Enhanced Continuing Professional Development Scheme

Transcription

1 Item 6 Council 18 March 2015 Enhanced Continuing Professional Development Scheme Purpose of paper Action Public/Private Corporate Strategy To invite the Council to agree the policy basis and proposed scheme of enhanced Continuing Professional Development For decision Public 2.0 Deliver proportionate and targeted regulation of dental professionals to improve public protection and enable the public to have confidence in dental regulation. 2.5 Complete the development and piloting of a revalidation scheme aimed at ensuring dentists remain fit to practise. Business Plan 2015 STRATEGIC OBJECTIVE 2: Deliver proportionate and targeted regulation of dental professionals to improve public protection and enable the public to have confidence in dental regulation Decision Trail Recommendations 5 December 2013, Council: Item 10 Draft Continuing Professional Development Rules Order of Council Public Consultation 26 September 2013, Council: Item 14 Revalidation Working Group Final Report 28 March 2013, Council: Item 11 GDC Response to CPD Consultation 2 August 2012, Council: Draft Consultation Enhanced Continuing Professional Development Consultation The Council is invited to agree the policy basis and proposed scheme of enhanced CPD Authorship of paper and further information Appendices Claire Herbert, Head of Policy (Continuing Assurance & Revalidation) cherbert@gdc-uk.org Elizabeth Petch, GDC Solicitor epetch@gdc-uk.org Appendix 1 Risks and Considerations Appendix 2 CPD consultations feedback Appendix 3 draft General Dental Council (Continuing Professional Development) (Dentists and Dental Care Professionals ) Rules Order of Council Page 1

2 Executive Summary 1. This report presents a summary of the proposed new Continuing Professional Development (CPD) scheme and traces the policy development and stakeholder engagement undertaken throughout the GDC s review of CPD. 2. In December 2013 the Council agreed the then draft CPD rules and agreed to hold a public consultation on them. A summary of the consultation findings, which were also circulated to Council Members in May 2014, are at Appendix The consultation feedback did not necessitate any proposed policy change, and revisions to the draft rules have been of a technical legal drafting nature. The revised draft rules which reflect the CPD policy now before the Council for approval, are set out at Appendix An overarching objective of our CPD review was to develop a revised CPD scheme that could make a stronger contribution to preventing impaired or poor performance and to providing regular assurance that all dental professionals on the registers are keeping their skills and knowledge up to date. 5. It is anticipated that an enhanced CPD approach will pave the way towards a potential, full scheme of continuing assurance of fitness to practise in dentistry. 6. The CPD review included commissioning independent research, enabling close stakeholder engagement, public consultation, and policy evaluation. 7. Our CPD requirements should provide a systematic and supportive framework for all dental professionals to keep their skills and knowledge up to date in accordance with the GDC s Standards, and enable the GDC periodically to check compliance in order to provide assurance of this to patients and the public. 8. A range of short comings of the current CPD scheme were identified during the review including: No link to the GDC s Standards Potential for irregular and long periods without CPD Failure to recognise specialist practice directly Failure to recognise learning outcomes No recognition of a learning cycle Unworkability for Temporary Registration Lengthy process to remove for non-compliance Complexity of legislative interpretation Cannot call in CPD Record until after 5 year cycle 70% of compliant CPD can be non-verifiable 9. The proposed new CPD approach would address the shortcomings and make our requirements more fit for any future continuing assurance of fitness to practise requirements by: Situating CPD in support of the GDC s Standards Relating CPD to defined high level learning outcomes linked to Standards Supporting regular CPD by dental professionals, retaining some flexibility for the registrant Focusing on current field of practice including specialist practice Page 2

3 Embedding the learning cycle based on - plan, do, reflect, record Supporting regular CPD for Temporary Registrants Removing unnecessary delay to removal for non-compliance Simplifying, consolidating and clarifying the legislative basis of the scheme Provide powers to call in CPD Record within and after cycle 10. Benefits of an enhanced CPD scheme like this include: For Dental Professionals: a more supportive and Standards targeted framework for CPD and enabling more transparency and accountability from CPD providers for the quality of CPD provision For Patients/Public: more frequent regulatory assurance that dental professionals are keeping their skills and knowledge up to date For the GDC: Simplified, more effective requirements, and streamlined processes For Employers/Commissioners: embedding reflective learning and practice across all professional groups For CPD Providers: clearer verifiable CPD requirements 11. Pending the Council s decision, an implementation plan will be tabled at the April Council meeting. Introduction and background 12. Our requirements should place CPD at the heart of professionalism in dentistry and contribute to continuous improvement and patient protection. 13. The proposed new CPD policy would make a contribution to this by introducing a framework for dental professionals to focus on CPD that supports them to practise in accordance with the GDC s Standards for the Dental Team. 14. Since the launch of the CPD review in summer 2011, the GDC has worked proactively and consistently with the dental sector to assess the merits and shortcomings of the current scheme and consider approaches for the future. 15. This has included a registrant CPD survey; a large national stakeholder event; discussion at 3 rd party events and conferences; calls for information; and two public consultations. It has also included discussion and engagement through the GDC s Continuing Assurance Stakeholder Forum, made up of approximately 30 key stakeholders (including patient groups), which was established in We have also worked extensively with the Department of Health in England throughout 2013 and 2014 to develop potential new underpinning secondary legislation. Furthermore, we have raised external awareness more widely across the regulation field, through the Inter- Regulatory Group on Continuing Fitness to Practise; the UK Inter-Professional Group s CPD Forum; and through our membership of PARN (Professional Associations Research Network). 17. We have held two major public consultations the CPD policy consultation in 2012 and the CPD rules consultation (which reflected the policy) in 2013 (see Appendix 2). Each consultation has indicated general support for the GDC s policy and legislative proposals in this area. Page 3

4 Evidence-base 18. The related policy development has demonstrated an evidence-based approach. 19. This includes six relevant independent research studies commissioned by us during the CPD review. These were: a literature review on CPD effectiveness (Eaton 2011) a registrant survey on CPD engagement and motivation (ERS: Research 2012) an assessment of CPD engagement as a performance management tool (Picker 2012) CPD industry evaluation (ICF GHK 2013) independent analysis of regulatory impacts (Europe Economics 2013 & 2014) approaches to auditing CPD (Europe Economics 2014) 20. The GDC Annual Registrant Surveys and a Patient and Public Surveys since 2011 have also provided relevant insights. Features of the proposed CPD policy 21. The revised CPD policy would comprise a number of key features which either retain current CPD requirements, remove or modify them, introduce a new approach, or make current advisory elements mandatory. 22. The features are proposed as: CPD High level Learning Outcomes (linked to Standards) Stays the same Removed Modified New Currently Advised Annual CPD Statements X X End of cycle Statements Embedding reflection X X Written CPD plans X X 5 year cycle X CPD year and cycle dates Power to require CPD Record Non-verifiable CPD Serving electronic notices 6 month grace period X Advance written request for grace period X X X X X X X Page 4

5 2 month grace period in exceptional circumstances only Non-compliance procedure Definition of CPD Link to the Standards X X Direct link to field of practice and specialist practice Frequency of CPD CPD minimum hours Requirements for Temporary Registration Transitional requirements (temporary) Restoration X X X X X X X X X What would stay the same, or be modified 23. The 5 year CPD cycle and the CPD year for dentists (1 Jan 31 Dec) and for Dental Care Professionals (1 Aug 31 July) would remain the same (except for Temporary Registrants see below). The new scheme would not change the current CPD cohorts. The registrant would be required to continue to hold a CPD Record which the GDC would continue to have the power to require, but both during and after the CPD cycle. The restoration provisions have been modified for simplification although do not introduce any significant change for the GDC or for registrants. There would still be the provision to serve legal notices by electronic communication where registrant consent was granted, as at present. What would be removed Non-verifiable CPD 24. CPD that is non-verifiable would no longer be admissible under the proposed new approach. Our consultations and feedback have indicated that CPD which is not verifiable may not command trust and assurance amongst dental professionals. This is because it is not possible to independently confirm that the CPD was undertaken, there may not be quality control and no proof the activity met the definition of CPD. Our 2012 policy consultation also indicated that 58.9% of respondents agreed with only admitting verifiable CPD in the scheme. 6 months grace period 25. The principle of the grace period is to allow a short amount of time immediately after the five year cycle has ended for compliance to be achieved, where this was not possible within the CPD cycle for reasons outside of the registrant s control. It is proposed that there would no longer be a six month grace period. The principle of a grace period would be retained but would be limited to 2 months after the end of a CPD cycle. It would only be awarded by the GDC with prior agreement and in exceptional circumstances. 76.5% of respondents to our policy consultation in 2012 agreed with a two month grace period. Page 5

