Upstreaming and CPDs for Reforming the Regulation

This blog is in response to a presentation by Matthew Hill , Director of Strategy, General Dental Council titled “Improving clinical and professional regulation: ‘fitness to practice’, indemnity and collaboration” presented at Westminster Health Forum, Keynote Seminar  â€œ Next steps for dentistry and oral health: regulation, prevention and dental contract reform”, 5^th July 2016.

The presentation provides a breath of fresh air and perhaps new thinking at the GDC. It gave an insight into how the  traditional fitness to practice (FTP) model is seen from the prism of the GDC:  â€œit’s old fashioned, it’s adversarial, it’s  legalistic, and it’s past its shelf life.  Patient protection benefits are not clear; it’s skewed to downstream sanctions and penalties, and not enough given to upstream prevention. Furthermore, opportunities to learn from mistakes are not  being used”-  a remarkably accurate summation from Matthew you might say.

So what does upstream in the context of professional regulation mean? It is about education and embedding standards. We are all familiar with the Grey/silver  Standards for the Dental Team, produced by the GDC and sent out to the dental profession back in September 2013, but not much was done after that. It kind of just sat on your bookshelf, hopefully with the shrink wrap taken off it.

How can these standards be embedded by working with the profession? The CPD requirements are part of the upstream picture and important for how best to extract and disseminate learning when things go wrong. The GDC want to introduce some learning built into the system of regulation, so that when people come unstuck, this can be fed back into education and communications with the profession. The idea is to prevent the problems in the first place. Finally the need for partnerships with the profession, soft powers, promoting good behavior, and incentives through communicating with the profession as a whole, instead of having to regulate every one on the GDC register.

Matthew Hill ended his presentation with this plea to the profession “we need to debate moving regulation more upstream, more active routing to other parts of the system and managing demand for FTP. The GDC intend to consult on a wide range of measures towards the end of the year, and hope that the profession will engage with that, because if one message is clear form this, the GDC says “we can’t do it ourselves”.

It has been customary over the past few years to pillory the GDC -with good reason, but whilst the Chair remains in place,the senior management team around him seem to offer a fresh vision and desire to reconnect with the profession.

My blogging is inspired by Matthew Hill’s presentation, and I aim to kick start the debate to encourage my fellow professionals to engage and debate, using all the tools available to us. It is the first in a series of blogs in the next few months. 

Your tweets, shares, comments and ideas are important to take our profession forward.