GDC Update: March 2023

View from the GDC Chair 

Our Chair takes a look at what the recent announcements on reform mean for the GDC, and encourages the dental team to review and respond to our proposals to improve guidance on scope of practise for the dental team, in his March blog post. 

Scope of Practice consultation launched: have your say

We’ve launched a consultation seeking views on proposed updates to the Scope of Practice guidance. Our proposals aim to provide dental professionals with clear boundaries around their role while also enabling those who are trained, competent, and indemnified to safely expand their scope of practice within those boundaries.  

The proposals are based on a recent review of the guidance, which included independent research and extensive engagement with dental professionals and stakeholders. Our proposed updates look to move the guidance away from providing a list of tasks that can be undertaken by each professional group, and instead provide criteria for decision making to support and guide professional judgement.

Please share your views by 11 May 2023.  

Legislative reforms for international registration  

Changes to legislation affecting international registration will come into effect on 8 March. The new flexible framework replaces outdated and overly prescriptive regulations that have prevented us from improving our processes or increasing capacity.

The changes have some immediate effects for those who have been unable to sit Part 2 of our Overseas Registration Exam (ORE), because their time limit expired while it was suspended due to the pandemic. They will now have more time to sit the ORE. The changes also mean that only those with a relevant dental care professional (DCP) qualification will be able to apply to register as a DCP, aligning overseas qualification requirements with those for UK applicants. The standards we apply for registration have not changed.

The reforms provide the flexible framework and powers needed to update and modernise our processes for the registration of those who qualify outside the UK. Our proposals for new rules for the ORE will be prioritised so we can scale up capacity to meet demand.

We will be consulting on proposed new rules for the ORE in the coming months.

Regulatory reform: consultation outcome and GMC reform proposals

While reform of international registration took a step forward last week, wholesale reform of GDC legislation now appears even further away. Last week, the Department of Health and Social Care (DHSC) published the results of its 2021 consultation, Regulating healthcare professionals, protecting the public.

The DHSC is now consulting on proposed regulations for the General Medical Council (GMC) that will apply to two new roles, physician associates and anaesthesia associates. These proposals are the template for future reform, including proposals that will eventually affect the dental team. Therefore, we encourage anyone with an interest in professional regulation to consider how the proposals may be applied and respond. 

Wider reforms for the GMC and proposals for the Nursing and Midwifery Council and the Health and Care Professions Council are being prioritised by DHSC. It means that wider reform of GDC legislation is several years away, at best. We continue to press for the timetable for reform to be accelerated, and in the meantime, we will be focused on updating our international registration processes.

You need to respond to the DHSC consultation by 16 May.

Specialist List Assessed Application process update

Since the Specialist List Assessed Application (SLAA) process was paused in the Spring of 2022, we have been working with the deans of the Royal Colleges to better understand the issues which have resulted in delays and a backlog in applications.

Stefan Czerniawski, Executive Director, Strategy, explains the steps we’re taking, and how we’re collaborating to restart the assessment of specialist list applications.

Making further improvements to our fitness to practise processes 

We’ve been making further changes to improve our fitness to practise processes where we can, in the absence of regulatory reform. The latest changes will help to reduce the uncertainty and stress that long-standing or multiple investigations can have on those who are the subject of an investigation. Overall these changes look to minimise the impact of investigations and make the most of our limited resources, while retaining the integrity of a process that protects patients and maintains public confidence.

With the approval of the Registrar, we are now closing cases that mirror an investigation by another authority (with exceptions for seriousness or repetition), and reviewing and closing older cases where there is no realistic prospect of establishing that fitness to practise is impaired. We will also no longer automatically open cases for matters referred to us from the NHS, where it is either investigating or managing the issues locally (with exceptions for cases that may pose serious and immediate risks to public safety or confidence).

We will be tracking the impact of these changes, and other improvements we have been making, through an updated set of key performance indicators and timeliness measures which more accurately reflect the composition of our caseload.

Our Executive Director, Fitness to Practise, John Cullinane, explains the latest changes to our fitness to practise processes.

Employment status guidance for associate dentists to be withdrawn

HM Revenue and Customs (HMRC) will be removing specific occupational guidance for associate dentists from the Employment Status Manual (ESM4030) from 6 April 2023. There are now just two months to go before the update.

There has been no change in the rules. The revised general Employment Status Manual and the Check Employment Status for Tax tool have replaced much of HMRC’s occupation specific guidance. Associate dentists, or those who engage them, should make an assessment using these resources.

You can find out more about the Employment Status Manual updates on GOV.UK.

Welsh Parliament inquiry into dentistry published 

The Welsh Parliament’s Health and Social Care Committee has published the report of its wide-ranging inquiry into dentistry. The Committee found a lack of clarity on the number of patients waiting for check-ups or treatment, and concluded that the true scale of the crisis in dentistry was unknown. It also found that there were pre-pandemic issues that continued to impact access to NHS dentistry. The committee has published 16 recommendations for the Welsh Government, including calls to look at funding, and to consider a centralised waiting list across Wales.

The Committee Chair, Russell George MS, said:

“Many people talk of a two-tier system, where those who can afford to pay for private treatment do so. But are we in fact in danger of creating a three-tier system? Where those who can't register with an NHS dentist but can't afford to pay privately are left with no access, and can only rely on an emergency dental service.”

Other committee recommendations included putting a greater focus on skills mix within the dental team, support for commissioning research into the fluoridation of the public water supply, and the case for a new dental school in north Wales.  

Temporary extension to NHS contract payments in Scotland 

The Scottish Government has written to NHS dental teams in Scotland to provide an update on bridging payments and reforms. It confirms that temporary extension will be in place until 31 October, and sets out the timetable and process for the presentation of the revised Determination 1.