6 Unnecessary non-compliance notices 26. The current CPD scheme requires a number of written legal notices to be sent to the registrant where they are not deemed compliant, prior to any removal from the register. This could be due to failure to declare compliance with the CPD requirement; failure to submit documentation to the GDC when required; or failure to comply with the CPD Record. Unnecessary notices may cause an unnecessary delay to the GDC being able to make a final decision about compliance. The operational teams estimate that in exceptional cases it can currently take up to 18 months to remove someone from the register for non-compliance with CPD requirements. The new scheme provides an opportunity to remove any unnecessary duplication of notices or delay. What would be new Definition of CPD 27. The current definition of CPD, which is focused on advancing dentistry, is broad and uncontextualised. The proposals would introduce a requirement for CPD to be relevant to the practitioner s field of practice. This would relate in a more targeted way to their current practice, their intended practice and their specialist practice (including where they are on a Specialist List). 28. The concept of high-level learning outcomes would also be introduced, that would create a direct link between CPD activity and the GDC s Standards. This is absent in the current scheme. The 2013 Rules consultation found that 60.7% of respondents agreed with the proposed high level learning outcomes. Regular CPD 29. Our research has shown that CPD can be more effective when it takes place regularly. However, under the current scheme CPD can be done at any point, and there is the potential for it to be concentrated at one point in the cycle such as the beginning or the end. The current approach does not necessarily provide a framework within which registrants are supported to undertake CPD regularly, although of course many registrants may choose to do so. 30. To provide a supportive framework for regular CPD, the proposed scheme would introduce a requirement for registrants to undertake at least 10 hours CPD every two consecutive years of their CPD cycle. This would allow flexibility to plan the timing of their CPD while avoiding long gaps. Temporary Registrants would be required to do at least 20 hours of CPD every year (see below). Temporary Registrants 31. The GDC s Temporary Registration Guidelines published in 2013 reminds those holding temporary registration (TR) that they must undertake CPD. It states: Once registered, temporary registrants are subject to the GDC s CPD rules in the same way other registered dentists are. Therefore it is recommended that the temporary registrant keep a CPD record as set out in the rules. However, due to the time limits of their registration, TRs have normally left the register before the GDC can undertake end of cycle processes. The proposed new scheme takes direct account of the variable pattern of registration of TRs, so enabling them to meet our requirements by undertaking a fixed annual minimum of 20 hours CPD per year. Verifiable CPD only 32. The current CPD scheme allows up to 70% of CPD done to be non-verifiable, although must still be logged, with a description and number of hours attributed to it, as part of the CPD Record. For Dentists up to 175 hours (of 250) and up to 100 (of 150) for DCPs are admissible. Page 6

7 33. The new scheme is proposed to require all CPD to be verifiable. There would also be a reduced overall minimum amount of CPD (Dentists 100 hrs, Dental Nurses and Dental Technicians 50 hours, and all other groups 75 hours). All CPD would be supported by the following documentary evidence: subjects learning content aims objectives and anticipated learning outcomes date CPD hours that the practitioner has participated in full the CPD is subject to quality assurance, and the name of the individual or body responsible provided signed declaration from the CPD provider that the documentary evidence is full and accurate CPD Record 34. Our research has indicated that a planned approach can make CPD more effective. It can enable good CPD decision making to take place, based on reflection on skills and development needs in the context of individual practice, the dental team, patient needs and developments in dentistry. All registrants would have to declare to us annually that they are holding and maintaining a CPD written plan in accordance with requirements. 35. The scheme would also require all registrants submit an annual statement about the CPD they have done, declaring that they are maintaining a CPD Record (see below). A CPD Record would comprise a CPD Plan; a description of the CPD undertaken and amount of hours attributed to it; documentary evidence of the CPD; and the learning outcome achieved from the CPD. Mandatory Annual CPD Statement 36. The current CPD scheme does not enable the GDC to require dental professionals to tell us about the CPD they have done within the CPD cycle we can only require that information at the end of a five year cycle. This means there can be 5 years of uncertainty for the GDC as to levels compliance. Although we already invite every registrant annually to voluntarily declare to us the CPD they have done, not all do so. The new scheme is proposed to introduce a mandatory Annual CPD Statement. This would enable the GDC to have more regular information about whether a registrant is doing CPD complying our requirements. The statement must provide the number of hours CPD undertaken during the CPD year, even where it is zero; confirm that a CPD Record has been keep in accordance with requirements; and confirm that the CPD undertaken is relevant to the practitioner s field of practice. Transition to the new scheme 37. The GDC already has requirements in place for CPD which means the introduction of any change would require a transition from one approach to another. There are 11 semiconcurrent cohorts comprising varying numbers of dentists or dental care professionals. Similarly the CPD year aligns with the registration year for dentists (1 st Jan 31 st Dec) and for DCPs (1 st Aug 31 st July). This is proposed to remain unchanged. Page 7

8 38. The GDC has considered how best the transition may be made from one set of requirements to another. 39. Due to the semi-concurrent nature of existing CPD cohorts it is inherently challenging to transition, because there is no single natural break point at which to make the switch. 40. We have considered taking an incremental approach whereby registrants would only transition at their natural next end of cycle (i.e. roll off-roll on). However, this was not proposed as it would mean some registrants would not transition for up to four years following the implementation of the scheme. This would not enable the benefits of an enhanced CPD scheme to be realised for some registrants for some time. It would also mean that the GDC would have to operate and administer two CPD schemes concurrently which would be administratively burdensome. 41. Reconfiguration of the cohorts was also considered so that all current CPD cycles would be ended at a single point and a new cycle and cohorts introduced which would also have the benefit of allowing the GDC to numerically rebalance the cohort sizes. However, that would require every registrant (circa 105,000) to start a new CPD cycle, and every registrant to go through an end of cycle process under the former scheme at the same time, in order to make the switch. We considered this to be confusing for registrants and administratively burdensome for the GDC. 42. The scheme is proposed to take a more pragmatic approach. Every registrant would remain in the same CPD cohort so their CPD cycle would be unaffected. However, on the coming into force date every registrant would be required to comply with the new scheme from that point forward, and their compliant activity under the former scheme would count on a pro rata basis towards their end of cycle. Their end of cycle point would remain the same. 43. This approach is not without some complexity because it would mean the registrant would have an end of cycle requirement that is a combination of the old and new schemes and may be different to what it would normally be. The Communications Team would develop a multi phased communications plan to enable all registrants to have the right information about what their requirement would be for them. CPD Rules 44. Sections 34A, 34AA and 34B (in respect of Dentists) and sections 36Z1 and 36Z2 (in respect of DCPs) of the Dentists Act 1984 provide the power to make rules for continuing professional development. 45. Any change to the current CPD requirements will require a change to secondary legislation. 46. The current General Dental Council (Continuing Professional Development) (Dentists) Rules Order of Council 2008 and General Dental Council (Continuing Professional Development) (Professions Complementary to Dentistry) Rules Order of Council 2008 would be revoked at the coming into force of any new CPD rules. 47. The Council approved the draft CPD rules in December 2013 for public consultation which was held from December 2013 to March The consultation feedback indicated general support (see Appendix 2). Although some technical legal drafting amendments have since been made, there have been no policy-based amendments to the draft rules since the Council approved them in December The revised draft rules are at Appendix 3, which have also been consulted upon by the Department of Health in England with the devolved administrations. Page 8

9 Risks and Considerations 49. Appendix 1 sets out the relevant risks and considerations. Recommendations 52. The Council is invited to agree the policy basis and proposed scheme of enhanced Continuing Professional Development. Page 9

