Source · Select Committees · Health and Social Care Committee
Recommendation 11
11
Accepted
Paragraph: 67
NHS dentist headcount does not reflect actual NHS work or address access issues
Conclusion
The Government states that the number of NHS dentists has increased over the past year. However, while the headcount has gone up over the past year, it has gone down over the past three years, and moreover headcount alone does not reflect how much NHS work these dentists are undertaking. We heard repeatedly that a lack of dentists and dental care professionals undertaking NHS work is the main driver behind both lack of access to appointments for patients, and the underspend in primary care dentistry.
Government Response Summary
The government accepts the importance of efficient processing for overseas dentists, confirming they are working with the GDC to clear the registration backlog. They highlight specific GDC actions to triple ORE Part 1 capacity and increase Part 2 sittings to address demand.
Paragraph Reference:
67
Government Response
Accepted
HM Government
Accepted
Accept The Department accepts this recommendation. We agree that efficient processing of applications for the Overseas Registration Exam (ORE) is vital and are working with the GDC to identify the most efficient measures to clear their current registration backlog of dentist and dental care professional applicants. We welcome the GDC’s decisions to triple the capacity of the next three sittings of the ORE Part 1 exam from August 2023, and to increase the number of sittings for the ORE Part 2 exam from three to four for 2024, creating more than 1300 places across the additional sittings. The GDC estimates there are 1500 eligible candidates for ORE Part 1 and, in the 12 months from August 2023, the GDC will have 1800 places available for those wishing to sit ORE Part 1. In respect of ORE Part 2, the GDC has increased the number of places available to 576, which we understand is sufficient to meet the current demand from those who are both eligible and wanting to sit Part 2. This has been evidenced by recent ORE Part 2 sittings not being fully subscribed when offered. The GDC will also be providing greater information and support to candidates which we expect to increase the pass rate, again increasing throughput as well as improving efficiency. We are pressing the GDC to streamline and increase the capacity of its current registration routes so that they are more efficient and effective and will meet with them regularly to make sure they are fulfilling their commitments on this. We have already passed legislation on international registration, which came into force in March 2023, to provide the GDC with the flexibility to amend the ORE content, structure, and fees. Earlier this year, the GDC consulted on proposals for international registration routes for dentists which include further increasing the capacity of the ORE. The consultation also called for evidence to inform longer term plans on international qualifications and registration, including the potential future structure of the ORE, and alternative routes to recognition that may enable overseas-qualified dentists to join the GDC’s register more quickly. Additionally, we have already taken further action through measures to streamline the process for dentists to deliver NHS care. These include: • Following a ministerial review of the standstill provisions, dentistry qualifications from the European Economic Area will continue to be unilaterally recognised by the GDC; • Reducing the time it takes to evaluate the skills, experience, and support that an applicant needs to join the Dental Performers List and work safely in NHS primary care dentistry, through the amendments to regulation 34(4)(c) of the National Health Service (Performers Lists) (England) Regulations 2013; and • Inserting a new regulation 5A into the National Health Service (Performers Lists) (England) Regulations 2013, to allow dentists who are already included on the Performers List in Scotland, Wales, or Northern Ireland, to work in England whilst their full application is being processed. Recommendations 12 and 13 The dental profession should be represented on Integrated Care Boards to ensure they have the necessary expertise to inform decision-making around contracting and flexible commissioning. This should include wider engagement with the profession locally, for example through Local Dental Committees and Local Dental Networks. (Paragraph 106) We contest the Department’s rejection of the recommendation in our ‘Integrated Care Systems: autonomy and accountability’ report, and reiterate that they should centrally gather information relating to the membership of ICBs, including the specific role of members and their area of expertise. We also recommended the Department should review that information with a view to understanding whether the policy of keeping mandated representation to a minimum is the right one and whether any specialties are especially under-represented. We believe this is particularly relevant in the case of NHS dental services. (Paragraph 107) Response Partially Accept NHS England have published implementation guidance on effective clinical and care professional leadership within ICBs. As part of the development of local frameworks and wider governance arrangements, system leaders were asked to commit that they ensured that the full range of clinical and professional leaders from diverse backgrounds are integrated into system decision-making at all levels. The Government has not changed its stance since the publishing of our response to the Committee’s report on integrated care systems: autonomy and accountability on 14 June this year. As stated in our response previously, ICBs are required to publish their constitution, which includes a list of ICB board members, in accordance with the Health and Care Act 2022. ICBs have made board member information, including members’ expertise and knowledge, publicly available on their websites. Where the ICB proposes a change to