Workforce, training and education
East of England

East of England

The Educational Supervisor's Role

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Dental Foundation Training and the NHS

Dental Foundation Training (DFT) is a process which dentists wishing to work within primary dental care within the NHS need to undertake before being accepted fully on to the NHS Dental Performers List in England. Any individual with a UK dental qualification must be able to show possession of a VT/DFT certificate or experience equivalent to one year of DFT to gain full acceptance to the Performers List. UK citizens who have a European Economic Area (EEA) degree are permitted to undertake DFT, and funding will be available for this. Any non UK citizens undertaking DFT will be required to have a Tier 4 visa.

The National Health Service (Performers Lists) (England) (Amendment) Regulations 2016 came into effect on 1st September 2016, and redefined Dental Foundation Training as a period of full time employment of at least one year but not exceeding two years. A Foundation Training Certificate will be awarded if the training is satisfactorily completed.

Foundation Training for Dental Therapists has been introduced as pilot schemes in all regions of England and the curriculum for this is similar to the DFT curriculum but working within a reduced scope of practice.

In England, NHS primary care dental services were the responsibility of NHS England but local commissioning is now passed to the Integrated Care Boards (ICBs). The ICBs have a responsibility to ensure that dental services are available for all, and they also have to ensure that local needs are addressed, not only now, but in the future. Thus a co-ordinated approach to the appointment of training practices must take place to help ensure access to dental care for all. Although the funding of Dental Foundation Training does not come directly from the local NHS England / ICB base allocations, many other DFT issues will affect the provision of dental care in the area. Questions such as; “Will the Foundation Dentist be able to remain at the practice at the end of the year?”; and “Who will take over care of the patients seen by the Foundation Dentist at the end of the training year?”; need to have been thought through at an early stage. We, in the appointment process, will seek information from NHS England and the ICBs about their support for your application, and the appointment process must examine these issues.

Nevertheless, the role of Educational Supervisor has not diminished in its appeal and you are encouraged to read further and find the way in which you can become an Educational Supervisor in East of England.

Foundation Training in East of England

In East of England there are six Dental Foundation Training (DFT) schemes and one Dental Therapist Foundation Training (DTFT) scheme. There is also a Joint Dental Foundation and Core Training (JDFCT) scheme, which runs over two years.

DFT Schemes - Each of the schemes is based within one of the ICB areas and caters for about fourteen trainees. Each has a Training Programme Director (TPD) who is responsible for organising the programme, looking after the Educational Supervisors and Foundation Dentists within the Scheme, and acting as a link between the Scheme members and the Associate Postgraduate Dental Dean. All of the TPDs are based in general dental practice and have had experience as an Educational Supervisor within Dental Foundation Training. The Foundation Dentists (FDs) are employed by a Lead Employer Trust, and are hosted at the training practice. They remain there for one year.

The FDs attend Scheme Study Days, a total of 30 in the year, and these are usually held at the Postgraduate Centre associated with the Scheme. Many study days are held on Fridays, but for the Cambridgeshire and Peterborough Scheme, they are held on Tuesdays.

DTFT Scheme – The Dental Therapist Foundation Training Scheme is regionally based and Study days are usually held at Cambridge. The Scheme is run by a Training Programme Lead, who is a dental therapist. The Foundation Dental Therapists (FDTs) are employed by the hosting practice, and each practice will host two FDTs. Each works clinically for two days and is employed for three days – Friday being the common day for both of them when they will be having study days or undertaking self-directed learning and project work. The employing practice is remunerated for the FDTs’ salaries (equivalent to NHS AFC Band 5 level 2)  and associated on-costs such as Employers NI and pension contributions.

JDFCT Scheme – This is a two year Scheme and the FDs spend alternate weeks in Dental Foundation Training in general dental practice and in Dental Core Training in a secondary care setting or a community setting. Each Foundation Training practice will have two FDs, who will be present in the practice on alternate weeks. The scheme runs for two years, so the FDs will remain at their training practice for the whole two years. As with the one year DFT, the Foundation Dentists (FDs) are employed by a Lead Employer Trust, and are hosted at the training practice.

The Educational Supervisor’s Role

An Educational Supervisor is an experienced general dental practitioner with high clinical standards and good ethical values, who is currently included in the Dental Performers List and who supervises a dentist or dental therapist hosted as a Trainee in the practice. As well as this, the Educational Supervisor needs to have the skills to create a learning environment for the Trainee, and also to assess the learning that takes place.