10 APPENDIX 1: RISKS AND CONSIDERATIONS Risks and Considerations Public Protection The proposed CPD scheme aims to improve the effectiveness and impact of the GDC s CPD requirements in the context of patient safety Policy The scheme has been developed using an evidence-based approach. Sign off Alex Hunter, Interim Director of Policy and Communications Alex Hunter, Interim Director of Policy and Communications Communications Effective implementation and delivery of any revised scheme of CPD, particularly during any transition phase, would require effective communication with registrants, CPD providers and other key stakeholders. Equality and Diversity An impact assessment considers any new impacts of the proposed CPD requirements on registrants. Alex Hunter, Interim Director of Policy and Communications Alex Hunter, Interim Director of Policy and Communications Legal Draft secondary legislation has been developed by Corporate Legal in conjunction with the Policy Team and the Department of Health and will require approval by the Council. Risks Continuing the current CPD scheme risks perpetuating an ineffective approach to supporting dental professionals to keep their skills and knowledge up to date. Unnecessary delay in agreeing a new CPD approach could create uncertainty and disengagement by registrants, CPD providers and employers following engagement with them in the development of the proposed scheme. The cost-effectiveness of the operational implementation of the scheme will affect its regulatory impact. Untargeted and ineffective communication about any new CPD scheme could result in confusion for registrants, CPD providers and other key stakeholders and mean there are higher levels of non-compliance putting registrants registration at risk. Frances Low, Director of Governance Alex Hunter, Interim Director of Policy and Communications Page 10

11 Resources Failure to cost-effectively modify the CRM system to take account of proposed new CPD hours requirements and annual declarations. Failure to cost-effectively achieve any operational readiness for implementing the proposed scheme. An analysis of implementation costs and options is in progress. Graham Masters, Director of Finance and Corporate Services Page 11

12 First circulated to Council Members May 2014 Appendix 2 March 2015 Summary high level analysis of CPD rules consultation GDC consultation on The General Dental Council (Continuing Professional Development) (Dentists and Dental Care Professionals) Rules Order of Council 2013 This analysis represents a high level and general summary of the responses received and is not a detailed transcription. 603 responses were received to the CPD rules consultation, including 39 from stakeholder organisations. 600 of these were analysed through our online consultations tool Questback, as detailed below. Supplementary responses have been taken into account under the relevant question, as appropriate. Based on those who told us about their professional title, 51.5% of responses were made by dentists and 42.2% by Dental Care Professionals (DCP). Of those telling us they are a DCP, 53.6% were dental nurses. Of those telling us where they practise, 82% of respondents told us they practise in England and 11.3% in Scotland, and 59.9% were female. 52.7% of those telling us where they had heard about the consultation told us it was through the GDC s website. The GDC also consulted on the proposed enhanced CPD policy in 2013 and this consultation did not duplicate or re-consult upon that previous exercise. Most respondents (60.7%) agreed with the proposed high level learning outcomes, which relate to the GDC s Standards and enable CPD that is in direct support of practice in accordance with Standards for the Dental Team. Some respondents made comments on this elsewhere in their consultation response or in supplementary submissions. For example a key stakeholder commented that: We understand the intention behind developing the high-level learning outcomes to be linked to all continuing professional development provision, but do not believe that their inclusion in a statutory document is Page 12

13 appropriate. Another said that they agree with the learning outcomes but would wish to emphasise the need to ensure that the CPD is relevant to the individual practitioner. A small number of individual respondents also made comments about perceived difficulty in linking CPD to the learning outcomes. Most respondents (79.5%) agreed with the principle of a minimum of 10 hours CPD in each two consecutive years of the CPD cycle. This is in order to ensure CPD is undertaken regularly throughout the CPD cycle and not undertaken at a single point in the cycle. Some respondents made comments on this elsewhere in their consultation response or in supplementary submissions. A very small number of individual respondents were concerned about the ability to undertake CPD regularly if suffering from ill health. In addition a key stakeholder commented We agree in principle with this proposal. However, there is a need to accommodate individuals who are unable to comply with this requirement, for example for reasons of serious illness, absence from work for caring duties as well as career breaks due to maternity leave. Page 13

14 Most respondents (73.5%) agreed with the documentary evidence required in support of CPD activity undertaken. Some respondents made comments on this elsewhere in their consultation response or in supplementary submissions. A key stakeholder commented We seek clarification of the requirement that registrants must have participated in the activity in full They also said We do not object to reference to quality assurance but, given that no central authority accredits all CPD provision in the UK and the term is not defined, this adds little to improve the current situation Another said There is insufficient clarity around what is meant by quality assurance of CPD. Who is to undertake this and how? Another stakeholder agreed with the documentary evidence required and also said they..welcome the consequence of this placing greater onus on the CPD provider to demonstrate the educational value of the CPD. A small number of respondents were concerned that CPD undertaken outside of the UK may not be compliant with the GDC s requirements. A small number of individual respondents thought that reading should be capable of being verifiable CPD. Most respondents (84.5%) agreed with the proposed approach to incorporating Temporary Registrants into the CPD proposals. Although a key stakeholder indicated that they did not agree with this proposal. Please note the response to the following question (Q5) needs to be adjusted due to one key stakeholder requesting a change to its response from No to Yes, following an earlier submission. The following findings now apply to this question: Y = 44.6% (n268); N=46.7% (n280); DN= 8.6% (n52) Page 14

15 The CPD Record is defined in the rules as comprising a number of parts, including a written plan, description of CPD and hours and link to a high level learning outcome. Responses were split between those that agree (44.6% adjusted) and those that disagree (46.5% adjusted). This part of the rules also specifies that the CPD record should be retained for 5 years after the CPD cycle, which represents no change to the current rules. Some respondents made comments on this elsewhere in their consultation response or in supplementary submissions. A stakeholder commented that It is unrealistic to expect that providers can provide any further evidence to the registrant which might be nearly 10 years after the CPD activity took place. (However the rules actually place responsibility upon the registrant, as is currently the case, to retain this not the CPD provider.) A key stakeholder commented We feel that it is absolutely inappropriate for the GDC should (sic) have access to the plan, which, in effect, is going to be a personal development plan (PDP). A small number of individual respondents also commented that the requirement to keep documentary evidence up to 10 years could be burdensome. A small number of individual respondents also commented on the challenges or concerns relating to a written plan including where they disagreed with the proposal, or that some further guidance or a template would be required. Page 15

16 Most respondents (65.4%) agreed with the proposed rules relating to a grace period. A small number made comments on this elsewhere in their consultation response or in supplementary submissions. A small number conveyed that they thought the grace period would be too short. A key stakeholder also disagreed with the approach to a grace period and said they have concerns about the regulatory demands this will place on those registrants who have a legitimate case for being granted a grace period. Page 16

17 Most respondents (72.8%) agreed with the proposed rules relating to restoration. A very small number of respondents made comments on this elsewhere in their consultation response or in supplementary submissions and thought the restoration requirements, regarding CPD, should be determined on a case by case basis. Question 8: Do you have any comments to make about the approach to transition to the new CPD requirements? This question required a free text response. Approximately 238 respondents made one or more comments in response to this question. The most frequently made comment, significantly higher than any other in response to this question, related to the perceived complexity and confusing nature of the transition approach. Fewer, but still a noticeable number, commented that there would be a need for clear communication from the GDC. A stakeholder said Given the legal constraints around the introduction of the new rules and the number of cohorts of registrants, the potential for confusion at transition is high. Communication via all available media will need to be carefully planned. Another key stakeholder said The approach to transition is very complex and hard to understand and will need clear guidance and the ability for individuals to seek clarity from the GDC. Another said There will be registrants groups (sic) who may find the transition period confusing. Clear guidance should be available and flexibly adopted. Another said that although it seems unfair to those who have satisfied the old requirements in their 5 year cycle, it is the most practical way to approach the transition A key stakeholder said We are very concerned about the pro-rata approach to transition. Despite the best efforts of the GDC and professional organisations to clarify these proposed requirements, the level of risk of confusion and wrong declarations is simply enormous. Another stakeholder said The proposed transition arrangements are complicated and likely to be confusing to registrants and there is room for misunderstanding clear and explicit guidance must be provided to every registrant to avoid confusion. Another key stakeholder said we believe that this is a fair way of carrying out the transition and allows adequate time for registrants to adapt. A small number suggested that all CPD cycles should be brought to an end at a single point and the CPD cycles then restarted. A noticeable number suggested a phased approach to the transition to the new rules, at the natural end of a cycle this was also proposed by two stakeholder Page 17

