School of Dentistry in "fragile state"

By Niall McCracken

THE Belfast School of Dentistry, voted the best in the UK only four years ago, remains in a “fragile state” and categorised “high-risk”, the dental governing body has reported nearly two years after a scandal broke over standards there.

A follow-up inspection by The General Dental Council (GDC) into the Belfast School of Dentistry at Queen’s University, has said that it is “alarmed” at the lack of progress that has been made since their previous inspection a year ago.

In the report Inspectors raised concerns over the effect this was having on the staff and, in particular, the students with confidence in the university’s commitment to the school “not as it should be”.

The report set out the findings of a two-day re-inspection of the School of Dentistry in March 2012 following a previous inspection held in 2011 after concerns were raised with the GDC regarding the suitability of training provision. The latest report outlined that there is a risk staff could become “deskilled”.

The failure to employ clinical academics to the school emerged as one of the biggest criticisms and inspectors said that a “much more proactive approach to improvements and, crucially, appointments is needed.”

However, the School has said that the feedback from its students has been overwhelmingly positive regarding their experience on the course. In response to the report the School points out that they have recently made a number of new staff appointments and are currently recruiting three senior lecturer/consultant positions.

AN AWARENESS

In Febraury 2011, it emerged that 135 patients had been recalled to the School of Dentistry at the Royal Victoria Hospital in Belfast. The patients were recalled after a review of the work of an oral medicine specialist at the School of Dentistry.

In May 2011 a GDC inspection into the internal problems of Queen’s School of Dentistry was carried out. It highlighted concerns about the level of clinical experience students were gaining in the areas of restorative dentistry, oral surgery, oral medicine and emergency dental care. Inspectors were told of a serious lack of patient sessions for dentally-qualified staff within the school.

The latest follow up report which was carried out in March of this year and published on the GDC’s website this morning (October 22 2012) outlines that inspectors were “alarmed” when told that a high level of risk has been applied to the programme via the university risk register. The main purpose of the risk register concept is to alert decision-makers to emerging problems and to ensure prompt action.

The inspectors said that, given previous recognition of the problems facing the programme, they were “unsure why so little progress has been managed in the time since our last inspection especially since there appears to be plenty of funding available to deal with the various issues”.

The report outlined that despite the on-going difficulties being experienced within the School, staff remained very committed and hard working. The inspectors noted that while there appears to have been some improvement in the level of morale, there was still “much room for improvement.”

Inspectors were told of a serious lack of patient sessions for dentally qualified staff within the School. The report outlined that some of the sessions had stopped altogether while others never had such a session. Inspectors said this created a risk that staff would become “deskilled” and this could pose problems for the on-going registration of some staff. The GDC said this policy should be revisited.

NO CONFIDENCE

Inspectors claimed ways of improving communication and understanding between the school and the wider university still needed to be developed and implemented.

The inspectors said their concern remained that the programme was extremely intensive – especially given the constraints placed on the staff team by the lack of new appointments being made.

The report set out that in some cases, teaching loads had increased by 20% and in others clinical academics were providing a 50% service commitment as well as clinical teaching. They described the programme as being in an extremely “fragile state”.

The inspectors concluded that there had been “limited progress” since the 2011 inspection took place and any progress had been at a “far slower pace” than they had anticipated.

In response to the findings of the report, Queen’s University’s School of Medicine, Dentistry and Biomedical Sciences said it was “disappointed that the report does not acknowledge or reflect the significant work undertaken by the university over the last 16 months.”

The school also said that while it accepted that the uptake of senior clinical posts had been slow, it believed it could not be ascribed to a lack of “proactive engagement or an inflexible approach.”

And it said that since the GDC inspection, it had appointed a Chair in Restorative Dentistry; the school had also advertised three clinical lecturer/senior lecturer consultant positions.

The GDC, meanwhile, has said that a further inspection will be required in 2013 when it will need to see evidence that “substantial progress has been made in the areas identified, especially those that relate to staffing.”