The Educational Supervisor must be available in the practice to provide supervision, help and advice, be it chairside or otherwise, and must be present for at least three days a week whilst the Foundation Dentist or Foundation Dental Therapist is working. There must also be available in the practice another suitably experienced dentist who is able and available to provide supervision for the trainee at times when the Educational Supervisor is not present.

Joint Educational Supervisors may split the three days attendance with the trainee between themselves, but if there are two Foundation Dentists in the practice then each Educational Supervisor will need to fulfil the three day requirement individually to ensure that at least one ES is present at all times.

For the Foundation Dentist,  satisfactory completion of the DFT programme is essential if they are to receive a Foundation Training Certificate, so assessment of the Foundation Dentists’ learning and competence is an essential part of Dental Foundation Training. The Foundation Dental Therapists are also assessed throughout the year, but the certificate they receive records their completion of the year.

The Educational Supervisor carries out much of the assessment using specific processes. At the start of the year, there is a full induction process to be followed, during which the general skill, competence and confidence of each trainee is assessed using questionnaires, simulations, and ‘Direct Observations of Procedural Skill’ (DOPSs). Later in the year clinical skills are assessed by the Educational Supervisor using ADEPTs (A Dental Evaluation of Performance Tool) and Case Based Discussions (CbDs). There are also Multi Source Feedback questionnaires and Patient Surveys to be organised within the practice.

The Educational Supervisor and the trainee record progress, development and assessments throughout the year in an Electronic Professional Development Portfolio (E-Portfolio) which has to be maintained regularly throughout the year. The Educational Supervisor has a responsibility to complete their parts of the E-Portfolio in a timely fashion and also to ensure that the Foundation Dentist maintains their sections of the E-Portfolio fully and promptly.

An important role of the Educational Supervisor is to help manage the patient flow and delivery of clinical work to the trainee, not only to prevent appointment book congestion, but also to ensure educational and developmental progression. It is important that trainee has exposure to specific clinical items at appropriate times for assessment or for case presentations.

As well as the normal help and advice, the Educational Supervisor also has to provide a weekly tutorial lasting one hour, (forty five minutes for therapists) during normal working hours.  The Educational Supervisor is also required to take part in not less than fourteen sessions (seven days) of postgraduate activity associated with DFT, but many of these sessions are taken up with attendance at events and meetings organised by the Scheme or East of England.

During the year there are Reviews of Competence Progression (RCP) based on the Annual Review of Competence Progression (ARCP) process used throughout Dental and Medical Specialty Training. The main components are: Early Stage Review by 6-8 weeks; Interim RCP at 6 months; and Final RCP at 11 months with defined outcomes.  The reports given by the Educational Supervisor about the progress and development of the trainee are key to each of these reviews.

Funding and Financial Arrangements

For Dental Foundation Training, the Educational Supervisor is paid a Training Fee of £11,700.00 per annum (£975.00 per month). A sum representing the service cost of employing the Foundation Dentist of £5,347.00 per month is also paid, less any patient charges based on your Foundation Dentist’s work (Figures correct at April 2023). Units of Dental Activity (UDAs) produced by the Foundation Dentist are specific to the Foundation Dentist and cannot be used for, nor contribute to the practice contract total. Although Dental Foundation Training is based within the National Health Service, there may be a very small amount of work which the Foundation Dentist will carry out privately, usually items not available within the NHS. Any such private fees will accrue to the practice, and must not be paid to the Foundation Dentist as an additional salary.

For Dental Therapist Foundation Training, the training grant is also paid, together with a service cost. As the Dental Therapists work to a reduced scope of practice with no laboratory costs involved, and the UDAs generated by the trainee therapist are part of the practice contract allocation, the service charge is proportionally less and in East of England it is currently £2,991.67 per month for a practice with two FDTs working clinically for two days each.

What Does the Educational Supervisor Have to Provide?

