View from the Chair: Our Council meeting was held in Glasgow in June; Improving Fitness to Practise; Discussing our performance and how we will monitor and evaluate it; Observe a Council meeting or ask a question

Our Council meeting was held in Glasgow in June

We held our Council meeting in Glasgow this month, which was an excellent opportunity to meet stakeholders in person and spend time listening and understanding their achievements, issues and challenges.

Both Council members who are currently based in Scotland, Simon Morrow and Bill Gunnyeon, along with other colleagues from the GDC, were pleased to visit the Buchanan Centre in Coatbridge to see dentistry in Lanarkshire first-hand. We met practice owner James Barrett and Vocational Trainee dentist Callum Riddell and had a walkaround of public dental services where we met Lanarkshire Childsmile Lead Gillian Shaw. Childsmile is Scotland's national programme to improve children's oral health and reduce inequalities in dental health and access to care. In Scotland, the percentage of 5-year-old children with dental caries has reduced from around 60% at the outset of Childsmile 20 years ago to around 25% at the last measure. It was really good to chat with some of the people delivering the service and hear how they make a difference to the oral health of children in Scotland.

Simon, Bill and other GDC colleagues also enjoyed a tour of the outpatient sedation service for anxious patients and children with additional support needs, and chatted to final year Oral Health Science students from Glasgow Caledonian University. We were welcomed by Paul Cushley, dental director at Public Services Delivery Scotland (PSD Scotland), and hosted by Geraldeen Irving, dental director for NHS Lanarkshire. It was a valuable visit and a great chance to see Scotland's dental workforce in action.

Some Council members then enjoyed a tour of the Royal College of Physicians and Surgeons of Glasgow (RCPSG) in the evening, and I’m grateful to Vicki Greig, Dean and Vice President (Dental), for explaining the College’s history and role in dentistry.

This was followed by senior stakeholders from Scotland observing and presenting at the Council meeting on Friday. Dr Gillian Leslie, Chief Dental Officer (CDO) for Scotland, commented on the discussions at Council and reflected on issues that are central to dentistry in Scotland. Gillian was joined by Lee Savarrio (postgraduate dean and director of dentistry, PSD Scotland), Antony Visocchi (chair of Scotland's Directors of Dentistry), Charlotte Waite (director of BDA Scotland) and Geraldeen Irving (Director of Dentistry for NHS Lanarkshire).

Gillian and others provided immediate and thoughtful feedback on some of the discussions Council had just had. Commenting, Gillian said:

“It was really interesting to hear the conversation and the hot topics. We really welcome the culture change within the GDC and the move away from fear to support. This helps us to engage more and find areas to work together.

We urged the GDC to do more to improve fitness to practise (FtP) and to look again at whether more low level concerns can be returned to health boards. We also welcomed the increased capacity of the Overseas Registration Exam (ORE) - internationally qualified dental professionals are very important to Scotland. But we see the need for a shift in how clinical competence and experience is reviewed by the GDC alongside the ORE.”

Improving Fitness to Practise

Council had a first look at proposals for bringing together a programme of activity to continue to improve FtP. Taken together, these aim to ensure that we are only taking forward the most serious of cases which require FtP action, and for any cases that do need to be taken forward, that we are dealing with them in the most efficient way possible. Our overarching goal is to improve timeliness and reduce fear.

We need to agree a sense of balance between making rapid progress alongside some realism of the challenges we’re facing because of the increasing volumes of concerns we are receiving. I want to see progress as quickly as possible, without compromising quality. If the limiting factor is something we can make positive decisions to change and address, our preference is to have FtP that’s timely and minimises stress.

Council then discussed proposals that would allow the GDC and registrants where a case has been referred to a practice committee to agree the facts about the matter, how they impact someone’s fitness to practise and the sanction that should be imposed to protect the public and maintain confidence in the dental professions. A practice committee would then approve the proposed approach which would then dispose of the case. We see this as a way to encourage shared decisions and remove the adversarial nature of a hearing. The proposed process is referred to as ‘Agreed Panel Determinations’, and it is a mechanism that does not currently exist within our framework but is successfully used by other regulators. There is much further work to do to take the proposals forward and we will engage with relevant stakeholders as we make plans to pilot this new approach.

Discussing our performance and how we will monitor and evaluate it

We have important work underway to improve the transparency of how we report progress against the GDC’s strategy, and Council are keen to be able to keep track of a small set of measurable impacts. After a series of deep and thoughtful internal reviews across the organisation, we have identified these impacts as the ones we want to watch:

• We work efficiently and effectively
• We are trusted and able to work effectively with stakeholders
• Regulatory approaches are not a driver of unnecessary fear
• People are confident that they can access safe oral care when they need it.

I’m looking forward to seeing the work develop, using existing performance metrics and some that we need to build over time. Since joining the GDC I have been struck by how complex the system of dentistry is. Everything we do is affected by a wide range of external factors. This makes establishing direct and definitive cause and effect between actions, outcomes and impacts impossible in most cases, because none of our actions are carried out in isolation. This new approach to monitoring and evaluation will help us to better understand and report on progress against our strategy, in a way that shows how you experience that impact.

Observe a Council meeting or ask a question

It was refreshing to take Council ‘on the road’, and I’m pleased that we continue to welcome such valuable insights from stakeholders into the meetings and our discussions. You can ask to observe a Council meeting, either in person or online. I appreciate the time commitment that this involves though, so another way to get involved would be to ask a question about any of the items on the Council’s agenda. When we receive these at least three working days before the meeting, we’ll answer them at the start of the meeting. If the question is received a bit later or takes further time to get a full answer, we’ll provide answers within three weeks, and all questions and answers are then published in the meeting minutes. You can ask to observe a Council meeting or ask a question on our website