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United Kingdom

Dental hygienist (United Kingdom)

  • Proportionality information

    1. Have you examined whether the requirements under your national legal system are
    directly or indirectly discriminatory on the basis of nationality or residence?
       The General Dental Council (GDC) has not examined this issue in detail. However, we accept applications for registration from dental hygienists via three distinct routes: UK approved programme; EEA mutual recognition rights (under Directive 2005/36/EC); and International applications. In 2013, we registered 22 European Economic Area (EEA) nationals in the category of dental hygienist on our Dental Care Professional (DCP) Register so that they have benefitted from mutual recognition rights for establishment purposes under Directive 2005/36/EC. For establishment purposes, each EEA mutual recognition rights' application is assessed on an individual basis which includes an initial assessment of the applicant’s regulated education and training against our pre-registration learning outcomes requirements, currently Developing The Dental Team and in the future Preparing For Practice, which define the outcomes required across dental education and training (i.e. the knowledge, skills and attitudes that an applicant for registration must demonstrate in order to join the DCP Register as a dental hygienist). These pre-registration learning outcomes requirements are the professional standards which every registrant (a professional on our Register) dental hygienist must meet in order to become registered. Registrants must maintain their competence, as part of meeting our ethical standards, in order to remain on our DCP Register. Once an EEA applicant’s professional qualification has been recognised by the GDC, the requirements and expectations are the same for each registrant regardless of their nationality or residence. Further information on applying for EEA mutual recognition rights is available on our website here: We firmly believe that our requirements under our national legal system are not unduly discriminatory on the basis of nationality or residence – they ensure that individuals meet the same standards, whatever their nationality or country of residence.

    2. Which of the following overriding reasons relating to the general interest justifies the measure(s)?
    • Protection of consumers and recipients of services

    3. What specific risks or benefits have you identified that your measure(s) is designed to, respectively, minimise or maximise?

       Please try to be specific in describing the nature of the risks/benefits you have identified
       Where you have selected more than one overriding reason relating to the general interest in question 2 please be sure to address each of these in your response. Wherever possible please include evidence.

       The overall risk that our regulation is designed to mitigate is the risk of harm to patients from unqualified practitioners and qualified practitioners whose fitness to practise may be impaired. The benefits are: - clear standards; a publicly accessible register so members of the public can make informed choices about from whom to receive dental services; the ability to approve education and training to ensure that it meets nationally agreed standards; the ability to take action against a registrant when things go wrong to prevent continuing harm to members of the public, including, in the most serious of cases, removing them from the DCP Register.

    4. How specifically do your measures operate to minimise the risk(s) or maximise the benefit(s) identified in question 3?

       When addressing this question please try to explain how the measures prevent the risks or guarantee the benefits.
       Where you have selected more than one overriding reason relating to the general interest in question 2 please be sure to address each of these in your response. Wherever possible please include evidence.

       The GDC is an independent statutory regulator which is set up to protect the public. We keep a DCP Register of dental professionals including dental hygienists who meet our rules and standards for their training, professional skills, behaviour and health. These standards are also how a registrant’s ‘fitness to practise’ is determined. These standards include: - Standards of education are used to make sure that education and training programmes which lead to registration as a dental hygienist will ensure that students are fit to practise when they complete their training. Pre-registration learning outcomes guidance describing the knowledge, skills, attitudes and behaviours a registrant must have to practise safely, effectively and professionally as a dental hygienist. The aim is to develop a rounded professional who, in addition to being a competent clinician, will have the range of professional skills required to begin working as part of a dental team and be well prepared for independent practice. Standards for conduct, performance and ethics are used to provide an ethical framework within which all our dental hygienists must work. Scope of practice is guidance describing what all registrants including dental hygienists are trained and competent to do. It describes the areas in which dental hygienists have the knowledge, skills and experience to practise safely and effectively in the best interests of patients as well as describing additional skills dental hygienists could develop. Rules and guidance for continuing professional development (CPD) are used to ensure that professionals including dental hygienists on our DCP Register continue to learn and develop throughout their career in order that they continue to practise safely, effectively, and legally, within their developing scope of practice. If a registrant/dental hygienist does not meet our standards we can take action via our fitness to practise process. Each complaint is assessed on a case-by-case basis. For cases which go to final hearing stage, there are a number of possible outcomes which include: issuing a reprimand (formal statement of our disapproval) setting conditions (to restrict individuals’ work), suspending individuals for a set period of time, striking individuals off our register so they cannot work as a dental hygienist at all. We also protect the professional title of dental hygienist. It is a criminal offence for someone to use a protected title or claim to be registered when they are not, and we take action against those who do so. Where the scope of practice for a dental hygienist becomes the practice of dentistry we may prosecute unregistered individuals in the UK courts for illegal practice.

    5. In so far as you are able, please provide information that you have gathered regarding the concrete effects of the measure(s).