18 organisations. A very small number of individuals commented that they had already paid for all their CPD upfront, in a package, and wondered how transitioning to new requirements would affect them. Some commented that they thought the current scheme was adequate so there should be no need for transition. A very small number said they simply disagreed with the proposals. Comments were also made by a small number of respondents (1 or more people) on a range of other points including: the proposed CPD hours are too low; the proposed CPD hours are too high; concerns about quality of CPD; that non-verifiable CPD should be retained. A sizeable number either chose to say they had no comment or that the proposals for transition were fine. Question 9: Do you have any other comments to make about and proposed new CPD rules? This question required a free text response and around 300 respondents made one or more comments. The most frequently commented upon aspect related to access, availability and/or costs of CPD activities. Second to that were comments about concerns relating to the quality of CPD provision. A key stakeholder raised concerns regarding the quality assurance of CPD (that) remains a major issue and is of key importance for providers to work together to ensure a level of consistency across CPD with respect to quality. Another said they have commissioned a Research Project and will make recommendations on the Quality Assurance of CPD in Dentistry. It is hoped that this will provide a potential blueprint for realistic QA of dental CPD... A smaller but still noticeable number questioned why the CPD scheme should change and what the evidence for change was. A similar small number also thought the proposals duplicated some existing requirements made by other bodies or would be bureaucratic. A small number of respondents thought the proposals were too prescriptive. A key stakeholder said Overall (it) supports and welcomes the changes to the CPD scheme. The proposals seem fair and appropriate to protect the patients of the majority of dentists. However (it) has concerns about how the requirements will affect some of the smaller dental specialties, dentists who do not have contact with patients and those who practice in a medical environment. Another said they broadly welcome the new approach as this means that CPD will be relevant to the person s field of practice rather than the current generic approach Another key stakeholder commented by saying We welcome the GDC s approach to embedding CPD as part of registrants professional lives and reiterate our support for the key themes that have been identified. (It) supports the introduction of mandatory annual CPD declarations to the GDC and the verification process to enable good quality. We would be keen to be alerted to any concerns arising from this process, where those concerns impact on the safety and quality of dental practice. A noticeable number of respondents also said they would need more information and guidance about the requirements. Comments were also made by a small number of respondents (1 or more people) on a range of other points including: all CPD returns should be made online and egdc should be improved; should be a requirement for some hands on CPD ; and a query about how the scheme would be audited. In addition to the comments relating to the rules directly, a significant number of comments were made that will be useful for the development of guidance in relation to the potential new requirements. These will be taken on board, as appropriate, at that stage. Page 18

19 Appendix 2 March 2015 First Presented to the Council March 2013 Summary Quantitative and Qualitative Analysis of CPD Policy Consultation 387 responses were received and uploaded to Questback and the information below relates to those responses. An additional two responses (not included in Qual analysis) were submitted after the close of the consultation. Verifiable CPD Do you agree or disagree that in the future CPD should be based only on verifiable activity? (paragraphs 42-48) Alternatives Percent Value 1 Agree 58,9 % Disagree 41,1 % 157 Total 382 Page 19

20 Do you have any suggestions about how the range of CPD activity could be verifiable other than by certification? 185 respondents made comments about this question. The theme of CPD quality was raised throughout the responses to this question and the need to address poor quality CPD activity, including that which isn t evidence based or where there is a low pass rate. Certification was generally considered the most straightforward approach, although some commented on the weakness of any self-certification. A key stakeholder organisation said we suggest that the GDC ensures that proof of attendance is made available only to those who have participated in the events in full. Several respondents referred to personal development planning and evidence of reflection as being a potential basis for verification. Another key stakeholder organisation commented on the value of CPD derived from within a dental team. A key stakeholder organisation suggested a short reflective commentary (as) a compulsory component of verifiable CPD. A small number of respondents suggested CPD activities should include testing and certification after the event and certification following a period of reflection. Several respondents suggested CPD providers should communicate directly with the GDC about participation so that no certification was required. A number of respondents commented on the ease of online CPD because it is deemed to be easily verifiable with online records/certification, while others questioned CPD that lacks engagement with other people. A number suggested that the GDC should approve or accredit CPD providers who then validate events and activity. One key stakeholder organisation suggested the use of OSCEs (Objective Structured Clinical Examinations) within CPD activity or that the GDC randomly samples the reflective statements of registrants. A small number of respondents suggested colleagues sign off CPD activity. One key stakeholder organisation commented that We must move away from the system that just turning up to an event complies with CPD requirements. Some respondents commented on performance management activities such as peer review or clinical audit being countable as verifiable CPD, others suggested preparation of articles/lectures, or mentoring as verifiable. CPD Cycle Do you agree or disagree that the five year CPD cycle should be maintained? (paragraph 49) Page 20

21 Percent Agree 2 Disagree Percent Alternatives Percent Value 1 Agree 87,4 % Disagree 12,5 % 48 Total 383 If you disagree, please explain why and what alternative approach you would prefer. 54 responses were given to this question. Many respondents suggested a shorter cycle than five years, including 1 year, 2 or 3 years. Comments included: I think a yearly approach should be adopted ; 5 years is too long. 2 yrs is more appropriate ; The present 5 year cycle seems too long, diminishing the importance of CPD. One respondent said There should be an annual review in order to prevent people cramming the requirements into the end of the cycle. Some respondents commented that a shorter time frame would sit more comfortably with personal development planning. A key stakeholder organisation said Due to the advances in technology and changes in legislation a 3 year cycle would seem more appropriate. Another key stakeholder organisation said the CPD cycle ensure there is an opportunity for both the individual and the GDC to review the effectiveness of CPD. Minimum Hours Do you mainly agree or disagree with our proposed minimum hours requirement for CPD? (paragraphs 49-59) Page 21

22 Alternatives Percent Value 1 Mainly agree 83,3 % Mainly disagree 16,7 % 62 Total 371 Is there any element of our minimum hours requirement you disagree with or are concerned about? (paragraphs 49-59) Alternatives Percent Value 1 Yes 37,0 % No 63,0 % 221 Total 351 If you disagree or are concerned about any element, why is that? 154 responses were made to this question. Page 22

23 There was some questioning of how the GDC arrived at the suggested minimum hours. A key stakeholder organisation said We would have welcomed greater clarity about the purpose of the input-based minimum hours requirement and how it was developed. They also would like to see the level of risk determine what CPD is done. Some respondents thought it was too much, and some also had concerns over the access to, quality and cost of CPD. One said This leaves us open to yet more costs, very little good quality CPD exists. Another said There is a risk that the courses and relevant CPD hours just aren t there to complete ones CPD. A small number referred to the difficulties of undertaking CPD where there is part-time working, maternity leave or health- related absences from practice. A key stakeholder organisation said Although we agree registrants do have substantially different needs and less opportunity to gain access to appropriate CPD. A noticeable number thought the minimum hours proposed were too few. One said I feel this would not be enough CPD and I could not possibly stay up to date with having to do 50 hours in a 5 year cycle. Another registrant said A 100 per cycle would suggest less than ½ hour per week throughout the cycle, which I think is not much of an achievement for a highly qualified professional Another said 100 hours in 5 years seems low. One key stakeholder said It would seem appropriate that all DCPs undertook the same amount of CPD 75 hours. Another said that they were concerned that the GDC proposes substantially fewer hours for the minimum verifiable CPD requirement for Dental Nurses and Dental Technicians. Another key stakeholder said they would like to see all registrants that are clinically involved with the patient carry out the same amount of hours of CPD. A small number of respondents questioned the notion of a minimum number of hours, and how the GDC could imply more may be needed. One key stakeholder said either the minimum is sufficient or not. Another key stakeholder went on to say We feel that input-based CPD requirements offer limited benefits in terms of assuring the continuing fitness to practise of professionals. One respondent questioned whether CPD can provide any assurance of continuing fitness to practise. They went on what evidence is there that practitioners routinely incorporate knowledge of new and proven techniques into clinical output? Another said CPD should be based on quality not quantity and another said an hours calculation says absolutely nothing about the quality or content of the CPD A key stakeholder commented There should be an expectation that all registrants complete CPD activities throughout the 5 year cycle rather than being able to complete 100 hours in a single short period. One key stakeholder organisation thought that further changes would be required in the light of any future Direct Access. Mandatory Annual PDP Declaration Do you agree or disagree with a mandatory annual PDP declaration? (paragraphs 60-64) Page 23

