East of England

A new Early Years Curriculum has been introduced for 2025/26. This Handbook is a guidance document to help support Educational Supervisors and Foundation Dentists in their role, if you require any support or clarification on your role, or have any queries in relation to the content of this guide please do contact your TPD.

The curriculum describes the introduction of Entrustable Professional Activities and levels of supervision expected to be achieved at the end of the DFT program. Please do familiarise yourselves with this document and reference outcomes supporting each EPA to help you provide Learning/Development needs for your FD/FT during training.

Quick Reference

Useful Links

• Axia ePortfolio – https://dentaleportfolio.hee.nhs.uk/
• NHSE Dental (East of England) – https://heeoe.hee.nhs.uk/dental
• NHSBSA Data – https://www.nhsbsa.nhs.uk/dental-data
• Support & Wellbeing – https://heeoe.hee.nhs.uk/dental/eoe-dental/support/trainee-support

Key Contacts

• Scheme queries: Training Programme Director (TPD) https://heeoe.hee.nhs.uk/node/138
• General DFT queries: england.dft.eoe@nhs.net
• Employment / leave / expenses: Mersey & West Lancashire NHS Trust: lead.employer@sthk.nhs.uk
• Visa queries and sponsorship: england.sponsorshipsupport.yh@nhs.net

Acronyms

Programme Overview

The 2025/26 Early Years Curriculum introduces:

• Entrustable Professional Activities (EPAs) – the central framework for training.
• Supervision levels – defining progression from direct to unsupervised practice.
• New portfolio design – focusing on feedback and evidence, not numerical scoring.
• Streamlined assessments – fewer SLEs, but tailored to the trainee’s needs.

Aim: By the end of training, all Foundation Dentists/Therapists must safely and independently perform the Essential EPAs. Enhanced EPAs demonstrate advanced skills and readiness for leadership.

Entrustable Professional Activities

Essential EPAs (must be unsupervised by programme end):


• EPA 1: Assessing and managing new patients – history, exam, consent, radiographs, planning. ↓

  Essential
  The Early Years Dentist adopts a person-centred and compassionate approach to practice with all patients, treating them with dignity and respect. They are able to establish capacity and seek informed consent from patients, ensuring they are fully informed in decision making about their care. The Early Years dentist is able to efficiently take a full and focussed history that informs and underpins their treatment planning with patients. They are able to conduct a full clinical extra- and intra- oral examination, identifying signs of oral pathology, including cancer. They can undertake a basic clinical examination (BP, pulse, respiration and temperature) if contextually relevant. They are able to appropriately prescribe, perform and interpret radiographic imaging in line with diagnostic need and national guidelines. They select and where appropriate perform diagnostic tests and procedures, interpreting findings accurately. They draw on all of the elicited information above to develop comprehensive and prioritised management plans that are documented in line with local and national guidance.

  Key programme domains and outcomes

  Clinical
  Clinical assessment, Treatment planning, Prescribing and therapeutics, Periodontal disease, Non-surgical management of head and neck pathology, Patient safety

  Communication
  Person-centred practice, Informed consent and capacity, Challenging communication situations, Written communication

  Professionalism
  Ethics and integrity, Scope of practice, Interactions with colleagues, Social justice and health equity

  Management and leadership
  Self-management, Legislation and regulation

  Evidence to inform entrustment decision
  Mini-CEX, DOPS, Case-based Discussion Clinical experience log, Reflective log, Multi-source feedback - to inform end of year review(s), Patient satisfaction questionnaire- to inform end of year review(s)

  
  
  
  
• EPA 2a: Routine care: periodontal and restorative – manage perio + caries, restorative work, RCT. ↓

  Essential
  The Early Years dentist is able provide routine periodontal and restorative care in accordance with treatment plans created and agreed with their patients. They demonstrate a person- centred approach, working well with the wider dental team to deliver timely and appropriate care. They are able to recognise and manage all common variants of periodontal disease, supporting behavioural change and ensuring patients have access to appropriate preventative and management options, including appropriate referral. The Early Years dentist is able to effectively evaluate the restorative prognosis for individual teeth, identifying conditions that may require treatment or onward referral. They are able to safely restore carious teeth to form, function and appearance, using a wide range of restorative materials and well matched restorative techniques. They are able to perform non-surgical root canal treatment and retreatment on single and multi-rooted teeth with mild curvature of the canal. They work safely and efficiently within their scope of practice and with appropriate help seeking behaviours. They manage their time and resources effectively.

