards - for the whole dental team and for education providers. This is what keeps patients safe. We have an ongoing programme on reviewing and updating our standards and guidance and the next one on the list is the standards for education, which we use as the basis for assessing the effectiveness of education providers and training organisations. We’re consulting on proposed new standards very soon. And then we’ll be implementing them.
We’re also supporting the final implementation of the Safe Practitioner Framework.
And all that alongside continuing to update standards for the dental team such as scope of practice, as well as developing proposals for new principles of professionalism to support professionals in delivering patient care in line with professional standards.
Being more user-centred
Our plans for next year also contain several discovery projects, where we’ll look into an area we want to improve, learn more about what would be involved and come up with a plan or roadmap for how we’ll do it.
These discovery projects are aimed at helping us to get better at what we already do, through things such as improving online services, making better use of data, and understanding the IT that we need to be effective.
Over time, these initiatives will improve the experience for dental professionals accessing online services, such as registration and renewal, and also the data that will help to increase transparency and build trust.
Our own modernisation is vital. We will look at our services and how well they work for all our users. I am yet to meet a person who believes that we make best use of digital. So we will focus on digital. We will deliver a new online registration process that is less reliant on paper and we will start a broader programme to digitalise more of what we do.
Our corporate strategy for 2026 to 2028
One of our biggest priorities for 2025 will be to develop our corporate strategy from January 2026 to the end of 2028. Work has already started, and I’m looking forward to sharing proposals with you in April 2025.
The GDC’s workforce matters too
It’s important that we continue to make the GDC a great place to work, for everyone, by focusing on our own people and our own culture. That will benefit the people in the GDC who share your passion for patient safety, and it will benefit you, because we’ll be more resilient, purposeful and transparent. Much of what we’re doing here is internally facing, but I’m sure it will resonate with those of you who are employers or employees.
We are starting to embed new values – to guide our staff and also what we should be like to work with.
These are to be transparent, respectful, inclusive and purposeful.
We will further improve how we attract and retain the best talent and develop our people.
My personal priorities
I am thinking a lot about what good regulation means. In my previous roles in a local authority and police conduct, I learnt that the most complex problems are tackled when leaders come together and recognise their shared aims.
I believe that a good regulator acts when they need to – but they work to make the profession stronger too – with a stronger profession the public are better protected, and they can be more confident. And a good regulator cannot do that on their own and without working in collaboration with the profession they regulate.
I will continue to listen and build relationships – through meetings, events and visits to dental settings. This wasn’t just for when I first joined. It’s who I am and how I want to work with you.
Finally, I want to be someone who you feel you can work with. Coming out of events like today, what are our shared challenges? How can we work together to tackle them? What will we as leaders do?
Thank you.”