NHS Education for

Scotland (NES)

Becoming a Vocational Trainer in Scotland

1

Contents Page No Introduction 2

Section I –Information for Prospective Trainers 201 3 3 The Purpose of Vocational Training 4 Trainer Selection 4

-Satisfactory CPD Record 4 -Satisfactory Dental Reference Officer references / Disciplinary actions / Level of NHS gross 4 -Evidence of Equality & Diversity and Employment Legislation training 5 -Satisfactory Practice Inspection 6

Future NES Training Practice Requirements 7 Selection and obligations of VDPs 9 The Training Programme 9 Legal Obligations 9 Finance 9 Criteria for Appointment and Role of the Trainer 10 Determination X Practice Improvement Grants 10 Applying to be a Trainer 11 Future Developments for VT Trainers 11 Selection Flowchart 12 Section II - Guidance on VT Requirements 13 Guidance on standards at practice inspection 14 Combined Practice Inspections – New Requirements 16 Documentation and Policies 17 Practice Equipment and Materials 21 Decontamination Observation Part of Visit 24 Useful Contact Addresses 26 Section III – Appendices 28

1. CPD Guidance for Vocational Trainers 29 2. Sample email attachment eDROref form 31 3 Sample email attachment eDROref (SDS) form 32 4. Guidance on Trainer Ranking process 33 5. Copy of VDP-Trainer contract. 37 6. Sample of NES Determination X Application/Report form, process notes 51 and flowchart

2

Introduction

Thank you for your interest in Vocational Training (VT) in Scotland. This booklet aims to give you all the

information you will need to meet the requirements to become a trainer for Dental Vocational Training

(DVT) or Longitudinal Dental Foundation Training (LDFT). Our aim is to help you through this process

and to reduce as much of the stress involved as we can. We hope that you will find that the process of

VT selection will be fair and that your involvement in VT will be of benefit to you and your practice/clinic.

Although we take account of your whole practice and your whole practice team during the selection

process, in the end it is only you who can be selected as a trainer.

The booklet is divided into 3 sections:

Section 1 Information for Prospective Trainers 2013. These notes are to help inform you of the

requirements to become a VT Trainer in Scotland, including the ranking score system

relating to trainer selection.

Section 2 Guidance on VT Requirements This section contains guidance notes relating to the

practice inspection, documentation, equipment and materials suggested for VT training.

Section 3 Appendices. These illustrate some of the forms used in Scottish VT

Once you have read over this document, if you have any questions, please contact your regional office who will arrange for an Adviser to explain the process and answer your questions. Good luck with your application.

3

Section I Information for Prospective Trainers 2013

4

The Purpose of Vocational Training

The purpose of Vocational Training is to provide 12 months supervised experience in General Dental Practice/SDS, supplemented by an educational programme, to help dental graduates make the transition to unsupervised competent practice in the National Health Service (NHS) General Dental Services. Trainer Selection

The selection and appointment of Trainers and training practices is the responsibility of the Scottish Dental Vocational Training Committee. A scoring system is used for trainer selection whereby a practitioner who applies to become a VT trainer accumulates points at various stages along the eligibility process. There are four major requirements for eligibility to progress to review or interview in order to become a Vocational Trainer in Scotland and these contribute, along with a score at review or interview, to an overall score for each applicant.

1. Satisfactory Continuing Professional Development (CPD) record 2. Satisfactory Dental Reference Officer (DRO) references/ Disciplinary actions/ Level of

NHS gross 3. Evidence of Equality and Diversity and Employment Legislation training 4. Satisfactory Practice Inspection