  Key programme domains and outcomes

  Clinical
  Clinical assessment, Treatment planning, Oral health promotion, Prescribing and therapeutics, Periodontal disease, Non-surgical management of head and neck pathology, Restoration of teeth, Patient safety

  Communication
  Person-centred practice, Informed consent and capacity, Challenging communication situations

  Professionalism
  Ethics and integrity, Scope of practice, Interactions with colleagues

  Management and leadership
  Self-management, Clinical leadership, Legislation and regulation, Environmental sustainability

  Evidence to inform entrustment decision
  Mini-CEX, DOPS, Case-based discussion, Clinical experience log, Reflective log, Multi-source feedback - to inform end of year review(s) , Patient satisfaction questionnaire- to inform end of year review(s)

  
  
  
  
• EPA 2b: Routine care: extractions and prosthetics – simple XLA, prostheses, manage complications. ↓

  Essential
  The Early Years dentist is able provide routine dental care involving the removal and replacement of teeth in accordance with treatment plans created and agreed with their patients. They demonstrate a person-centred approach, working well with the wider dental team to deliver timely and appropriate care. The Early Years dentist is able to safely and effectively extract primary and permanent erupted teeth, including erupted uncomplicated third molars. They can manage and extract multi-rooted teeth and extract where appropriate buried roots. They can manage common complications associated with extractions and prescribe appropriately. They make appropriate use of referral pathways for patients requiring sedation or general anaesthesia or more complex surgical treatments. The Early Years dentist is able to appraise options for the replacement of teeth, including the provision of prostheses and preventive and supportive care for patients with dental implants. They work safely and efficiently, within their scope of practice, with appropriate help seeking behaviours and managing their time and resources effectively.

  Key programme domains and outcomes

  Clinical
  Clinical assessment, Treatment planning, Prescribing and therapeutics, Non-surgical management of head and neck pathology, Removal of teeth, Replacement of teeth, Patient safety

  Communication
  Person-centred practice, Informed consent and capacity, Challenging communication situations, Written communication

  Professionalism
  Ethics and integrity, Scope of practice, Interactions with colleagues

  Management and leadership
  Self-management, Clinical leadership, Legislation and regulation, Environmental sustainability

  Evidence to inform entrustment decision
  Mini-CEX, DOPS, Case-based discussion, Clinical experience log, Reflective log, Multi-source feedback - to inform end of year review(s), Patient satisfaction questionnaire- to inform end of year review(s)

  
  
  
  
• EPA 3: Assessing and managing children – exams, anxiety management, prescribing, ortho monitoring. ↓

  Essential
  The Early Years dentist demonstrates person-centred practice with children, young people and their parent(s) or guardian(s). They are able to establish capacity, seek informed consent and know when to maintain confidentiality. They are able to draw on a range of approaches to prevent and manage anxiety where relevant. They are able to adapt their prescribing, ensuring the appropriate selection, use and dosage of drugs approved for use in children and young people. The Early Years dentist is able to assess periodontal health and offer specific guidance and preventative treatment as relevant. They are able to assess skeletal, dental and occlusal relationships in primary, mixed and permanent dentition, identifying conditions which may require active management and treatment (including onward referral). They effectively monitor patients receiving orthodontic treatment, relieving trauma and discomfort related to orthodontic appliances, including arranging emergency repairs when required.