24 Percent Agree 2. Disagree Alternatives Percent Value 1 Agree 64,5% Disagree 35,4 % 134 Total 378 If you disagree, can you set out why that is? There were 143 free-text responses made, although a number actually gave comments supportive of the principle of a PDP declaration. Of those that were in disagreement the response themes included: it is too bureaucratic or should be encouraged as voluntary, and that they should not be made available to the GDC. For example Pointless for many people ; I am a professional and should be trusted to develop my career effectively ; and Dentistry can be seen as an art and one needs the feeling of freedom to produce art, even though regulation exists to control it. One key stakeholder organisation commented that the annual PDP should be by self declaration but that no details of the PDP should be sent to the regulator. Other respondents commented they are not effective and waste time or could be made up, such as: It doesn t actually show anything simply that you have claimed CPD rather than the quality of courses ; Total waste of time! I have seen many people just making up any old tripe for these ; and It will set up unfair competition amongst dentists: Is your PDP better than my PDP?. Some commented on their perceived lack of evidence that PDPs are effective, such as I don t feel there is any evidence that it will improve standards and The principle is sound but what evidence is there that PDPs are effective. One commented Being heavily involved in postgraduate training I am well aware that there is little concrete evidence that PDP-style recording is of meaningful benefit A small number of respondents made reference to the costs. One commented This means more administrative costs to the GDC, which will lead inevitably to an increase in our annual fee for registration. Another said Funding is required to support this proposal both in terms of training and in implementation. A small number of others thought it may put people off the dental profession. Some respondents thought it would be difficult to roll out personal development planning across dentistry, such as I can see the benefit of this as within my current job we have annual appraisals and PDP, however I doubt this will be manageable across dentistry ; Funding is required to support this proposal both in terms of training and implementation ; I agree with the proposal, but employers will need to be clearly advised and understand their responsibility to facilitate and Page 24

25 support the production of PDPs ; and Registrants would initially need support in preparing their PDP and ensuring it is fit for purpose. A number of comments were also made about the equality and diversity impact. For example one key stakeholder organisation agrees that a mandatory PDP declaration is a good idea. However provision would need to be made for individuals who may be off for extended periods ; another said We would also urge that the system make allowances for situations of long term illness, maternity leave etc. A further key stakeholder commented that a staged rollout of this requirement may help those who do not already have a PDP. A small number made comments proposing that the GDC audit a small number of PDPs, including some key stakeholder organisations. However the one key stakeholder organisation rejected any submission of the actual PDP to the GDC. Core and recommended topics Should the concept of core and recommended topics be retained? (paragraphs 65-71) Alternatives Percent Value 1 Yes 86,3 % No 13,7 % 52 Total 379 If yes, should they be mandatory? Page 25

26 Alternatives Percent Value 1 Yes 68,2 % No 33,5 % 116 Total 346 Do you have any other comments to make about this? There were 179 responses to this question. The quality of CPD was a theme running through responses to this question. Some also thought that CPD topics should be derived from reflection and PDPs. Where there were comments on the specific topic areas there was certain support for retaining medical emergencies and radiation protection, although some others didn t think the latter was relevant to all. One key stakeholder organisation said it is (our) view that there is a place for mandatory core topics, such as medical emergencies. However this should be kept to a minimal proportion Several respondents particularly called for the adoption of child protection as an additional topic. A small number of comments referred to the inflexibility of having defined topics in a changing world of dentistry. One respondent said: The problem with this is it can easily become inflexible the modern world requires a system that can respond to change more quickly. Another said: It does not fit in with the variety of roles dental registrants take on in the 21 st century world of dental/oral health. One key stakeholder organisation said If it were made mandatory then a number of registrants would just be going through the CPD requirements with no focus on their own CPD needs. Some respondents commented on the disadvantages of core/recommended topics becoming the focus of activity to the exclusion of other relevant topics, while others said that having core and recommended at least stopped some practitioners repeatedly concentrating on their favourite topics. For example: Making them mandatory would drive all the providers and dentists to a bias on what to do for CPD ; and Core CPD is beginning to dominate many registrants CPD planning and steadily grows. One key stakeholder organisation said if it were made mandatory then a number of registrants would just be going through the CPD requirements with no focus on their own CPD needs. Another key stakeholder organisation said If CPD is to be based on an individual professional s personal development plan then it makes little sense to stipulate care/recommended topics which may not be relevant to the area of dentistry in which that professional practices Page 26

27 A number of respondents made comments on their support for core/recommended topics. One key stakeholder organisation said A limited number of mandatory CPD activities could be identified and should refer only to what is legally required by a particular registrant ; another said Retaining core topics ensures CPD is focused. A further key stakeholder organisation said Not having recommended topics may lead to individuals missing out on important areas of practice with in the cycle. Another said they would like to see the recommended topics retained.. but Making the topics mandatory would result in a system too prescriptive to encourage professionals personal responsibility for self-directed learning based on a PDP. CPD Learning Outcomes Do you agree or disagree with linking CPD learning outcomes to the GDC's standards? (paragraphs 72-75) Alternatives Percent Value 1 Agree 66,7 % Disagree 33,9 % 128 Total 378 Do you have any comments to make about our proposals to embed reflection into the new CPD scheme? 183 responses were made to this question, which focused on reflection as well as linking CPD learning outcomes to the Standards. Many respondents to this question thought reflection was important to effective CPD. Comments included Agree reflection on learning needs and learning outcomes is important ; This may be the most important change being made as recording reflection might alter the way CPD is viewed by dentists and DCPs ; reflection allows the author an opportunity to demonstrate insight ; and Reflection is an essential part of CPD and including it is very sensible. Others thought reflection was positive if more than a tick-box exercise. Page 27

28 One key stakeholder organisation commented that Reflection should be at the heart of CPD, and there is strong evidence that it improves the degree of learning from each activity. In welcoming the emphasis on CPD outcomes another commented if measures to regulate CPD are to be effective, they need to focus on outcomes rather than inputs and should enable registrants to continue to meet standards of professional competence and conduct. A further key stakeholder commented We strongly support this aim since a written reflection helps to embed learning and can provide some evidence of learning and behaviour change, particularly if linked to e.g. outcomes of clinical audits. Other respondents thought reflection was difficult to achieve or a waste of time. For example: Much of CPD does not require any deep reflection ; this is more box ticking for the sake of it.. ; and utter nonsense. Some commented that prescribing reflection was not useful and it is more paperwork. A small number commented that reflection could be part of feedback to CPD providers. There were also some concerns over time to reflect and that some dental professionals may struggle with the concept. One respondent suggested that the GDC should provide guidance on how to demonstrate reflection. Another key stakeholder raised the issue of quality of CPD in the context of proof of anything being learned at all citing situations where they believe verifiable CPD awarded for mainly wrong answers. Some thought that reflection should be counted within CPD hours. One response commented that The expanded use of egdc should be encouraged to support the need for monitoring compliance with reflection requirements. A key stakeholder was concerned as to how the GDC would monitor compliance and the resource implications, that reflection should be private to the individual. Another asked what the GDC will do with reflection information, and thought it was very personal to the individual. Mandatory Annual CPD Declarations Do you agree with the introduction of mandatory annual CPD declarations? (paragraphs 76-84) Alternatives Percent Value 1 Yes 77,5 % No 23,8 % 90 Page 28

29 Total 378 If no, please set out your reasons why. 90 responses were made to this question. Some however were in favour of annual mandatory declarations. Many of the comments against mandatory annual declarations referred to the perceived time consuming nature of declarations. Some thought a declaration at the end of the 5 year cycle was sufficient. Some respondents questioned what would happen if on maternity leave or abroad for a year. One key stakeholder saw two perspectives that registrants are already used to a five year cycle and that annual declarations would be an extra administrative hurdle and that the proposal has the merit of promoting the taking of a disciplined and organised approach to CPD. Another response commented that the ability to leave CPD to the last minute is not in anyone s interest. If yes, do you have any additional suggestions about what should be required within a mandatory annual CPD declaration? 120 responses were received to this question. Some respondents preferred a simple hours only approach to mandatory declarations. Some respondents queried how much this approach would cost the GDC and what would be done with the information. Others suggested additional information such as CPD topics, supporting documentation, reflection and what was learned, submission of the PDP. One key stakeholder asked how the GDC intended to monitor compliance of annual declarations. Many respondents suggested core or recommended topics and cited suggestions. Another key stakeholder supported the idea of mandatory declarations although warned the GDC of imposing a burden. Another said We support the introduction of a mandatory annual CPD declaration if it includes learning outcomes and reflective statements related to registrant s PDP. Another suggested that a minimum number of CPD hours per year are specified for each registrant group to ensure registrants can demonstrate an on-going commitment to learning and professional development. Another said they support the introduction of mandatory annual CPD declarations as it will help the GDC and registrants be aware of CPD compliance at an earlier stage than under the current system. 2 month grace period Do you agree or disagree with a 2 month grace period for non-compliance? (paragraphs 85-91) Page 29