The following passages explain these individual requirements more fully. 1. Satisfactory CPD record It is mandatory that you comply with NES’s verifiable CPD requirements. You may be required to provide certification of 75 hours of verifiable CPD in the previous 5 years preceding interview, or since the completion of your own training. Although VT and Dental Foundation Training (DFT) training programmes all contain verifiable CPD, any hours gained during the applicant’s own training cannot be included in the total number of hours required to become a VT Trainer. Details of your attendance at courses provided by NES can be found in your CPD record in Portal and will automatically be included within the NES CPD section of your application form. Your non-NES CPD can be added during the application process and any supporting evidence can be uploaded at the same time. This is required for any non-NES CPD on radiography/radiation protection and medical emergencies. Guidance on CPD requirements can be found in Appendix 1 of this document. 2. Satisfactory DRO references / Disciplinary actions/ Level of NHS gross This is based on nationally agreed criteria, using your DRO reports within the 3 complete calendar years preceding the relevant VT year. DRO references are taken since they are the only clinical quality assurance system to which there is access. Trainers must also comply with a requirement to have a minimum NHS gross income. The standards required for VT in order for DRO grades not to negatively impact on the trainer’s score are:

• No disciplinary action or significant numbers of complaints against the practitioner in the last 3 years. • None of the following within the 3 complete calendar years preceding the relevant VT year:-

a) more than three Grade ‘3’ post treatment DRO reports, b) more than three Grade ‘C’ pre-treatment DRO reports, c) more than a combined total of 3 grades at Grade ‘3’ or Grade ‘C’, d) any grade ‘D’ or ‘4’ DRO reports

GDS applicants must have minimum NHS earnings of £27800 in the financial year up to April 2012. (20% of notional TAGI).

5

SDS applicants will have their NHS workload verified by the NES Assistant Director for SDS. Included in this documentation as Appendices 2 and 3 are the forms eDROref and eDROref(SDS). The purpose of these is to request verification that you comply with the above criteria. Applicants will be sent a word version of this form by email. This form should then be completed by replacing the type in red with your own details and emailing the form as an attachment directly to Lorna Anderson at the Scottish Dental Practice Division (Lorna.Anderson2@nhs.net ) who will check your record and confirm your compliance with the above criteria by either:- a) returning an email of confirmation and sending a copy directly from PSD to your NES regional administrator. or b) sending by post, to the applicant only, a hard copy of confirmation, which requires in turn to be forwarded to your regional VT administrator. Clearly, option a) will save time. Lorna Anderson’s email address and the email addresses of the regional administrators are noted on pages 26 and 27 of this document. If you do not comply, a minus score will be incorporated into your overall trainer ranking score. There are different levels of negative scoring, as follows:-

• If you have failed to reach the stated standard and the grades responsible for this were fully or in part due to DRO grades acquired directly by your own treatment, you would be awarded a score of -35 points. Effectively this will make it very difficult for anyone with such a score to become a trainer.

• If you have failed to reach the stated standard and the grades responsible for this were fully attributable to work carried out by an assistant, including a Vocational Dental Practitioner, under a second personal list number, a score of -10 will be applied.

3. Evidence of Equality & Diversity and Employm ent Legislation training This third requirement is evidence of completion of Equality & Diversity and Employment Legislation training. Applicants must produce, by the time of application for VT, evidence of completion of 3 modules of the “Same Difference” Equality and Diversity online e-learning programme, which is available from NES. This training should be undertaken every three years. The modules which must be completed by trainers are:-

• Equality, Diversity and the Law • Working Together • Fair Selection

(Note – Normally new trainers on START must complete the required modules by 31st January.) NES will provide trainers with usernames and passwords in order to access this programme. Completion of these modules will be accepted as verifiable education for the trainer’s own CPD requirement. For 2013, current and returning trainers who have previously completed the three modules must have completed the updated module, “Equality, Diversity and the Law” by 31st January 2013 and must specify when they completed these modules in their application form. In relation to employment legislation, New Trainers on the START course will undertake this on their first training day in January 2013. Current and Returning Trainers must specify the date they undertook this training on their application form and must read the update document which will be issued in due course. Any Returning trainers who have not previously attended this training must attend a session on employment legislation which is run as part of the START Part 1 course in January 2013 and should discuss attendance at this event with their regional Director as soon as possible.

