As you will be aware by now, the council of the GDC (General Dental Council) made the decision on 30 October 2014 to increase the Annual Retention Fee (ARF) for dentists.
This was not a decision that was taken lightly. Indeed it followed two consultations and a review by the accountancy firm, KPMG to assure the council that the assumptions underlying the proposal to increase the fee were sound.
It is worth noting that this is the first increase in the ARF for dentists in four years and follows a period in which we have seen a 110% increase in complaints made to the GDC.
We have involved the profession on the issue of the ARF since April this year, when we launched an initial consultation on the basis on which the ARF should be set.
Around 65% of respondents agreed that the level of the ARF should directly reflect how much each registrant group – dentists and dental care professionals – costs. The fees agreed for 2015 are based on that approach and on that basis the fee for dentists increases to £890 for 2015. However the fee for dental care professionals, who make up 61.1% of the profession, decreases. It is now set at £116 for 2015.
Fitness to practise
The primary driver for the increase in expenditure by the GDC remains the increase in complaints about the Fitness to practise (FtP) of dental professionals, mainly dentists.
The decision to increase the ARF for dentists is directly related to the effective delivery of our primary duty of patient protection and the additional funds that will be collected as a result of this increase will enable us to deal effectively with the increase in our FtP caseload.
We are looking at how we can help dentists and DCPs to reduce incidents that can give rise to complaints. We are also working on a number of initiatives to ensure that a greater proportion of complaints are dealt with at a local level.
Right now, the number one priority for the GDC is to ensure our FtP function has the resources it needs to deliver an efficient and effective complaints process. We are determined to lead the changes that will result in a much improved performance in a reasonable time.
The Department of Health has already agreed to a key change to our legislation that will enable us to streamline the early stages of our FtP processes. The introduction of case examiners, with powers to deal with cases at an earlier stage, will bring us in line with other regulators.
The advantages of case examiners would be an increase in the speed and agility with which decisions on FtP cases could be made – improving the process for both the registrants and patients involved. We hope to have these new powers by the middle of 2015. It is anticipated that this will reduce by £2 million the costs of handling FtP cases.
Patients complaints system
Another key piece of work is to improve the patient complaints system covering the multitude of complaints bodies. Currently the system is extremely complex and we want to ensure that complaints are handled by the right organisation and are being resolved locally where this is possible.
We are working closely with NHS England on piloting a more proportionate and efficient approach to managing performance concerns that are raised about registrants who work in the NHS. The aim of the proposed pilots will be to ensure that cases are managed by the appropriate organisation (either the GDC or the NHS). Key benefits of this approach will be using local performance management processes within the NHS more effectively and reaching an outcome within a shorter time frame than currently.
Over the coming year, all the organisations involved in dental regulation have agreed to work together to ensure that the system works as efficiently as possible and also to provide clarity about where responsibility for individual elements of regulation sits. The GDC is one of the main partners in this work, together with the Care Quality Commission, NHS England and the NHS Business Services Authority. This work supports the Cabinet Office commitment to reduce the burden of red tape on all public sector services.
A significant limitation on us dealing effectively with an increasing FtP caseload has been that we are forced to operate outdated processes that require legislative change to allow us to work more efficiently. The introduction of case examiners referred to above will go some way to streamline our processes. However, we need wholesale legislative change to provide a more effective and efficient regulatory framework.
We campaigned for this and worked alongside the Department of Health and Law Commissions for two years to shape a draft bill that we hoped would be in the Queen’s Speech in 2014. This did not happen and so we must wait until after the General Election.
But be assured that we will continue to press ministers and officials to introduce the bill as soon as possible and we would encourage lobbying from across the dental sector – in particular from defence organisations and professional bodies like the British Dental Association (BDA).
It is unfortunate that the BDA has decided to focus its attention on a legal challenge of our decision to increase the ARF.
It is accusing the GDC of ‘failing to provide clear evidence of the policy or business case’ that underpinned the proposed increase in the ARF.
The GDC will robustly defend this legal action, which is expected to be heard in mid-December.
The council and executive of the GDC are determined that we will succeed in making the improvements necessary to be a more effective and efficient regulator. The additional funds raised in 2015 will help to ensure that we meet this challenge.