30 Alternatives Percent Value 1 Agree 76,5 % Disagree 24,0 % 90 Total 375 Are there any equality and diversity considerations we should take account of in making final decisions about a grace period? 192 responses were made, although 29 people answered no to the question. Many respondents favoured a longer grace periods, including in the context of factors such as ill health, maternity leave and childcare, sabbaticals, bereavement or time spent working abroad. Some suggested 3 months, 5 months, or six months. One key stakeholder commented that in addition to equality and diversity considerations it may be the case that due to conflicting timescales it is appropriate to delay the completion of CPD. Another commented that Practitioners working in remote and rural areas might find it difficult to access courses required to comply with regulations. One made comments that the whole team need to be allowed to attend and accrue CPD hours and in turn learning. Another called on the GDC to consider the proposal in the context of the Disability Discrimination Act and to retain the 6 month grace period. A number of respondents agreed with the 2 month grace period, such as from a key stakeholder who said 2 months is sufficient time for a dentist who has good reasons for having fallen behind with CPD to make up the deficit. Another key stakeholder thought that the annual and five year points should give everyone the chance to comply but that individual mitigating circumstances may need to be considered. Another said In a cycle period there is ample opportunity to undertake CPD as professionals it is an individual s responsibility to ensure the mandatory amount of hours are achieved within the timescale. Some comments suggested the GDC should have discretion to determine a grace period. Other comments stated they did not agree with a grace period, for example No each registrant has 5 Page 30

31 years in which to plan and execute their CPD, a couple of extra months will only encourage those who do not wish to, to leave it until they are asked for proof of CPD activity ; if you have a deadline, they should meet it ; and It should be taken seriously from year one not left until time has ran out!! Improved GDC online system to manage and record CPD Would you make use of an improved GDC online system to manage and record your CPD if it was made available to you? (paragraphs 92-97) Alternatives Percent Value 1 Yes 86,6 % No 14,2 % 53 Total 372 Please set out any equality and diversity implications you perceive arising from our proposals to encourage the use of a GDC online system to record and manage CPD? 128 responses were made to this question. Page 31

32 Many respondents commented that some registrants may not have IT connections or IT skills. One key stakeholder organisation said in an age of digitalisation, we very often hear about the haves and have nots, the information rich and the information poor. The national statistics show a huge percentage of the population who are either not digitally able or who do not have access because of poor networks or financial implications. Another said Whilst it shouldn t be an issue for many, some registrants may have difficulty accessing computers or be unfamiliar with systems. Some commented that there needs to be an alternative approach to those without access to IT. One respondent suggested a phased transition to online facilities and incentivise use of IT through an ARF reduction: to promote more rapid adoption. Another key stakeholder commented that an individual affected by physical or a learning disability could have difficulties in accessing an online system. Another respondent also commented that There are certain impairments which make it difficult for some disabled people to use online systems. Others were concerned about the consequences of IT technical problems. One commented If it turns out to be as inefficient as the current one, why bother. Another said The current recording system is too basic and the GDC needs to invest in this if revalidation is introduced. Information security and use was also mentioned by a small number, for example one said Also perceive that Big Brother is wanting to watch! Security of information!! and from another Data protection/caldicot. One respondent asked How do I know you are securing my electronic data securely?! One key stakeholder commented that We believe that the GDC should not be the organisation in whose system the detailed information is logged. We are very concerned about the regulator holding a full set of its registrants CPD and PDP data. Several responses asked whether the GDC could link up to existing CPD recording systems in some way, including to Deanery or NHS Trust systems. One said Every possible online CPD environment is offering this system. The trouble is that they do not link up with each other. Another said Deaneries keep a record and many now offer PDP online. Would GDC consider linking electronically to Deanery databases Others suggested the development of a GDC App for CPD recording. A small number of respondents asked how much this would cost. Several respondents welcomed the suggestion of an improved online system and made comments on the need for it to be simple and concise. One said Simple and be easily accessible for the noncomputer minded individuals. One key stakeholder organisation said We would want it to be as simple and easily accessible. Another said Most registrants should be able to access an online system, and this should be encouraged. Another said likewise, This should be encouraged. Page 32

33 Appendix 3 S T A T U T O R Y I N S T R U M E N T S 20xx No. 000 HEALTH CARE AND ASSOCIATED PROFESSIONS DENTISTS AND DENTAL CARE PROFESSIONALS The General Dental Council (Continuing Professional Development) (Dentists and Dental Care Professionals) Rules Order of Council 20xx Made *** Coming into force - - *** At the Council Chamber, Whitehall the *** day of *** 20xx By the Lords of Her Majesty s Most Honourable Privy Council The General Dental Council has made the General Dental Council (Continuing Professional Development) (Dentists and Dental Care Professionals) Rules 20xx which are set out in the Schedule to this Order, in exercise of the powers conferred by sections 34A(1) and (4), 34B, 36Z1(1) and (4), 36Z2, 50A(6) and (7), and 50C(5) and (6) of the Dentists Act 1984( 1 ). By virtue of section 50C(2) and (3)(b) of that Act, these rules are not to come into force until approved by Order of the Privy Council. Citation and commencement 1. This Order may be cited as the General Dental Council (Continuing Professional Development) (Dentists and Dental Care Professionals) Rules Order of Council 20xx and comes into force 28 days after it is made. Privy Council approval 2. Their Lordships, having taken these rules into consideration, are pleased to and do approve them. Name Clerk of the Privy Council ( 1 ) 1984 c.24. Section 34A and 34B were inserted by S.I. 2001/3926 and substituted by S.I. 2005/2011 article 27; sections 36Z1 and 36Z2 were inserted by S.I. 2005/2011 article 33; and sections 50A and 50C were inserted by S.I. 2005/2011 article 43. (b) Section 50C(2) was amended by S.I. 2009/1182 Sch 1 para 10. Page 33

34 SCHEDULE General Dental Council (Continuing Professional Development) (Dentists and Dental Care Professionals) Rules 20xx These rules are made by the General Dental Council, in exercise of their powers under sections 34A(1) and (4), 34B, 36Z1(1) and (4), 36Z2, 50A(6) and (7), and 50C(5) and (6) of the Dentists Act 1984( 2 ). Citation, commencement and interpretation 1. (1) These rules may be cited as the General Dental Council (Continuing Professional Development) (Dentists and Dental Care Professionals) Rules 20xx and come into force on 1st August 20xx. (2) These rules take effect (a) in respect of dental care professionals, on 1st August 20xx; (b) in respect of dentists, on 1st January 20xx. (3) In these rules the Act means the Dentists Act 1984; CPD means continuing professional development through learning, training, or other developmental activities which (a) can reasonably be expected to maintain and develop a person s practice as a dentist or dental care professional; and (b) is relevant to the person s field of practice; CPD cycle means, in respect of (a) a dentist, a period of five years beginning on 1st January following the date the dentist is first registered and each subsequent period of five years; (b) a dental care professional, a period of five years beginning on 1st August following the date the dental care professional is first registered and each subsequent period of five years; (c) a temporary registrant, an accumulation of 1826 days of temporary registration beginning on the first day of temporary registration; CPD record means the record kept by a practitioner in accordance with rule 3; CPD requirement means the number of CPD hours required to be undertaken in accordance with rule 2; CPD year means, in respect of (a) a dentist, a period of 12 months beginning on 1st January in any calendar year; (b) a dental care professional, a period of 12 months beginning on 1st August in any calendar year; and (c) a temporary registrant, an accumulation of 365 days of temporary registration; dental care professional means a registered dental care professional( 3 ); dentist means a registered dentist( 4 ); field of practice in respect of a person means the activities that comprise the person s practice and intended practice, having regard to the title under which they are registered or in respect of which they are applying for restoration to the register, or area of specialist practice, within that title; learning outcome means an outcome intended to maintain or achieve a standard of conduct, performance and practice for dentists or dental care professionals (as the case may be) relating to the guidance prepared by ( 2 ) 1984 c.24. ( 3 ) Registered dental care professional is defined in section 53 of the Act to mean a person for the time being registered in the dental care professionals register under a title or titles. ( 4 ) Registered dentist is defined in section 53 of the Act to mean (subject to section 17(4) of the Act) a person for the time being registered in the register. Page 34

