Monitoring dental education programmes

We introduced risk-based monitoring in 2018-19 and sought evidence on all requirements. Further to feedback from providers as well as lessons learnt during the COVID-19 pandemic, we have revised the process, seeking to ensure greater proportionality whilst gaining the necessary information to give us assurance.

In 2022-23 we piloted a further revised approach to our risk-based monitoring activity. We consulted with providers and our EAs to review and improve the monitoring to make it less burdensome to complete, avoiding duplication of previously submitted data, and including a declaration to be signed by programme leads. This places more trust in what providers were telling us. We identified lessons learnt from previous processes and designed monitoring that focused on the current and recent challenges faced by providers. Due to the recent full monitoring between 2018-2021, we felt confident in having a firm understanding of providers who are safely delivering their programmes and sought information on areas that might affect that safe delivery.

A significant benefit was that we were able to trial potential elements of a longer-term process to gauge their effectiveness. One example is through the removal of a routine set of documentary evidence to be provided with the monitoring return. We wanted to explore this avenue as many other healthcare regulators do not routinely request evidence when they monitor so the GDC’s approach was comparatively burdensome, and we know from provider feedback that the demand on gathering and providing such information can be significant.

DCP programme monitoring was undertaken with education providers and awarding organisations. Whereas we quality assure education providers to ensure that the Standards for Education are being met, awarding organisations are quality assured to ensure that they are effectively quality managing their education providers and can assure us that the Standards for Education are met.

A ratification meeting was held in late January 2023 and the providers were informed of their outcomes in February 2023. There were four potential outcomes:

• Regular Monitoring
• Inspection in the next academic year
• Inspection same academic year
• Further conversation – to provide clarity which may lead to one of the above three actions

The outcomes of the risk-based monitoring activity are shown in the table below. Of the 15 programmes monitored in the 2022-2023 period, we determined that four programmes would be inspected, with the remaining two to be subject to regular monitoring. The inspections for the four programmes took place in the 2022-23 academic year.

The approach adopted for interim monitoring will largely be mirrored in the ongoing process with some key differences:

• A fully researched risk model is being implemented that allows us to better explain to EAs how we want returns to be assessed and also allows decisions to be fully explained if necessary. It was not possible to adopt such a risk model in time for the interim monitoring.
• Exploratory discussions will be part of a supplementary ‘additional monitoring’ process which is better defined and has supporting documentation.
  

The new process is being rolled out this academic year and will be used for both BDS and DCP programmes will be reflected in the next Review of Education. The revised process has been well received by both internal and external stakeholders and allows for a more proportionate method of quality assurance, which in turn increases the overall engagement and quality of data that is submitted.

From the monitoring and inspection activities, we have found that whilst we do not have any significant concerns that relate to patient safety, there are overall quality concerns that relate to the quality of assessment and the teaching of professionalism in programmes that are overseen by Awarding Organisations. Providers continue to struggle to consistently achieve requirements 11 and 17. These findings are now informing the Thematic Review into Dental Nursing that is happening in 2023-24.

We have been reviewing our approach to the Royal Colleges and how we quality assure the undergraduate programmes that they award.

During the 2022 awarding organisation monitoring, an orthodontic therapy (OT) provider, delivering the RCS England qualification submitted a monitoring return, despite the decision to exempt the Royal Colleges from that round of monitoring. The outcome of the monitoring assessment was a risk-based inspection which will be carried out in October 2023. During the 2022-23 academic year, the EQA team reviewed how the Royal College of Surgeons of England (RCSEng) and the Royal College of Surgeons of Edinburgh (RCSEd) oversee the pre-registration qualifications within their remit. RCSEng currently awards one OT programme and is responsible for the LDS Examination.

RCSEd awards an OT qualification for a number of providers and has a role comparable to other awarding organisations with which the GDC engages. Due to the similarities, RCSEd will be quality assured as an awarding organisation, with their providers being sampled as part of the inspection process. The new Royal College monitoring and inspection pilot will enable the EQA team to:

• Fully understand the structure of the Royal Colleges and how they award diploma qualifications;
• Quality assure undergraduate programmes in a using similar processes that are used elsewhere and are commensurate with all other QA activity.