East of England

Non UK Dentists

To find information for EU and Overseas dentists regarding immigration and registration

The General Dental Council provides information about application registration and whether you will need to pass the overseas registration exam before you register.

Joining the National Performers List: Terms of Agreement

To work in primary care within the NHS you must apply for inclusion on the NHS National Performers list.

This advice is for General Dental Practitioners who wish to join the National Performers List (NPL) but have not completed Dental Foundation Training (DFT).
In the past there was a system called Performers List Validation by Experience (PLVE). This process is no longer in use. The replacement for PLVE is known as Terms of Agreement (TOA).

The TOA Process

• The GDC registered and indemnified TOA Dentist finds, and names, a Practice (with sufficient NHS contractual capacity) willing to take them on as a performer. There will also need to be a GDP at the Practice who will act as a supervisor.
• The TOA dentist will apply for a performer number in the normal way

• The NPL application will identify that a dentist requires TOA.
• The TOA Dentist will have a structured interview with a Dental Professional Advisor (DPA) working for NHSE.
• NHSE will assess the suitability of the supervisor before the TOA process can proceed.
• The TOA period is normally set at 6 months but can be extended to 12 months depending upon the clinical experience and perceived competence and communication skills of the TOA Dentist. The DPA sets this period.
• The Dentist is assigned a Case Manager and a DPA (Dental Practice/Professional Advisor) who will oversee the schedule of TOAs and offer remote support if required.
• When the TOAs are agreed the TOA Dentist is assigned a performer number, with a provisional flag, to allow entry onto the NPL and working within the NHS.
• The TOA Dentist will need to gather a set of evidence during the period of the TOA process.
• The Dentist reaches the end of the process when the TOAs having been assessed by the DPA and the Supervisor and the allotted timescale has been completed. They are provided with a short clinical reference based on their assessment indicating that the Dentist is fit to practice unsupervised. The provisional flag is removed from the performer number and the Dentist is free to continue unsupervised within the NHS.
• Typically, the Dentist will be working full time in the NHS and the supervisor present to help for at least 60% of that time. Shared supervision is accepted and indeed may be of benefit. Shorter working weeks will result in a longer timescale for the TOAs, to gain enough evidential NHS experience.

Taking a Break

If you are planning to take a break from Dentistry it will still be important for you to keep up to date with all the changes that will take place while you are away from practice. This will be relevant for whichever sector of dentistry you work in be it primary or secondary care, NHS or private. Clinical techniques and materials, best practice, standards, and many regulations change rapidly; so it is vital that you keep yourself well informed and up to date.

Some of the things you should consider while you are on your break are:

• Keeping up your GDC registration
• Retaining your membership of your indemnity organisation
• Maintaining your membership of the British Dental Association (or joining if you are not already a member)
• Participating in CPD to a level well above that required by the GDC as a minimum to retain your registration
• Attending Dental courses (EoE courses and elsewhere); this not only provides you with CPD hours but also enables you to meet, mix and exchange ideas with other dentists.

The GDC have requirements in terms of the amount of time spent on Continuing Professional Development (CPD) that you must complete annually in order to be able to maintain your registration with them. These requirements should be considered as the minimum that you should do.

Returning to Practice

If you are returning to practice after a period away from clinical work, for whatever reason, you may well find it somewhat daunting to return to dentistry or just want some information about the possibilities of doing so. You are not alone in feeling like this and yet the experience of some people is that if the break is not too long their dental skills can return quite quickly as soon as they are working in a supportive clinical environment. However, it is vital that patient safety is not compromised and that you are confident that you are able to operate in a safe, consistent manner according to best practice. Hopefully you will have planned your break in advance and will know what you need to do when you return.

When you are ready to return to practice you will need to decide how and where you wish to work. This could be full or part-time, in primary or secondary care, and could be in a predominantly NHS or private practice. Obviously you will first have to ensure that your full registration with the GDC is current (which will entail, among other things, having kept up your CPD hours) and that your indemnity is organised.

East of England run Dental Workforce Development courses, which are booked on-line via Accent.

Some of the London teaching hospitals can offer hands-on refresher or specialised courses. The LonDEC centre provides courses;

If you decide that you wish to return to primary care NHS dentistry you will first have to find a practice that can offer you a position, and then apply to join, or re-join, the NHS National Performers List..

Restoring Efficiency of Registrants

Sites offering free information and downloads

Dental indemnity organisations

Some indemnifiers offer free downloads and verifiable CPD to their members; there are other indemnity organisations available as well.

Subscription Websites