Stefan Czerniawski considers what Provisional Registration might mean for UK dentistry
Stefan Czerniawski, GDC Executive Director, Strategy, was speaking at the Dental Leadership Network meeting on 14th March. He opened by looking out at his audience and declaring that he could ‘feel the energy in the room’. Dental Review reports.
Editor’s note: The government has declared itself committed to ensuring that everyone needing NHS dentistry will be able to access it. The recently published Faster, simpler and fairer plan to recover and reform NHS dentistry (‘the dental plan’) outlines a wide range of measures which are said to make dental services faster, simpler and fairer.
This includes increasing workforce capacity domestically as the government committed to do in the NHS Long Term Workforce Plan, and improving the processes by which dentists trained overseas can start practising in the UK. At present, this requires passing the Overseas Registration Exam (ORE) run by the GDC or the Licence in Dental Surgery (LDS) run by the Royal College of Surgeons, which can take years although the GDC has committed to streamlining the ORE process.
The government believes it should be possible for overseas-qualified dentists to be able to register to practise in some form before they have achieved full registration with the GDC thanks to the introduction of a system of provisional registration. Provisional registration, says Westminster, would allow an overseas-qualified dentist to practise in any dental setting, including high street dental practices, under the supervision of a dentist who has full registration on the GDC’s dentists register.
But what does that mean in the real world?
Regarding provisional registration Stefan explained that the government set the concept up in broad principles then handed it to the GDC to work out the details by translating broad strokes into a system that meets both patients’ needs and regulatory requirements, while also deciding how these provisionally registered dentists should identify themselves.
Research around provisional registration was published in 2020. It considered ways to introduce to the workplace clinicians who were post qualification but not yet fully experienced in practice with the idea of streamlining the registration of overseas dentists. The GDC will ask stakeholders to help design a system that works, but – Stefan stressed this point – who gets on the register really, really matters. It is about quality and patient safety not numbers.
The proposal regarding provisional registration is currently only about dentists. Whether that will change to include other DCPs is a question for the future. The important points for now is that registration should not and must not be compromised, and that registration should not be an onerous process. The view is, explained Stefan, that we should bring the provisional registrant into a supervised environment until we are confident that they can become a full registrant.
The GDC sees the process as three stages: Entry – Supervised Practice – Exit. Put simply, the point is to bring the provisional registrant into full registration, but how do we recognise when they are ready? Stefan explained that we need something bespoke, something tailored to the situation that completes the three stages fairly and consistently.
Any pre-registration qualification will need to be rock-solid, the GDC and patients will need to be confident in both the person and the procedure. At present two models are being considered; practice-based – a bit like foundation training – and course-based, which is more like a conversion opportunity.
Of course, these two models could overlap with the provisional registrant moving from educational environment to the practice environment, but, Stefan noted, there are innumerable issues that must be folded into an effective model before it can be delivered – all of which must be paid for – and not by the GDC.
Editor’s note: oversea applicants currently have to pay for training, and we heard that international dentists might pay an agency up to £10,000 to be placed in a UK practice.
The GDC is looking at potential policy design through engagement with stakeholders to get an idea of how the delivery models can work after a government consultation regarding provisional registration completes on the 16th May. Stefan added that it will take time to create something fit for purpose that works smoothly and effectively for registration purposes, protects the patient, and benefits the provisional registrant.
To read the government consultation document click HERE