To be selected as an Educational Supervisor, you must: be a performer on the NHS Dental Performer List; have significant experience in general dental practice (normally equivalent to four years full time experience); and have been in your present practice for not less than one year. It is expected that you would be the practice owner and/or provider, but in many circumstances, (corporate bodies, longstanding associateships, salaried services) this is not necessary. You must have a personal contracted commitment to working within the NHS, covering all Mandatory Services, and there must be a practice commitment of not less than 1,000 UDAs. This NHS commitment must be demonstrable during the year of application and appointment and throughout the whole period of training. You have to provide an approved surgery for the trainee to work in, together with a trained and experienced dental nurse at all times. As stated in the earlier section, you must be present, working in the practice, for at least three days a week whilst the trainee is working, and you are expected to be able to make yourself available for help, clinical and non‑clinical, throughout the day. There also need to be satisfactory approved arrangements for supervision of the trainee in your absence.  East of England region also requires several core areas of CPD to have been undertaken within specified time periods, including training in Equality and Diversity skills, and Bullying and Harassment Management within the previous three years. The EoE Person Specification (Appendix 1) gives full details

The Appointment Process and Timetable

The Foundation Training Year begins on the 1st September, the national starting date, thus present Educational Supervisor applications will be for Foundation Dentists and Foundation Dental Therapists to start on 1st September 2024. The process of application and appointment is straightforward, but has a fixed timetable. It involves completion of a structured application form, which will help to ensure that you and your practice are prepared for Training.

New applicants

If you are a new applicant, your application will be passed to one of the Scheme Training Programme Directors (TPD) who will arrange a visit to your practice. The TPD will discuss your application with you and will also complete short reports on many specific areas of your application and the practice.  If you feel that you could and would like to become an Educational Supervisor, then you must apply using the interactive application form which you can download from the East of England website. The interactive form is in .pdf format and must be opened and completed using Adobe Reader, which can be downloaded from the Adobe website ( http://www.adobe.com/products/reader.html ). It needs to be opened using a computer, a tablet or phone will not open the form, and it will need to be signed electronically using Adobe Reader. The completed form is then saved and emailed to england.dft.eoe@nhs.net . The form must arrive at East of England before noon on Friday 15th December 2023 in order to be considered. There are further instructions on the process in the ‘Application Notes’ document.

Current Educational Supervisors

If you are a current Educational Supervisor, the application form is a Performance Review to provide evidence to East of England to confirm your suitability to continue in your training role. The appointment process has been adapted to allow detailed scrutiny of Educational Supervisor performance. You will need to download the application form from the East of England website and complete it fully. When it is complete, you must email it to your TPD and also to england.dft.eoe@nhs.net  before noon on Friday 15th December 2023 in order to be considered. There are further instructions on the process in the ‘Application Notes’ document.

There are several sections within the interactive application form, but not all sections will be seen and  completed by all applicants.  The first section asks for personal and practice details, and also asks about Joint ESs and working with the FD in a second practice location.

There are then sections about your core CPD, your status within the practice, and also full details about the practice in terms of its educational and training facilities. Your presence at the practice needs to be set out and also that of any Joint Educational Supervisors with whom you plan to work. Please ensure that you collaborate with your joint applicant so that all the working times given align with each other. You must also supply details of educational experience and availability of other dentists who can provide cover for you at times when you are not present in the practice.

Training practices must comply with certain minimum standards, and these are set out in the EoE Practice Specification (Appendix 2) and listed in greater detail in the application form. Thus if there are areas where your practice does not meet the requirements, you have the chance to alter things before submitting your application by Monday 15th December 2023. Late applications will not be accepted, only those which are complete and correct will be accepted to take part in the Educational Supervisor selection process. We regret that applications which are incomplete will NOT be accepted.

If you are a new applicant a TPD will arrange a practice visit to verify the information you have set out in the application and to assess the facilities available within your practice. The TPD will then complete a report about your practice and application. The visit usually lasts about an hour and gives the TPD a chance to sort out any queries that may have arisen from your application and it also provides opportunity for the TPD to meet and get to know the potential Educational Supervisor.

If you are a current Educational Supervisor within East of England, the TPD will be asked to complete a report about the practice and your current and previous performance as an ES as part of the mid-year visit.  

Before or during the visit, the TPD will ask to see copies of the Core CPD certificate and your NHS end of year (2022-23) practice contract reports, downloaded from the NHS BSA Compass Portal. The TPD will also send a blank form for you to undertake a short clinical records audit which will be verified at the visit.

Additionally, NHS England WT&E will require that you submit a signed permission form for NHS E, ICB and GDC checks to take place or your application will not be considered.

