Dinner at the Dentist? The Bizarre Tale of Dental Regulation

GDC, CQC & the Issue of Regulation 14 in Dental & Other Clinics

Introduction to Regulation 14

The Care Quality Commission (CQC) in the United Kingdom has established Regulation 14 under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, focusing on meeting the nutritional and hydration needs of service users. This regulation is pivotal in ensuring that individuals receiving care and treatment have their nutritional and hydration requirements adequately met, thereby reducing the risks of malnutrition and dehydration.

Regulation Scope and Intent

Regulation 14 requires providers to ensure adequate food and drink are available to meet the nutritional and hydration needs of service users. This includes accommodating individual preferences, religious, and cultural backgrounds in the provision of food and drink. The regulation applies to settings where accommodation is provided by the service provider, including overnight stays and situations where nutrition and hydration are integral to care or treatment.

The Practicality in Dental and Short-term Care Clinics

The application of Regulation 14 in dental practices and similar clinics, where patients typically spend only a few hours, presents very significant practical challenges. These clinics focus on specific treatments and do not involve overnight stays or prolonged care, making the requirement for a nutrition policy seem disproportionate. Implementing such a policy has led to administrative burdens and operational complexities, diverting resources from core services. In addition, organisations such as the GDC and the CQC have tried to enforce such regulation which has allegedly made matters worse.

Assessing the Feasibility

The feasibility of assessing and meeting the nutritional needs of patients in these short-duration settings is questionable. Dental and similar clinics are not equipped like residential care homes or hospitals to cater to diverse nutritional needs. The regulation’s emphasis on individualized nutritional assessments and catering to personal preferences, while essential in long-term care, appears excessive for short-term care environments.

While Regulation 14 plays a vital role in long-term care settings, its application in dental practices and similar clinics may be an overextension. These settings require a more tailored approach that recognizes their specific service nature and duration. A balanced implementation that ensures patient well-being without imposing undue burdens on providers is essential.

Strained Relationship Between GDC & Dentists

John Makin, the head of the Dental Defence Union (DDU), has expressed significant concerns over the General Dental Council’s (GDC) continued shortcomings in handling fitness to practise cases. For six consecutive years, the GDC has failed to meet the expected standards for timeliness in these cases, a situation that Makin firmly believes is unacceptable. The call for the GDC to step up and enhance its performance is loud and clear. This ongoing issue isn’t just about maintaining regulatory standards; it profoundly impacts the lives and careers of dental professionals entangled in these drawn-out investigations. Makin’s frustration is palpable, as the DDU has repeatedly brought this issue to the GDC’s attention, yet substantial progress remains elusive.

The implications of these protracted investigations are far-reaching. Dental professionals find themselves embroiled in lengthy and stressful proceedings, impacting their mental wellbeing and professional standing. But it’s not just the professionals who suffer; patients are also caught in the crossfire. At a time when dental care provision is already facing challenges, these delays are detrimental to patient interests. Looking ahead to 2024,

Makin is hopeful for a tangible improvement in the GDC’s handling of these cases. Moreover, he is urging the government to step in by introducing legislation that would enable the GDC to evolve into a more adaptable and efficient regulator. The need for modernization in regulatory practices is evident, and government intervention could be the catalyst for much-needed change.

Tony Jacobs, a dentist in Manchester has written a damning report on the GDPUK website of which he is the Founder. He argues that in the world of dental regulation, the General Dental Council (GDC) has been a central figure, particularly in the last decade, marked by controversy and strained relations with dental professionals.

Let’s start with the financials. The GDC, he argues, to replenish its coffers after nearly running dry from pursuing numerous dentists for alleged offences, made a bold move. They decided to build their financial reserves to about £30 million. How? By collecting around £750 from each of their 40,000 registrants over a few years he alleges. This hefty sum was then parked in their reserve fund, presumably earning a tidy sum annually, he estimates.

But while their bank balance might have looked healthier, their Fitness to Practise (FTP) operation was gasping for breath. Justice was delayed, and the Professional Standards Authority continued to criticize this aspect of the GDC’s operations in their reports. Yet, despite the continuous condemnations, change remained elusive.

In a move that raised many eyebrows, the GDC once advertised in a national newspaper, calling for more complaints against dentists. This unprecedented step, which was not repeated due to the uproar it caused, raised questions. Was this a deliberate strategy to investigate more dentists and expand their quasi-non-governmental empire, Jacobs asks.

A particularly tragic and concerning issue is the topic of suicides among dental professionals, a subject that has been paralleled with the treatment of sub-postmasters. There’s a growing awareness in the dental community about the impact of regulatory processes on mental health.

The GDC’s communication strategy, or lack thereof as he puts it, is another point of contention for Tony Jacobs. He goes on to allege that their press and media office has been notably uncooperative with GDPUK, engaging only on seemingly accidental occasions. This non-engagement isn’t unique to GDPUK he claims; others have also found the GDC less than cooperative. Freedom of Information requests appear to be the only way to glean information, with the GDC reportedly employing tactics to avoid or delay responses.

What could be the solution to these issues? Greater transparency and honesty from the GDC would be a start. There’s a call for the Council members and executive officers to make their press office more transparent and respond to inquiries openly, rather than acting defensively, according to Jacobs.

But the GDC isn’t the only regulator under fire from Tony. The Care Quality Commission (CQC), another dental practice regulator, was also under criticism. Tony claims that they burst onto the scene about 15 years ago, wielding threats of closure over dental practices for non-compliance with what some view as petty or irrelevant regulations. One such example is the requirement for every dental practice to have a nutrition policy for patients (Regulation 14 as mentioned above), a seemingly unnecessary demand given the nature of dental visits. This kind of overreach has fostered an industry of compliance experts and a culture of fear among dental practices.

The GDC and CQC were contacted for comment.

About the Care Quality Commission

The Care Quality Commission is the independent regulator of health and social care in England. It ensures health and social care services provide people with safe, effective, compassionate, and high-quality care and encourages care services to improve. The CQC monitors, inspects, and regulates services to make sure they meet fundamental standards of quality and safety, publishing what it finds, including performance ratings to help people choose care.

About the General Dental Council

The General Dental Council (GDC) stands as the regulatory body overseeing dental professionals in the UK. Its primary mandate claims to maintain standards in dentistry, ensuring that dental practitioners provide high-quality care and uphold patient safety and trust. The GDC’s responsibilities include registering qualified professionals, setting educational standards, and managing fitness to practice hearings to address professional misconduct or incompetence.

While the GDC plays a crucial role in safeguarding public health and maintaining professional integrity, it has faced criticism for its administrative processes, particularly regarding financial management and the efficiency of its regulatory procedures. Despite these challenges, the GDC remains an influential institution in the dental sector, which has to balance the interests of the public with the realities of professional practice.