Laura Pearce, Senior Solicitor
Dentistry 2016: What does 2016 hold for Dentistry?
DENTAL BULLETIN, ISSUE 13
Performance of General Dental Council in 2015; the good, the bad and the ugly?
2015 was not a good year for the GDC; on 11th May 2015 the Professional Conduct Committee slammed the GDC’s conduct of the Fitness to Practice hearing of Dr Singh; just over a month later, on 26th June 2015 the Professional Standards Authority’s (PSA) Performance Review Report for 2014/2015 ranked the GDC last out of all the health regulators, noting that it did not meet 8 out of the 24 good standards of regulation; and less than six months later, on 21st December 2015 the PSA published its findings of an investigation into complaints raised by a whistleblower. The investigation highlighted serious failings in the organisation and specifically singled out Bill Moyes, Chair of the GDC, for his failures and ‘inappropriate’ decision making.
On 9th November 2015, shortly before the PSA’s findings were published, the GDC announced that Evlynne Gilvarry, the Chief Executive and Registrar, would be stepping down with effect from January 2016. No reasons were given for this decision. Is the timing pure coincidence?
The BDA has called for Bill Moyes to resign as a result of the damning report from the PSA but he has remained in his appointment. The GDC will be publishing their response to the findings early this year. Whatever the response, change is needed, as the profession has lost faith in its regulator.
Following the Performance Review Report, in August 2015 the PSA published ‘rethinking regulation’, which argues that the regulatory framework for health and social care “needs radical change”. The PSA noted that regulators were trying to fix problems of the past rather than adapt to the challenges of the future. Junior Health Minister Ben Gummer MP has told Parliament that the Government recognises the need for reform. However, no timetable has been given as to when these reforms are likely to take place.
In the meantime, Ian Brack has been appointed as Interim Chief Executive and Registrar. Before joining the GDC, he was the Interim Chief Executive at the Office for Legal Complaints and led the Olympic Lottery Distributor committee. Given his background is not dissimilar to Evlynne Gilvarry’s, we predict that 2016 is unlikely to see any big shake ups at the GDC.
Is Dental Regulation about to change?
In April 2015 the CQC launched its new approach to inspection and regulation of dental services. We reported on this new era in Issue 9 of our Dental Bulletin. This was following recognition from the CQC that when it began inspecting dental practices it did not get the model right. This could see the start of a tidal wave of change for dental regulation.
In December 2015 the Regulation of Dental Services Programme Board published a report entitled ‘the future of dental service regulation’. The Board comprised of the CQC, GDC, Department of Health and NHS England. This was the first time all the dental regulators had met. The report recognised:
‘Dentists feel over-regulated. A dentist might find themselves being investigated by the General Dental Council, who are concerned about fitness to practise; the Care Quality Commission may investigate the safety and quality of the practice, while the NHS may also question whether services are being delivered according to the regulations. This multiple intervention and potential duplication of effort is both wasteful and stressful and can have far reaching professional and personal consequences for those whose performance is a cause of concern. There is a need to think differently and ensure that any regulation is focused where improvement is required and where we can measure a difference in encouraging improvement.’
It does seem this report is simply highlighting what dentists knew already; the profession is overregulated and there is overlap amongst that regulation. However, the fact the regulators are working together for the first time to implement change is promising.
The report highlighted the following areas for development, which will be reviewed over the next 12 months:
- Define roles and responsibilities and development of joint working protocol;
- Define a clear model for dental regulation;
- Improve data and information/intelligence sharing. The long term goal to develop a centralised system;
- Define a system with recognised roles for complaints handling;
- Define the system for quality improvement;
- Develop a system for proactive and joined up conversation between the regulators;
- Develop a practical approach for keeping patients informed
Hopefully, the development of new systems will result in less bureaucracy and paperwork, giving dentists time to concentrate on what they do best, dentistry.
Will we ever see a new NHS Contract?
Professor Jimmy Steele first published his independent review of NHS Dentistry on 22nd June 2009. Since then we have seen dental practices test pilot schemes, surveys have been undertaken, and research and consultations completed. This all resulted in the Department of Health publishing its detailed findings on the dental contract reform on 15th January 2015 and confirming that it would now launch prototyping. In the prototype stage, dental practices are testing whole versions of a possible new system; you can find details of the two prototypes here.
Dental practices that are participating in the prototyping ‘go live’ in three stages. The first two stages will comprise of practices that took part in the pilot schemes. They began in December 2015 and early January 2016. The third stage will consist of new practices and will commence from February.
Unfortunately, it has been confirmed that any change to the NHS contract is unlikely to take place until at least 2018/19, if there is any change at all. The Government has made no guarantees that there will be amendments to the current system.
On 4th January 2016 Dr Tony Kilcoyne along with 400 dentists wrote a letter which was published in the Telegraph describing the NHS Dental system as ‘unfit for purpose’ and highlighting how charities that provide dental care to third world countries are stepping in to provide dental care in England. This was shortly followed by an article in the Independent reporting on how the Real Junk Food Project in Dewsbury, along with the charity Dentaid, have set up an out of hours ‘pay if you can’ emergency service to fill the gap in NHS Dental care.
However, what is clear is that change is needed; and quickly.
If you need advise on dental or employment law, please contact Laura Pearce on 020 7388 1658, or email her at lpearce@jfhlaw.co.uk.
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