Appointment as an Educational Supervisor

All applications will be assessed by the EoE Selection Committee. This includes Lay Representatives who input the patient and public voice and also ensure that candidates are dealt with in a fair and courteous manner.

Following the selection process candidates will fall into two following groups:

  • Appointable, and thus eligible to receive a training place.
  • Not appointable at this time.

Appointable applicants will be allocated to the available training places according to location, experience and suitability. Applicants not allocated a place will be placed on a reserve list in case more places become available or a candidate withdraws from the process.

If you are offered the position of Educational Supervisor on a training scheme you will need to confirm this immediately since if you do not wish to take up this place another suitable candidate can then be offered a place as an Educational Supervisor. All appointed ESs will be subject to an annual performance review process and their continuation is dependent upon a satisfactory performance being noted in the review.

Recruitment of Trainees

Foundation Dentists

The recruitment of Foundation Dentists is now carried out through a national process. Those wishing to undertake Dental Foundation Training starting in 2024 will undertake a situational judgement test and will be ranked in order of score. They will also be asked to preference the Schemes from a list of all the national Schemes, and will be then be allocated in turn according to their score rank. Local allocation of Foundation Dentists to Training Practices will be made through a process using the Foundation Dentists National Recruitment ranking and information from descriptions of the appointed Training Practices available on the East of England website. You will be asked to provide the information for the description.

Foundation Dental Therapists

Foundation Dental Therapists are recruited regionally. Those wishing to undertake Dental Therapist Foundation Training in the East of England region will apply directly by means of an application form which will be scored and applicants will then be ranked in order of score. Allocation of Foundation Dental Therapists to Training Practices will be made through a process using their scored application ranking and information from descriptions of the appointed Training Practices available on the East of England website. You will be asked to provide the information for the description.

 

Preparations for the Foundation Training Year

Training courses will be held for all Educational Supervisors in the Region, during June. New Educational Supervisors will be required to attend two days of Induction training, and all Educational Supervisors (current and new) will attend a further one day Preparation course. Dates for these will be shared with successful applicants. Many of the skills required for the job of an Educational Supervisor are introduced and discussed, often in an informal way. Preparation within the practice for  the start of the Foundation Dentist at the beginning of September is essential, and this can be discussed fully with a ‘buddy’ Educational Supervisor allocated to each new Educational Supervisor.

The Dental Foundation Training Year

The Foundation Dentists and Dental Therapists starts in practice on the 1st September. The Educational Supervisor must not take leave during the first six weeks of the trainee’s appointment. Study Days for each Scheme begin at the start of September. During term time the trainee will usually attend the Study Days on Fridays (Tuesdays for Cambridgeshire and Peterborough Scheme), and the Educational Supervisor will need to ensure that the tutorials match the input of the Study Days when perceived relevant. If difficulties arise the Educational Supervisor always has access to the Scheme TPD for advice, support or help. The TPD in turn has access to the Regional team for help.

During the Winter holiday period, the Scheme TPD will make a Mid-Year ‘visit’ to the practice, either a virtual visit, or face to face to see the trainee at work. A virtual visit will usually take about half an hour, but a face to face visit will occupy an hour or two. During a face to face visit, the TPD will wish to see the Foundation Dentist  or Foundation Dental Therapist working with patients and will need to speak to both Foundation Dentist or Foundation Dental Therapist and Educational Supervisor about the training process.

All trainees will have specific online learning to undertake, a clinical audit and case presentations. The Foundation Dentists have a series of ‘Milestone’ case presentations. Input from the Educational Supervisor is essential with these activities so that the trainee can develop skills in these areas.

During the year the Educational Supervisor completes a report for the Early Stage review and two reports for the RCP Assessment Panels; one for the Interim Review at the end of six months, and one for the Final Review in the eleventh month.  The TPD also makes a report and the Panel will then review these reports together with evidence that the trainee has completed: the specified study days; a full training year; any  required coursework; the required number of assessments; a case report; a clinical audit; and the E-Portfolio. Only then can the panel decide upon an outcome recommending that a Certificate of Completion is awarded to the Foundation Dentist. If the conditions are not met satisfactorily then the Panel may recommend further training or even in some cases leaving the programme.