       For example, through impact assessments or information gathered during implementation or review of a measure. Member States who have recently undergone reforms may in particular be able to contribute helpfully to this field. Where you are able to provide cost-benefit analyses this would be particularly valuable.
       Information on whether the measures indeed successfully prevented risks from being realised (e.g. the number of sanctions imposed, a drop in transgressions since the measure was introduced or consequences from previous modifications of the regulation) would equally be helpful.
       Where you have selected more than one overriding reason relating to the general interest in question 2 please be sure to address each of these in your response. You may also wish to include evidence on consumer satisfaction or other measurements of the impact.

        We have not carried out specific research related to the wider economic impact of our role, for example, the preparation of cost-benefit analysis for regulating the dental hygienist profession. However, we have contributed to a Department of Business, Innovation and Skills (BIS) / Queen Mary University of London project which intends to provide an economic analysis of licensing occupations in the UK. We are continuing to see an increase in the total number of fitness to practise allegations which we receive for our professions as a whole. The increase in the total number of fitness to practise allegations across all of our professions over this period illustrates the continued importance of our role in safeguarding the public. Fitness to practise action acts to prevent continuing harm to service users and patients. We also conduct and commission research with the aim of improving our standards and regulatory processes. Further information on our research can be found on our website here:

    6. Is the general interest objective you indicated in question 2 pursued in a consistent and systematic manner?.

       In approaching your response to this question please consider examples where you have addressed similar risks for comparable professions, not necessarily within the same sector. Is the approach you have adopted in this particular profession comparable or distinct from such similar cases and why?

       Yes. We are a multi-professional regulator of 7 different dental professions and 2 dental specialties with common standards and processes which apply to all the professions. Our standards are common to all of our professions, with the exception of the learning outcomes and Scope of Practice guidance which contain both generic and profession-specific standards for dental hygienists. Further information on our standards can be found on our website here: If a dental hygienist does not meet our standards, we can take action which might include stopping them from practising. Our fitness to practise process is designed to protect the public from those who are not fit to practise. We assess each individual concern on a case-by-case basis to decide whether we need to take any action. We have adopted a consistent approach to our fitness to practise processes described here: All final decisions are published on our website . There is also an appeal provision for any final decision taken

    7. Please explain in how far the degree of complexity or the nature of the activities
    which are reserved justify that these activities can be exclusively performed by professionals possessing a specific professional qualification?

       For example: when the tasks are essentially of a straightforward nature (such as preparing and printing pay slips etc.), or involve essentially the execution of instructions, specific professional aptitudes should not be required.

       We consider that the nature of the dental hygienist profession is such that there would be serious risks to the health and wellbeing of the public if it was undertaken by individuals who did not meet our standards. As outlined in the general section tab, the GDC regulates by statute the dental hygienist profession on the basis of protected title. This system of regulation allows flexibility and supports the development of the profession.

    8. Where you have indicated several measures in place in the screening tab,
    have you reviewed the cumulative effect of all these measures on professional activities?

       If not, why not?
       If yes, please outline for us how you approached assessing this issue as well as the results and conclusions or any learning you drew from this. Where possible please include evidence.

       As outlined above, the GDC regulates by statute the dental hygienist profession on the basis of protected title. This system of regulation allows flexibility and supports the development of the profession. We have not reviewed the cumulative effects of the various measures which we have outlined in the screening tab for each of our professions. However, we believe that they are proportionate for meeting our objective to protect the public and are not prohibitive for the profession or professionals concerned. This includes the acquisition of an appropriate qualification, adequate duration for education and training programmes in order to obtain such a qualification, mandatory registration with a professional body (competent authority), and a requirement to hold professional indemnity insurance. The level of qualification and duration for education and training programmes are normative expectations. However, as referred to above, each EEA applicant's regulated education and training is initially assessed against our pre-registration learning outcomes requirements. If we identify shortfalls in the applicant's regulated education and training against our pre-registration learning outcomes requirements we check whether this has been compensated elsewhere through other relevant education, training or professional experience. If not, we then may require the applicant to undergo a period of adaptation or the applicant may request an aptitude test in place of the adaptation period. There is also an appeal provision. The UK Government has introduced a requirement for all our registrants including dental hygienists to have a professional indemnity arrangement in place as a condition of registration with us. The UK Government has introduced this requirement as part of implementing European Union legislation. The requirement has been introduced so that if a service user or patient is harmed in some way because of the negligence of a registrant, the service user will be able to recover any compensation they may be entitled to.

    9. Have you considered the use of alternative mechanisms to achieve your objective(s)?

       Please briefly explain. Where you have selected more than one option, please be sure to address each of these in your response.

       No, we have not considered the use of alternative mechanisms to achieve our objectives.

    10. Conclusion

       Following your internal examination of this regulated profession, which of the following have you concluded?

    •    Maintain current system

       Explain where relevant:

       Regulation of the profession of dental hygienist is a matter of UK national legislation and is required by the Dentists Act 1984.

    11. Any other comments?
       No further comments.
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