6

4. Satisfactory Practice Inspection Once you have returned a copy of your CPD record and DRO reference confirmation to your Regional Office VT administrator, he/she will liaise with your health board regarding the fourth major element for accreditation; your Practice Inspection. The purpose of the practice inspection is to ensure that all Vocational Training practices/clinics attain a minimum standard that is compatible with training in General Dental Practice. As Vocational Dental Practitioners (VDPs) are employees of the practice or Health Boards, every effort must be made to ensure that the practice/clinic complies with current requirements with regard to Health & Safety at Work and other statutory regulations. This standard applies throughout Scotland to all applicants. In order to help new trainers be clear about the requirements of a practice inspection, a mentoring visit will be carried out as part of the START programme. During this initial pre-inspection visit, one of the VT Advisers or DPGDPEs will visit the practice at a pre-arranged time to clarify what will be required of prospective trainer(s) and of the practice/clinic. The practice/clinic will subsequently be notified, by means of a report, of any shortcomings and advice will be offered on how to address any deficiencies. As you will appreciate, this mentoring process involves a considerable use of Adviser time and it is expected that the applicant will be familiar with the inspection paperwork at the time of the mentoring visit. Mentoring of a practice new to training will normally take up to three hours. This session is funded for new trainers and it is expected that the prospective trainer will be available, without interruption, throughout this session. This help is primarily aimed at practices that are new or returning to Vocational Training. Requests for mentoring visits from existing training practices can also be granted. Going through the mentoring procedure will not guarantee the granting of satisfactory status and you will still need to meet all the practice/clinic inspection requirements for VT. Following the mentoring visit, the regional postgraduate office will liaise with your health board in order to arrange the practice/clinic inspection. For 2013, if the practice is due a health board inspection, the new combined health board / VT inspection will be c arried out, using the new associated documentation. In this case, the inspection will be carried out by an agent of your health board. If a health board inspection is not due and /or the health board are unable to carry out an inspection by the date required for VT, the combine d inspection checklist will be used by NES inspectors although in this case the inspection wil l only be recognised by NES and not by your health board. If shortcomings involve items of equipment, these will be noted at this time in case the practitioner wishes to access Determination X funding from their NHS Board. Determination X funding is explained on page 10 of this document and prospective trainers are also advised to read the appropriate sections of the Statement of Dental Remuneration (SDR). Appendix 6 illustrates the form used and provides a flowchart of the process. The combined practice inspection will normally take about four hours due to significant expansion in the requirements when compared to previous health board or VT inspections. During the allocated time for inspection, an experienced dental nurse who knows where everything is kept should also be available. The practice/clinic does not have to close but the inspectors should have easy access to all areas of the practice/clinic. Inspectors will make every effort to keep to the appointment time but circumstances may dictate that they may be delayed. In this event the inspectors will inform the practice/clinic of the revised timetable. The inspectors will try to minimise the disruption to the practice/clinic and will be sympathetic to the workings of your practice/clinic. Inspectors would appreciate your co-operation in the preparation of your practice/clinic and staff before they arrive. Applicants should also note that some documentation requires to be completed prior to the inspection visit. The same inspection criteria and documentation are used throughout Scotland. The CPI documentation is available at http://www.scottishdental.org/index.aspx?o=1019&newsitem=1106

7

The inspection paperwork is divided into various sections with the initial sections describing a list of the paperwork that inspectors will require to see during the inspection. Please have this paperwork collated in a single folder and in the order of the list to facilitate the process. Inspectors will examine all areas on the practice/clinic inspection checklist. In addition they will need information about the workload of your practice/clinic and your practice/clinic administration systems, plus your decontamination processes. As agents of the health board, they will ask to see current patient record cards but they will be examining standards of record keeping and radiographs only. The identity of the patients is not important to the inspectors. The inspectors will wish to examine your appointment book to assess your workload and will also ask to observe the prospective trainer and dental nurse simulating routine clearing, cleaning-up and decontamination processes employed after a simple dental appointment. The Inspectors If the visit is directly organised and carried out by NES as an interim measure during the transition from NES inspections to health board inspections, one of the inspectors will normally be a Vocational Training Adviser from the region nearest to your practice/clinic. The other inspector may be a GDP from the GDS or SDS who is experienced in practice inspections. If the inspectors are from the health board, the normal role of the inspectors will be dependent on the format used by individual health boards to carry out inspections. Inspectors will have to arrange many practice/clinic visits. Please be as flexible as possible regarding the visit time. Future NES Training Practice Requirements