The Educational Supervisor - A Specification

When the Selection Committee looks at your application, they will be considering you as an individual and will be matching you against the Person Specification for EoE Dental Foundation Educational Supervisors 2024-25 (Appendix 1). Experience enables an Educational Supervisor to be able to deal with the problems of a Foundation Dentist or Dental Therapist, but not all experiences are of equal value. Some non-dental experiences may be invaluable in the educational role of an Educational Supervisor.

Many of the necessary skills or qualities may be difficult to demonstrate. You need to be able to think of examples of situations where you believe you have demonstrated these qualities. Making time within the practice day is an important point, and may mean planning your practice day differently from its present arrangement. Will this cause difficulties? Being a Dental Foundation Educational Supervisor does, without doubt, alter your practice and you need to be able to accept this alteration. You need to be special to be an Educational Supervisor and to be able to provide for the needs of someone starting their career in dentistry. The responsibility placed upon the Educational Supervisor for forming the lifetime professional values and habits of the Foundation Dentist is not a light one, and yet many of our colleagues have found this responsibility to be one of the most rewarding challenges of their practising life.

As mentioned in other parts of this guide, you need to be present in the practice whilst the Foundation Dentist works for a minimum of three days per week and maintain a demonstrable personal commitment to the NHS and a practice commitment of no less than 1,000 UDAs.

The Practice - A Specification

If you wish your practice to be a training practice it will need to comply with the Practice Specification for EoE Training Practices 2024-25 (Appendix 2). You will need to have a surgery available for the Foundation Dentist to use from September 2024. It must be of at least nine square metres in floor area and must be fully equipped for low seated dentistry, and ideally for four handed dentistry.

A list of the requirements in terms of equipment and facilities is found later in this document, and the information is repeated in the application form, but a well maintained normal practice should comply with these requirements. Infection control arrangements need to be well established and comply with the ‘Essential Quality Requirements’ of Health Technical Memorandum 01-05 (HTM 01-05). There need to be sufficient instruments and equipment available. Additionally there must be evidence that there are sufficient patients available for the Foundation Dentist to see, and that there are sufficient numbers of experienced support staff available.

There also needs to be sufficient supervisory support for the trainee so there is a requirement for another suitably experienced dentist, who is able and prepared to provide supervision of the Foundation Dentist, to be available in the practice at times when the Educational Supervisor is not present. If you are not sure about any items, the TPD will be very willing to discuss this with you or other members of your dental team before you complete your application form.

The educational aspects of the practice are equally important, and good access between the Foundation Dentist and Educational Supervisor is vital. Availability of educational resources is paramount and this will be checked at the practice visit, as will the availability of Wi-Fi and internet access sufficient to allow video communication. The involvement of the practice team in the learning process is something that must not be underestimated and the forms ask for details of the involvement of individual team members. The Practice also has to be providing a full range of treatments within the NHS, and this will also apply to the Foundation Dentist. The practice team will also have to assist the trainee's patient and appointment book management, not only to prevent appointment book congestion, but also to ensure specific clinical items are provided at the appropriate times.

Study Days

Study Days are run on a small group basis most of the time, with an emphasis on encouraging group participation. The sessions will sometimes be held online, but when clinical work is being covered, the session may be held face to face. The topics covered in the year are mapped out against the national Dental Foundation Training Curriculum, but will also depend upon the educational needs of the particular group of Foundation Dentists, whilst maintaining an underlying structure in the planning. The first term covers the ‘Introduction to Practice’, and covers basic NHS administration, treatment planning within practice and teamwork within practice. The second term is based on ‘Improving Quality of Care’, with the introduction of further clinical and administrative skills. The third term's theme is ‘Widening the Horizons’, and topics such as practice management, selection and purchase are introduced.

Some of the Study Days are timetabled for self-directed online learning. The trainees have a range of online learning modules which they have to cover, many of which are found in the e-Learning for Healthcare platform.

During the year the Foundation Dentists also have three Milestone presentations to give. Two of these are reviewed anonymously by Educational Supervisors and Foundation Dentists using the APLAN online platform. You will be required to take part in these reviews and will be allocated presentations to review and comment upon.

It is important that the trainees attend every day of the course as there is a requirement that they attend all sessions in order to obtain their Foundation Training Certificate. Thus, the trainees will normally be able to take leave only outside of the term time.

 

 

Wednesday, 5 August, 2020
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