  Key programme domains and outcomes

  Clinical
  Clinical assessment, Treatment planning, Oral health promotion, Prescribing and therapeutics, Periodontal disease, Malocclusion and management of developing dentition, Patient safety

  Communication
  Person-centred practice, Informed consent and capacity, Challenging communication situations, Written communication

  Professionalism
  Ethics and integrity, Scope of practice, Interactions with colleagues, Social justice and health equity

  Management and leadership
  Self-management, Legislation and regulation

  Evidence to inform entrustment decision
  Mini-CEX, DOPS, Case-based discussion, Clinical experience log, Reflective log, Multi-source feedback - to inform end of year review(s), Patient satisfaction questionnaire- to inform end of year review(s)

  
  
  
  
• EPA 4: Providing emergency care – dental & medical emergencies, safe urgent care. ↓

  Essential
  The Early Years dentist is able to recognise and appropriately prioritise patients requiring immediate assessment and treatment. They are able to recognise and effectively manage common dental emergencies, including those resulting from treatment complications and failure, infection, allergic response or trauma and associated pain and discomfort. They are also able to recognise the onset of common medical emergencies (such as anaphylaxis, cardiac arrest and fits) and have demonstrated that they know how to provide basic treatment, including basic life support, facilitating a team response. They are able to prescribe and/or administer appropriate pharmacological agents, with an awareness of potential drug interactions and side effects (including how to prevent and /or manage). In all cases, they are able to take appropriate action, working within their scope of practice, seeking help when needed and making timely and appropriate onward referral when required.

  Key programme domains and outcomes

  Clinical
  Clinical assessment, Prescribing and therapeutics, Periodontal disease, Non-surgical management of head and neck pathology, Removal of teeth, Dental emergencies, Medical emergencies, Patient safety

  Communication
  Person-centred practice, Informed consent and capacity, Challenging communication situations, Written communication

  Professionalism
  Ethics and integrity, Scope of practice, Interactions with colleagues, Social justice and health equity

  Management and leadership
  Self-management, Clinical leadership, Legislation and regulation

  Evidence to inform entrustment decision
  Mini-CEX, DOPS, Case-based discussion, Clinical experience log Reflective log, Multi-source feedback - to inform end of year review(s),

  
  
  
  

Enhanced EPAs (progress expected towards independence, but essential in JDFTC):


• EPA 5: Managing complex patients – frail/medically compromised patient care. ↓

  Enhanced
  The Early Years dentist works collaboratively across disciplinary and organisational boundaries to ensure joined-up, holistic and person-centred care for people with complex needs. They ensure that patients have capacity to make decisions about their care and that informed consent is in place for all interventions, recording this carefully and in keeping with local and national guidelines. They are able to adjust their communication to meet needs, treating every patient and their families with compassion, dignity and respect. The Early Years dentist is able to adopt an approach to treatment planning and care that carefully balances risk and benefit for people who are frail, medically unwell or approaching the end of their life. The Early Years dentist safely and effectively manages patients with complex needs, routinely taking steps to reduce harm from over-investigation, multiple interventions and polypharmacy.

  Key programme domains and outcomes

  Clinical
  Treatment planning, Oral health promotion, Complex needs, Medical emergencies, Patient safety

  Communication
  Person-centred practice, Informed consent and capacity, Challenging communication situations, Written communication

  Professionalism
  Ethics and integrity, Scope of practice, Interactions with colleagues, Social justice and health equity

  Management and leadership
  Self-management, Clinical leadership, Legislation and regulation

  Evidence to inform entrustment decision
  Mini-CEX, DOPS, Case-based discussion, Clinical experience log, Reflective log, Multi-source feedback - to inform end of year review(s), Patient satisfaction questionnaire- to inform end of year review(s)

  
  
  
  
• EPA 6: Promoting oral health in the population – public health, prevention, behaviour change. ↓

  Enhanced
  The Early Years dentist is able to reflect and act upon their role in supporting the oral health of the communities they serve, as well as the individuals they work with on a daily basis.
  They demonstrate a commitment to health improvement, seeking to improve oral health and reduce oral health inequalities across the lifespan, which may include contributing to the design and delivery of dental care pathways. They demonstrate the ability to work collaboratively and in partnership with relevant public sector, voluntary and community organisations to raise awareness of strategies that improve oral health. This includes the adoption of a person-centred, evidence-based approach to preventative education and instruction in self-care methods. The Early Years dentist is able to purposefully draw upon a range of strategies that support behavioural change linked to lifestyle choices that impact on oral health, such as smoking, drug and alcohol consumption. Underpinning this activity is a sound appreciation of the relationship between socio-economic factors and oral health inequalities, including risk factors for dental disease and general and oral health.

