Shifting the balance: a better, fairer system of dental regulation

Patients, Professionals, Partners, Performance, our corporate strategy for 2016-19, sets out what we will do to become an efficient and effective regulator.​

However, we want to do all we can to put patient safety at the heart of what we do. In order to do this, we believe there needs to be a fundamental rethink of how dental professionals are regulated. 

This is why we have developed the Shifting the balance programme, which has developed many of the themes set out in Patients, Professionals, Partners, Performance in order to ensure dental regulation is fit for the future.

The discussion period for Shifting the balance closed on 26 April 2017. We'd like to thank all of our stakeholders that responded to our proposals to modernise dental regulation. We're currently analysing responses and will publish a report outlining your views on our non regulatory reform in the coming months. 

In the meantime we will keep our stakeholders abreast of the emerging themes in the responses. Shifting the balance is a continuing programme and we would like to encourage our stakeholders to continue to engage with us even though the closing date has elapsed.​

Discussion document

Download your copy of the Shifting the balance discussion document.


Watch Matthew Hill Executive Director Strategy and Jonathan Green Executive Director Fitness to Practise talking about Shifting the balance​ and our proposals to modernise dental regulation​:​



What needs to be looked at?

The GDC believes that the current model of dental professional regulation has become unsustainable. It can be cumbersome, inefficient and, crucially, does not do enough to put patient safety at its heart. 

The GDC has a strategic objective to improve its performance.  We have invested heavily in this in recent years. It has required significant change to the way we function and in particular, we are working hard to improve how workload and the associated costs are managed. 

However, this will take us only so far. Continuing in this manner, our business model will have a severely limited shelf life unless we can make significant change. 

The GDC is open to this change and wants to work with patients, the public and the profession to put change into action.

Wha​t needs to change?

​The GDC currently faces a number of challenges. We have limited control over the number or complexity of the main drivers of our cost, our fitness to practise caseload. 

Our main mechanism for dealing with things that go wrong – fitness to practise investigations and prosecutions – are not the best tools for dealing with the wide range of issues relating to performance and conduct that people raise with us.

In fact, many of the issues raised with us could be better resolved by other organisations. But there are limited processes in place to reroute these matters to a more appropriate body.

Part of the solution will be clearer information for patients and the public about where their complaint might be best dealt with including in the practice wherever possible.

The GDC recognises the need to improve the support for professionals to ensure harm is prevented rather than focusing on taking action after harm has occurred. The GDC is exploring ways to achieve this.

What is the GDC doing about it?

​The GDC is engaging all of our stakeholders – patients, dental professionals and our partners– to develop a series of proposals that aim to ensure dental professional regulation is fit for the future and ensures that patient safety is put squarely at its heart.  This major programme of regulatory reform work is looking at four interlinked areas:

  • Moving upstream:  Placing greater emphasis on supporting and empowering the profession to focus on prevention.  This means the GDC identifying areas throughout the career pathway of dental professionals, to promote and support them in the understanding of the GDC’s statutory powers; through education, professional standards, registration and continuing professional development.  

  • First tier complaints: The GDC acknowledges that, even with increased focus on prevention through upstream activity, sometimes things can still go wrong and result in a complaint being made by a patient.  Shifting the balance acknowledges this inevitability and proposes different ways of working with the profession in how to deal with it, to make outcomes satisfactory to patients and more beneficial to the profession.

  • Working with partners: We made a commitment in our corporate strategy to work better with our partners to improve the regulation of dentistry in the UK and we have come some way in achieving this.   However, there is more to do, and we need to develop our relationships with a whole range of organisations, including the systems regulators and the NHS in each of the four nations, professional associations, indemnity providers and employers. 

  • Refocusing Fitness to Practise: The GDC’s fitness to practise powers are an important part of our role in protecting patients and maintaining public confidence in dental services.   However, we would like to rethink how these enforcement powers are used.  There is no doubt that sometimes it is unavoidable and necessary for cases to go through the fitness to practise process so that serious risk to patient safety within the profession is managed and sanctioned appropriately.  Further avenues for cases which do not amount to an impairment to practise are being explored. 

Engaging with our stakeholders?

​The GDC cannot do this alone. We need help with this work, and are working very closely with stakeholders including patients, the professions we regulate and our partners throughout this process.  All of this will need us to be bold and to challenge all our assumptions about why we do things in the way we do them.
The Department of Health has published its Consultation Promoting professionalism, reforming regulation, which is considering fundamental reform and modernisation to health professional regulation.


Contact GDC

+44 (0) 20 7167 6000

37 Wimpole Street

London W1G 8DQ


Secure area for dental professionals