35 the Council under section 26B(1) and 36M(1)( 5 ) (as amended from time to time) and achieving one or more of the following in part or full (a) effective communication with patients, the dental team, and others across dentistry, in all relevant circumstances, including when obtaining consent, dealing with complaints, and raising concerns where patients are at risk; (b) effective management of the practitioner, and effective management of, or work with, others in the dental team, to serve the interests of patients at all times, and provide constructive leadership where appropriate; (c) maintenance and development of knowledge and skill within a practitioner s field of practice; (d) maintenance of skills, behaviours and attitudes which maintain patient confidence in the practitioner and the dental profession and which put patients interests first; practitioner means, a dentist or a dental care professional other than a person referred to in section 34AA(1) or 36Z4(1)( 6 ); register (a) in respect of a dentist, means the dentists register established under section 14(1); (b) in respect of a dental care professional, means the dental care professionals register established under section 36B(1); and in both cases registered shall be construed accordingly; temporary registrant means a person registered under section 17( 7 ). (4) In these rules, references to numbered Parts, sections and subsections are references to so numbered Parts, sections and subsections of the Act. CPD requirement 2. (1) Subject to paragraph (2), for each CPD cycle, the practitioner must complete the minimum number of hours of CPD set out in the entry in column 2 of the table which corresponds with the entry in column 1 in respect of the title under which the practitioner is registered. Column 1 Column 2 Title Minimum hours of CPD per cycle Dentists 100 Dental therapists 75 Dental hygienists 75 Orthodontic therapists 75 Clinical dental technicians 75 Dental nurses 50 Dental technicians 50 (2) A practitioner registered under more than one title, must complete the minimum number of hours of CPD specified in respect of the highest of the entries in the table under column 2 which apply to that practitioner. (3) The CPD undertaken in each CPD cycle must include activities relevant to each field of practice in which the practitioner practised during that cycle. (4) In completing the minimum number of hours required under paragraph (1) the practitioner must ensure that (a) in respect of a temporary registrant, at least 20 hours of CPD must be undertaken during each CPD year; or ( 5 ) The Council has produced the guidance Standards for the Dental Team under section 26B(1) and 36M(1) of the Act. ( 6 ) Persons referred to in section 34AA(1) and 36Z4(1) are visiting dentists from a relevant European state. ( 7 ) A person registered under section 17 is registered to practise dentistry in a particular post in a hospital or other institution for a specified period of time and holds a recognised overseas diploma. Page 35

36 (b) in respect of any other practitioner, at least 10 hours of CPD must be undertaken during each period of two consecutive CPD years (including any such two year period which spans over more than one CPD cycle). (5) Any CPD undertaken by the practitioner is only to count towards the minimum number of hours referred to in paragraphs (1) and (4) if (a) there is documentary evidence from the provider of the CPD which states (i) the subjects, learning content, aims, objectives and anticipated learning outcomes of the CPD and the date that the CPD was undertaken; (ii) the total number of hours of CPD undertaken; (iii) that the practitioner has participated in full in the CPD activity; (iv) that the CPD is subject to quality assurance and the name of the person or body providing the quality assurance is provided; (b) that documentary evidence includes a signed declaration by the provider that the information contained in it is full and accurate; and (c) the CPD delivered a learning outcome identified in the practitioner s CPD record in accordance with rule 3(2)(a)(ii). CPD record 3. (1) A practitioner must keep an up-to-date record in writing relating to all CPD that the practitioner plans to undertake and has undertaken during the CPD cycle. (2) The CPD record must comprise (a) a plan which identifies (i) the CPD which the practitioner plans to undertake during the relevant CPD cycle; (ii) the learning outcome which the CPD identified under sub-paragraph (2)(a)(i) aims to meet; (iii) a timeframe for completing the CPD identified in sub-paragraph (2)(a)(i); (b) a description of the CPD undertaken, the date it was undertaken and the number of hours attributed to the CPD; (c) the documentary evidence referred to in rule 2(5)(a) in relation to the CPD undertaken; and (d) the learning outcome achieved from the CPD undertaken. (3) A practitioner must retain the CPD record for five years after the end of the CPD cycle to which it relates. Annual CPD statement 4. (1) For each CPD year, a practitioner must, within the notice period, submit to the registrar a statement ( annual CPD statement ) which (a) provides the following information (i) the number of hours of CPD undertaken by the practitioner during the CPD year to which the statement relates or, if the practitioner has not undertaken any CPD in that CPD year, confirmation that no CPD has been undertaken; (ii) confirmation that the practitioner has kept a CPD record in accordance with rule 3; and (iii) confirmation that the CPD undertaken (where applicable) was relevant to the practitioner s field of practice; and (b) includes a declaration by the practitioner that the information contained in the annual CPD statement is full and accurate. (2) In the final CPD year of the CPD cycle, the annual CPD statement must also include (a) the total number of hours of CPD undertaken by the practitioner during the CPD cycle; and (b) confirmation that the CPD undertaken by the practitioner during the CPD cycle included activities relevant to each field of practice in which the practitioner practised during that cycle. Page 36

37 (3) In this rule notice period means the period of time not exceeding three months before the end of the relevant CPD year and one week after the end of the CPD year to which the statement relates. Notice to submit CPD record and other documents 5. (1) The registrar may send the practitioner a notice requiring the practitioner to submit to the registrar (a) at any time during a CPD cycle, the practitioner s CPD record in relation to part of that CPD cycle; (b) at any time within the period of five years after the end of a CPD cycle, the practitioner s CPD record for that CPD cycle; (c) any documents or information the registrar considers relevant for their assessment of the practitioner s compliance with the requirements of these rules. (2) The notice referred to in paragraph (1) must specify a date, not less than 28 days after the date on which the notice was sent, by which the practitioner must comply with the notice. Notice for failure to comply with the CPD requirement or CPD record 6. (1) Where the registrar is not satisfied that the practitioner has met the requirements in any of rules 2, 3,13 and 14, the registrar must send a notice to the practitioner (a) stating the reasons why the registrar is not so satisfied; (b) inviting the practitioner to make written representations or submit written evidence to the registrar on the matters specified in the notice; (c) specifying a date, not less than 28 days after the date on which the notice is sent, by which the registrar must receive the practitioner s response to the notice; (d) informing the practitioner that the practitioner s name may be erased from the register or, in the case of a dental care professional, the dental care professional s name may be erased from any of the titles under which the dental care professional is registered, if (i) the registrar remains not satisfied that the practitioner has met the requirement in any of rules 2, 3, 13 or 14, after considering any response made by the practitioner under sub-paragraph (b); or (ii) the registrar does not receive from the practitioner any response to the notice within the time limit specified by virtue of sub-paragraph (c). Notice for failure to submit documents 7. (1) Where the practitioner has failed to comply with any of the following requirements (a) to submit an annual CPD statement in accordance with rule 4, or has submitted the statement but it does not contain the information specified in that rule, (b) to submit the whole or part of a CPD record in accordance with rule 5, or (c) to submit any further documents requested in accordance with rule 5, the registrar may send the practitioner a notice requiring the practitioner to comply with any of the requirements the practitioner has failed to comply with. (2) The notice must (a) state which of the requirements referred to in paragraph (1) with which the practitioner must comply; (b) specify a date, not less than 28 days after the date on which the notice is sent, by which the practitioner must comply with the notice; and (c) state that if, by the date specified in the notice, the practitioner does not comply with the notice that (i) in the case of a dentist, the dentist s name may be erased from the register or, (ii) in the case of a dental care professional, the dental care professional s name may be erased from any of the titles under which the dental care professional is registered. Page 37