  Key programme domains and outcomes

  Clinical
  Clinical assessment, Treatment planning, Oral health promotion, Prescribing and therapeutics, Periodontal disease, Non-surgical management of head and neck pathology, Complex needs, Patient safety

  Communication
  Person-centred practice

  Professionalism
  Ethics and integrity, Personal and professional development, Scholarship, Teaching and learning, Interactions with colleagues, Social justice and health equity

  Management and leadership
  Self-management, Practice or departmental management, Clinical leadership, Legislation and regulation, Quality improvement, Environmental sustainability

  Evidence to inform entrustment decision
  DtCT, DENTL, Case-based discussion Clinical experience log Reflective log, Multi-source feedback - to inform end of year review(s), Patient satisfaction questionnaire- to inform end of year review(s),

  
  
  
  
• EPA 7: Managing the service – managing time, team, governance. ↓

  Enhanced
  The Early Years dentist focusses on clinical priorities, managing time and resources efficiently, ably managing the throughput of patients in the clinical settings in which they work using supporting information technology. They model high levels of professionalism and foster this in others and consistently act in ways that are respectful, co-operative, inclusive and non-discriminatory. They have a developed understanding of the roles, responsibilities and scope of practice of all members of the dental team, and delegate appropriately and effectively. They are familiar with human resource management strategies and relevant legislation, the financial mechanisms and flows, and governance arrangements and regulations that relate to their working environment. The Early Years dentist demonstrates inclusive and compassionate leadership, facilitating effective teamwork and person-centred care. They are forward thinking, recognising opportunities to develop and innovate practice in order to reduce inequalities and improve oral health outcomes for individuals and populations.

  Key programme domains and outcomes

  Clinical
  Oral health promotion, Patient safety

  Communication

  Person-centred practice, Challenging communication situations, Written communication

  Professionalism

  Ethics and integrity, Personal and professional development, Interactions with colleagues, Social justice and health equity

  Management and leadership
  Self-management, Practice or departmental management, Clinical leadership, Legislation and regulation, Quality improvement, Environmental sustainability

  Evidence to inform entrustment decision
  DENTL, Reflective log, Multi-source feedback - to inform end of year review(s)

  
  
  
  
• EPA 8: Improving quality of dental services – audits, significant events, service development. ↓

  Enhanced
  The Early Years dentist is aware of the factors that influence the delivery of safe, timely, effective, efficient, equitable and person-centred care and the actions that may be taken to improve everyday practice. They demonstrate the ability to adapt and change practice in light of new information and evidence, embracing the quadruple aim of healthcare improvement, to improve population health outcomes, enhance experience of care, reduce per capita cost (including environmental cost) and ensure that staff and colleagues can derive joy and meaning from their work. The Early Years dentist is able to work well with others collecting, analysing and interpreting routine and elicited data that sheds light on the performance of the dental team, department or organisation. They are able to meaningfully participate in quality improvement activity, including quality improvement projects, audit and significant event review. They appreciate the ways in which they can influence change and lead developments in practice within and beyond the settings in which they work.

  Key programme domains and outcomes

  Clinical
  Patient safety

  Communication
  Person-centred practice

  Professionalism
  Ethics and integrity, Personal and professional development, Scholarship, Teaching and learning, Interactions with colleagues, Social justice and health equity

  Management and leadership
  Self-management, Practice or departmental management, Clinical leadership, Legislation and regulation, Quality improvement, Environmental sustainability

  Evidence to inform entrustment decision
  DENTL, Reflective log, Multi-source feedback - to inform end of year review(s)

  
  
  
  
• EPA 9: Developing self and others – reflection, teaching, mentoring, professionalism. ↓

  Enhanced
  The Early Years Dentist identifies and actively responds to their own learning needs, embracing opportunities to develop their practice, evidencing this in meaningful ways throughout their training. They work within their scope of practice, demonstrating appropriate help seeking behaviours. They have an appreciation of the ways learning can be facilitated in the workplace and are able to support the development of learners and team- members, working within their scope of practice. They are able to act as a mentor and to offer timely and useful feedback when invited to do so. They are able to plan and deliver teaching sessions designed to meet the needs of one or more learners. They model inclusive and respectful practice, actively encouraging high levels of professionalism throughout the dental team and demonstrate the attributes of a reflective practitioner in all aspects of their work.

