The changing face of dental care
Delivering Patient-first Regulation – Evlynne Gilvarry, Chief Executive and Registrar of the General Dental Council, outlines some key changes taking place at the GDC.
There are a number of significant changes taking place in the dental care landscape. I am sure you all see this through your interactions with patients and colleagues. I wanted to set out how the GDC is evolving so that we may meet these changes together. At the heart of this is ensuring patients have access to safe treatments performed by well-trained professionals.
The GDC’s role in dealing with complaints about dental care is a key element of our approach to effective regulation. A major surge in the number of complaints over the last 4 years – up 115% since 2011 – imposed significant pressures on our resources and exposed the need for significant improvement. We have risen to this challenge, implementing a major change programme that is already delivering real improvements in the efficiency of the complaints process. We want to operate a process that reduces the stress of a complaint for the patient and the dental professional alike.
We also aim to achieve the right balance between dealing with complaints quickly and achieving a fair outcome for all parties. It is for this reason that we have reviewed our processes to ensure that they are as efficient as they can be within the existing statutory constraints. We have invested substantially to clear a backlog of cases that had built up over the years of big increases in complaints. We have completely overhauled our training and performance management of staff, and upgraded our IT systems. I think it is important to set out the impact that this is having.
Our most recent data shows that we are making progress in all stages of the process.
We invested £620,000 in 2014 to provide two additional casework teams to clear a backlog of 750 FtP cases through the investigation stage. At the end of 2014, this work was practically complete; most of the cases had completed the investigation stage and the small number remaining will have been dealt with by August 2015.
At the end of June 2015, 83 cases were in the initial triage stage of our FTP process and 54 of these were being progressed within our 10 day key performance indicator (KPI). This compares with 340 cases in the first three months of 2014, of which only 56 cases were within our KPI. Our triage team are closing approximately 30% of the new complaints received.
At the beginning of October 2014, the average number of assessments completed each month by our Casework managers was 45 assessments per month per team. At the end of June 2015 this number had increased to 57 assessments per team per month. The number of teams had reduced from 6 to 4 as part of a rationalisation of resources.
We have increased the number of Investigating Committee and Practice Committee meetings to handle the increase in investigations and subsequent prosecutions.
At the end of Q2 2015, our data showed that the Investigating Committee had had its most productive period in the last three years, with 84% of listed cases securing an outcome.
In 2014, we heard 194 initial Conduct Committee meetings compared to 133 in 2013. We have so far heard 138 Conduct cases in 2015 and made arrangements to hear a further 159 hearings in 2015; an increase of 53%.
We have implemented new induction, training, quality assurance and performance management to reinforce with staff at all levels the importance of meeting the standards required by the PSA in relation to timeliness, accuracy, compliance with procedures and decision-making. The GDC has an Internal Compliance Team, independent of the Fitness to Practise directorate, which audits the casework of the Fitness to Practise teams, using a similar methodology to the PSA. Our audit scores in the areas of timeliness, accuracy, compliance with procedures and decision-making have significantly improved over the last twelve months and in June 2015, were 75%, 93%, 95% and 98% respectively.
This improvement does not show through in the latest Performance Review due to the historical nature of the evidence the PSA use in their process. However, I am very positive about the direction of travel of our fitness to practise function.
We are confident that a number of other steps and reforms we are taking (for example, the proposed introduction of Case Examiners with powers to dispose of more cases at an earlier stage and an ‘end to end efficiency review’ of the complete FtP process) will result in further, greater improvements.
Our programme of change is not limited to fitness to practise process but spans the entire function. The steps we are taking range from structural changes to reduce operating cost such as bringing our legal work in-house in order to reduce the reliance on external lawyers
We are aware of the challenges of the past and have actively confronted them. Our performance is improving and the programme of change is already yielding significant results. We are also working with other bodies – such as NHS England and the Care Quality to improve the overall system of dental regulation in the UK, in particular in the area of dealing with complaints. We are committed to ensuring that we are more efficient, effective and proportionate.
This should bring benefits to patients and the dental profession.