Written evidence submitted by The General dental Council (WBR0078)

1. Introduction 

1.1.   The General Dental Council (GDC) is the UK-wide statutory regulator of around 113,000 members of the dental team including dentists and dental nurses, dental therapists, dental hygienists, dental technicians, clinical dental technicians, and orthodontic therapists. Our recent research suggests that at least 80% of them provide NHS care, either exclusively (20%) or at a mixed NHS and private care setting (63%)[1].

1.2.   Our primary purpose is to protect patient safety and maintain public confidence in dental services. To achieve this, we register qualified dental professionals, set standards for the dental team, investigate complaints about dental professionals’ fitness to practise (FtP), and work to ensure the quality of dental education.

1.3.   Workforce planning and deployment fall outside the GDC’s statutory remit, but as the regulator for dental professionals, the way in which the GDC carries out its functions has the potential to have an impact on the NHS’s achievement of its objective of having a ‘capable and motivated multidisciplinary dental workforce, of a sufficient size, distributed across England to meet population health needs[2].

1.4.   We are currently collecting evidence on mental health and wellbeing in dentistry, and on the impact of COVID-19 on dental professionals, and until we have the results of that research are unable to provide responses to many of the questions posed by this inquiry. The Committee may, however, find some of our published research useful in understanding more about the pre-COVID landscape in dentistry. References to published research are provided in this submission, where appropriate.

2. Submission

2.1.   Dental professionals, particularly dentists, report to the GDC[3] and to the NHS[4] that meeting the demands of regulation in all forms is one of the biggest challenges in their working lives, and that it affects their morale, and their wellbeing and mental health. We have recently commissioned a ‘rapid assessment’ of evidence of mental health and wellbeing of dental professionals to explore this further.

2.2.   We are not insensitive to the fact that professional regulation can contribute to this challenge, and we have taken some steps to address it. We are working with others in the sector, including the NHS and systems regulators, to ensure that the regulatory burden is not greater than it needs to be, and that the effect of regulation fulfils its purpose of maintaining public safety and confidence, rather than being perceived as punitive in nature or effect. 

2.3.   A key focus of our corporate strategy is to shift the emphasis of regulation away from enforcement action and towards an “upstream” system of regulation, focused on education, professionalism, and learning.

2.4.   Our strategy also seeks to ensure that our fitness to practise processes are proportionate, fair, and efficient, and do not result in unnecessary stress for those involved. We have been able to cut ten weeks from the average time it takes to progress a case from initial receipt to case examiner assessment and ten weeks from initial assessment to final hearing[5]. We have improved the tone and clarity of our communications with dental professionals in the FtP process, and have worked with mental health charities Samaritans and MIND to help our FtP staff to better handle difficult conversations and to increase their awareness of mental health[6].

2.5.   When the COVID-19 pandemic struck we took steps to ensure that our regulatory requirements were proportionate, and to minimise the regulatory burden on dental professionals. We issued guidance to professionals setting out our approach[7]. This included assuring the profession that we will consider relevant environmental and human factors, should concerns arise about practise which departs from established procedures in the highly challenging circumstances they currently operate in.

2.6.   We also worked with education and training providers, Dental Faculties, and others to ensure that dental students and trainees were able to graduate in 2020 or to return to education and training this autumn[8].

2.7.   We are seeking evidence into the impact of COVID-19 on dental professionals, by conducting  surveys of the public and patients and dental professionals, and becoming participants in research conducted by others[9], so that we can take it into account in developing our regulatory response.

2.8.   We are working with the Department of Health and Social Care to ensure that the proposed legislative reform of healthcare professional regulation achieves its aims, and better enables us to fulfil our statutory objectives while regulating proportionately and effectively.