  Key programme domains and outcomes

  Clinical

  Communication

  Challenging communication situations, Written communication

  Professionalism
  Ethics and integrity, Personal and professional development, Scholarship, Teaching and learning, Interactions with colleagues, Social justice and health equity

  Management and leadership
  Self-management

  Evidence to inform entrustment decision
  DtCT,  DENTL, Reflective log, Multi-source feedback - to inform end of year review(s)

  
  
  
  

Supervision Levels

• Starting point: most FDs/FTs begin at Level 2.
• Evidence-based progression: SLEs, feedback, and ES reports guide advancement.

Portfolio & Assessments

Supervised Learning Events (SLEs) ↓

• Types:
  • DOPS – Direct observation of a clinical skill ↓

    DOPS are an observation by the ES/CS of a clinical procedure completed by the FD/FT as part of a patient encounter. They are useful to ascertain certain clinical capabilities that form part of a Clinical Encounter, rather than the ES/CS observing the entire clinical encounter. Pragmatically, DOPS can be utilised to assess various clinical procedures as part of a patient encounter (e.g. for a patient attending an endodontic procedure, DOPS on Access / Rubber Dam / Obturation could be completed), rather than the ES observing the entire Endodontic procedure. DOPS also form part of early assessments completed at the start of the DFT/DTFT program to ascertain appropriate and safe levels of supervision, this will be discussed further in this guide. The DOPS Under Simulation is a similar observation but completed during a simulated exercise.
    

  • Mini-CEX – Observation of a whole clinical encounter ↓

    The mini-CEX are an observation by the ES/CS of an entire clinical encounter, performed by the FD/FT on patients. They are useful to provide a holistic overview of performance, where both technical clinical skills and supporting non-technical skills, such as communication, leadership and professional behaviours can be observed. The mini-CEX can be linked to new patient encounters, management of children, providing emergency dental care and simple restorations. They are also useful to support the development of FD/FT should the need arise to view more complex and time-consuming procedures, where the mini-CEX could be part of assigned Protected Learning Time.
    

  • CBD – Case-based discussion (clinical reasoning) ↓

    The CBD is linked to clinical reasoning/knowledge, utilising patient records, clinical photography and radiographs to ascertain the clinical knowledge and reasoning the FD/FT displays, the CBD may be linked to one patient encounter or be structured around radiographic interpretation for several patients. CBD can be utilised to pose 'what if...' questions, to explore different scenarios based around clinical decision making.
    

  • DENTL – Evaluation of non-technical skills (leadership, teamwork) ↓

    The DENTL is an observation of 'non-technical skills' linked to the FD/FT chairing a practice meeting, leading a team, carrying out service improvement or sustainability projects. Other opportunities for completing a DENTL may be opportunistic in nature, linked to the FD/FT publishing a research article or presenting research at a local/regional or national event.

    TPDs will also complete DENTL SLES during the DFT/DTFT program linked to study day activities, professional behaviours and milestone presentation days.

    At least one DENTL should be completed as part of the JDFCT program, being completed within the secondary care environment.
    

  • DtCT – Developing the Clinical Teacher (teaching activity) ↓

    The DtCT is an observation of teaching practice by the FD/FT, normally linked to community engagement projects, such as school visits. It provides an opportunity for feedback on both teaching practice and facilitating learning and could be utilised when the FD/FT must deploy behavioural change conversations that are provided for challenging patients.

    At least one DtCT should be completed as part of the JDFCT program, being completed within the secondary care environment.

    Like the DENTL SLE, during the DFT/DTFT one-year program there may be opportunities to complete the DtCT if the FD/FT has been asked to formally provide a teaching opportunity for their peers, which may be completed by a TPD.

    *There is no absolute requirement for the DENTL or DtCT SLEs to be completed during the one-year DFT/DTFT program, however they will provide important informing other EPAs and should, if the opportunity arise be completed.
    

    
    
• Expected numbers: minimum 24 per year (plus MSF + PSQ). ↓

  Within each program year, it is expected that at least 24 SLE's will have been completed, as a minimum (not including MSF/PSQ).