38 Erasure from the register 8. The registrar may erase the practitioner s name from the register or, in the case of a dental care professional, any of the titles under which the dental care professional is registered if (a) the registrar (i) has not received from the practitioner any representations or written evidence in response to the notice sent under rule 6 within the time limit specified by virtue of paragraph (1)(c) of that rule, or (ii) having considered any written representations or written evidence submitted by the practitioner in response to the notice sent under that rule, is not satisfied that the practitioner has met the requirements under rules 2, 3, 13 or 14 (as the case may be); (b) the practitioner has failed to comply with a notice sent under rule 7 within the time limit specified by virtue of paragraph (2)(b) of that rule( 8 ). Grace period 9. (1) A practitioner who has not complied with the CPD requirement as set out in rule 2 in respect of a CPD cycle may, before the end of the CPD cycle, apply in writing to the registrar for a further period in which to complete the outstanding CPD in respect of that cycle (a period of grace ). (2) The registrar must not consider an application under paragraph (1) if it is received more than six months before the end of the CPD cycle to which the period of grace relates. (3) Where the registrar is satisfied that there is good reason to do so, the registrar may grant a person bringing an application under paragraph (1) a single period of grace ending 56 days after the end of the CPD cycle. (4) Where a person has been granted a period of grace (a) rule 4 is to apply to them as if the reference to the CPD cycle was a reference to the end of the period of grace; and (b) any outstanding CPD undertaken during the period of grace will not be counted as CPD for the CPD cycle in which it is undertaken. Restoration to the register: requirements 10. (1) This rule applies to an application for restoration to the register made by a person ( the applicant ) who was previously registered and whose name was erased for any reason. (2) An application under this rule must be accompanied by (a) evidence that, in relation to the most recent CPD cycle completed by the applicant, the applicant met the requirements (where applicable) of (i) rules 2, 3 and 4, (ii) rules 3, 4 and 5 of the General Dental Council (Continuing Professional Development) (Dentists) Rules 2008( 9 ) or rules 3, 4 and 5 of the General Dental Council (Continuing Professional Development) (Professions Complementary to Dentistry) Rules 2008( 10 ) (as the case may be); (b) a record of all CPD undertaken in the shorter of the period (i) beginning with the end of the CPD cycle to which the evidence submitted under sub-paragraph (a) relates and ending on the date the application under paragraph (1) is received, or (ii) of five years preceding that application, or ( 8 ) The registrar s decision to erase a dentist from the register is an appealable decision under Schedule 2A of the Act (paragraph 2) and the decision will not take effect until the time for the an appeal has expired or the appeal has been determined (paragraph 4). In the case of a dental care professional, erasure is an appealable decision under Schedule 4A of the Act (paragraph 2) and the decision will not take effect until the time for the an appeal has expired or the appeal has been determined (paragraph 4). ( 9 ) Scheduled to S.I. 2008/1822. ( 10 ) Scheduled to S.I. 2008/1823. Page 38

39 (iii) beginning with the date of first registration and ending on the date the application under paragraph (1) is received. (3) The record in paragraph (2)(b) must (a) in relation to any dentist (i) where CPD is undertaken before 1st January 20xx, contain the information set out in rule 4(2) of the General Dental Council (Continuing Professional Development) (Dentists) Rules 2008; and (ii) where CPD is undertaken after 31st December 20xx, contain the information set out in rule 3. (b) in relation to any dental care professional (i) where CPD is undertaken before 1st August 20xx, contain the information set out in rule 4(2) of the General Dental Council (Continuing Professional Development) (Professions Complementary to Dentistry) Rules 2008; and (ii) where CPD is undertaken after 31st July 20xx, contain the information set out in rule 3. (4) The applicant must satisfy the registrar that, in respect of the period which is applicable under paragraph (2)(b), the applicant has completed (a) in relation to an application for restoration to the dentists register (i) for each CPD year which elapsed before 1st January 20xx, at least 50 hours of CPD, of which a minimum of 15 hours are to be verifiable CPD; and (ii) for each CPD year which elapsed after 31st December 20xx, a minimum of 20 hours of CPD; (b) in relation to an application for restoration to the dental care professionals register (i) for each CPD year which elapsed before 1st August 20xx, at least 30 hours of CPD, of which a minimum of 10 hours are to be verifiable CPD; and (ii) for each CPD year which elapsed after 31st July 20xx, a minimum of one fifth of the number of hours of CPD which is required in rule 2 in respect of a CPD cycle. (5) In this rule references to verifiable CPD have the same meaning as prescribed by the General Dental Council (Continuing Professional Development) (Dentists) Rules 2008 and of the General Dental Council (Continuing Professional Development) (Professions Complementary to Dentistry) Rules Restoration to the register: procedure 11. (1) Where the registrar receives an application to which rule 10 applies and the registrar is satisfied that the application satisfies the requirements of the relevant paragraphs of that rule, the registrar may restore the applicant s name to the register. (2) Where the registrar receives an application to which rule 10 applies and the registrar is not satisfied that the applicant satisfies the requirements applicable under that rule, the registrar must send a notice to the applicant which (a) states the reasons why the registrar is not satisfied that the application satisfies the requirements of the relevant paragraph or paragraphs; and (b) invites the applicant to make written representations or submit written evidence to the registrar on the matters specified in the notice. (3) The notice must specify a date, not less than 28 days after the date on which the notice is sent, by which the applicant must respond to it. (4) Where, after considering any written representations made or written evidence submitted by an applicant in response to the notice, the registrar is still not satisfied that the application satisfies the requirements of the relevant paragraph or paragraphs of rule 10, the registrar may decide not to restore the applicant s name to the register. Service of notices by electronic communication 12. Any notification to be served by the registrar under these rules may be served on a person by an electronic communication, but only if (a) the person consents in writing to the receipt of such notifications by electronic communication; and Page 39

40 (b) the communication is sent to the number or address specified by that person when giving consent. Transitional provisions 13. Where a dentist has commenced a CPD cycle within the meaning of the General Dental Council (Continuing Professional Development) (Dentists) Rules 2008 on any day before 1st January 20xx and that CPD cycle comes to an end on any day after that date, the CPD requirement for that CPD cycle is to be calculated as follows (a) for the period beginning with the day on which the CPD cycle commenced and ending on 31st December 20xx, the CPD requirement is to be calculated on a pro-rata basis in accordance with the General Dental Council (Continuing Professional Development) (Dentists) Rules 2008; and (b) for the period beginning with the 1st January 20xx and ending on the last day of the CPD cycle, the CPD requirement is to be calculated on a pro-rata basis in accordance with these rules. 14. Where a dental care professional has commenced a CPD cycle within the meaning of the General Dental Council (Continuing Professional Development) (Professions Complementary to Dentistry ) Rules 2008 on any day before 1st August 20xx and that CPD cycle comes to an end on any day after that date, the CPD requirement for that CPD cycle is to be calculated as follows (a) for the period beginning with the day on which the CPD cycle commenced and ending on 31st July 20xx, the CPD requirement is to be calculated on a pro-rata basis in accordance with the General Dental Council (Continuing Professional Development) (Professions Complementary to Dentistry) Rules 2008; and (b) for the period beginning with the 1st August 20xx and ending on the last day of the CPD cycle, the CPD requirement is to be calculated on a pro-rata basis in accordance with these rules. Saving provision 15. The General Dental Council (Continuing Professional Development) (Dentists) Rules 2008 are to continue to have effect as they applied on 31st December 20xx for the purposes of (a) administering a dentist s CPD cycle which finished on 31st December 20xx; and (b) calculating the CPD requirement where rule 13(a) applies. 16. The General Dental Council (Continuing Professional Development) (Professions Complementary to Dentistry) Rules 2008 are to continue to have effect as they applied on 31st July 20xx for the purposes of (a) administering a dental care professional s CPD cycle which finished on 31st July 20xx; and (b) calculating the CPD requirement where rule 14(a) applies. Revocations 17. The General Dental Council (Continuing Professional Development) (Dentists) Rules 2008 are to be revoked on 31st December 20xx. 18. The General Dental Council (Continuing Professional Development) (Professions Complementary to Dentistry) Rules 2008 are to be revoked on 31st July 20xx. Given under the official seal of the General Dental Council this *** day *** of 20xx Chair Registrar Page 40