  For the JDFCT program, this equates to 48 SLE's, with 24 being completed in the primary care DFT practice and a further 24 being completed in Secondary care, being evenly split between both workplace environments over the two-year program.

  For the one-year program a minimum of 2 MSFs (linked to the Early Stage Review and IRCP) are required and 1 PSQ.

  For the two-year JDFCT program a further MSFs will be required in the second year of the training program.

  
  
• Focus: feedback, linked learning needs, evidence towards EPAs.

Other Evidence

• Multi-source feedback (MSF) – at least 2 per year.
• Patient satisfaction questionnaires (PSQ) – minimum 20.

ES Reports – structured reports (ESR, IRCP, FRCP) + ad-hoc if needed.

Induction (First Month)

ES–Trainee Induction Meeting ↓

• Review Educational Transition Document (ETD) (confidence + capability).
• Explore learning goals and prior experience.
• Draft Personal Development Plan (PDP).
• Record initial Learning/Development Needs in the portfolio.

Clinical Skills Assessment (CSA)

• Simulated exercise to confirm safe operative technique.
• Assessed by DOPS under simulation.
• Usually undertaken as Scheme clinical skill refresher course.
• If concerns arise → repeat exercise; if persistent complete an Ad-hoc ES Report. → escalate to TPD.

Induction Checklist

• Use both portfolio checklist ↓ + Induction to Practice Checklist PDF ↓
  
  
  
• Download Induction to Practice Checklist
• Completed checklist must be uploaded to portfolio.

Early Stage Review

• This is carried out using the AdHoc ES Report. ↓
  
  
  
  
  

Induction timeline diagram. ↓

Workplace Learning & Tutorials

• Work-based learning: primary route to competence.
• Supervisor responsibilities:
  • Expose trainee to meaningful cases.
  • Stage progression appropriately.
  • Label implicit learning (thinking aloud).
  • Provide feedback that directly informs EPAs.
• Protected Learning Time: ~40 sessions/year (weekly average).
  • Uses: tutorials, case discussions, simulation, joint treatment, feedback sessions.

Dental Milestones and APLAN

Dental Milestones are essentially Clinical Case Reports that are representations of the clinical records and treatment that the Foundation Dentist has completed for patients under their care during DFT/DTFT/JDFCT programs. The purpose of taking part in the Milestone process is to help demonstrate essential clinical skills and provide opportunities for increased sources of feedback, to help formatively with the Foundation Dentists clinical insight, reflection and self-assessment skills, which are essential skills for the continued professional development after DFT. The Milestones also provide further evidence towards appropriate treatment being demonstrated in relation to the Early Years Curriculum and Entrustable Professional Activities (EPAs)

You will be asked to provide anonymous feedback on up to three clinical cases for Milestone 2 (Molar Endodontics) and Milestone 3 (Multi-disciplinary case) via APLAN (Anonymous Peer Learning & Assessment Network), an online tool designed to facilitate the anonymous distribution and assessment of clinical cases for peer review.

Foundation Dentists will need to upload their case onto APLAN at specific times, completing feedback on cases that have been assigned to them from Foundation Dentists from different study schemes. Full details of dates for submissions and reviews are given in your Scheme Handbook.

Your TPD will also provide a forum and invite you to contribute on discussions, following an FD/FT presentation of their clinical case during a peer reviewed Milestone study day.

Reviews & Timeline

1-Year DFT/DTFT Programme

• Month 2 – Early Stage Review (ESR): establish baseline supervision levels.
• Month 6 – Interim Review (IRCP): check progress; ensure on track for independence.
• Month 11 – Final Review (FRCP): confirm all Essential EPAs unsupervised.

2-Year JDFCT Programme

• Month 4 – Early Stage Review (ESR): establish baseline supervision.
• Month 11 – Interim Review (IRCP): assess first-year progression.
• Month 23 – Final Review (FRCP): confirm Essential + Enhanced EPAs.

Appendices

• Induction to Practice Checklist (PDF)
• Sample SLE Template
• Sample ES Report
• Example Personal Development Plan (PDP)
• Glossary of Terms & Acronyms