In addition to the standard requirements for a satisfactory health board inspection, NES is likely to introduce a scoring process for practice inspections after the initial transition period from the NES to the combined practice inspection. Although the health board inspection will be standard, there will be recognition of quality of the practice as a training environment via the application of this scoring process. A guide to this is available on page 14. Additionally it is worth emphasising the following points to assist GDPs in their application to be a VT Trainer: • The practice should ensure that adequate support to the VDP will be provided by the Trainer for not

less than the time stated in his/her contract, e.g. 3 days (21 hours) per week for a full-time trainer. All treatment should only be provided at the premises visited and approved for VT. If more than one site is used for training, all locations need to be visited and approved separately.

• There should be good support from reception/secretarial staff, and the VDP should have exclusive

assistance from a GDC registered and preferably qualified Dental Nurse. VDPs must be chaperoned at all times with special arrangements for domiciliary and out-of-hours on-call surgery re-openings.

• The VDP’s surgery should have an area of not less than 9 square meters. There should be

adequate space for reception and secretarial staff, and a well-kept waiting room. All staff must be employed under written contracts, a Health & Safety code of practice should be available, and an employer’s liability certificate should be on display.

• Premises should be well equipped, have modern decontamination facilities and have easily

accessible x-ray equipment. Ideally there should be an X-Ray unit in the VDP’s surgery. Facilities for 4-handed and low-seated dentistry should be available.

• Although not mandatory, it is strongly advised that, where possible, dental units and VDP surgeries

can be adapted for use by left-handed trainees. Ensuring that such flexibility is in place will protect the trainer against enforced limitation of choice of VDP at the time of recruitment.

• All staff should comply with practice/clinic policies.

8

• Inspectors will pay particular attention to the arrangements made for cross-infection control and

Health & Safety within the practice/clinic. A decontamination protocol in line with current recognised guidelines should be implemented. Current best practice should be followed for decontamination procedures in line with the advice given in the CDO’s “top 10 tips” as a minimal requirement. This document can be found in the useful website http://www.scottishdental.org/ The top 10 tips document, which contains further useful website links, can be viewed at http://www.scottishdental.org/index.aspx?o=2647

• The sections on practice/clinic equipment and materials (pages 21-24) suggest the equipment and

materials that a VDP would expect to have access to during the VT year. Practices/clinics may use other materials or equipment which are equivalent.

• All staff must be regularly trained in the use of emergency equipment and drugs which must be

complete and easily accessible in the practice/clinic • Inspectors would expect to find broadband internet access within the practice, suitable for trainees to

use at any time without disruption. There will be no upper or lower limit placed on the gross earnings of a VDP, which should be mainly NHS earnings. The workload of the practice/clinic is of importance and account will be taken of the balance between ensuring that the Trainer has adequate time to meet the training commitment and, on the other hand, that the practice/clinic can provide sufficient clinical experience for a VDP. It should be recognised that the range, quantity and pattern of work will vary between individual practices/clinics. It is expected that within a reasonable period of time after joining the training practice/clinic, VDPs will have access to new patients and that they would not normally be restricted in their prescribing by their trainer. VDPs should be encouraged to provide the full range of treatment of which they are capable under NHS regulations, with a minimum of 90% of the VDP’s time spent on NHS work. It is emphasised that if, at the end of the year, the trainer and VDP wish to continue their association, the trainer’s future participation in VT schemes will not be jeopardised. All new trainers will attend an interview and will be awarded a score at interview. . The overall trainer score will then be assessed and a decision taken by the National Selection Committee on the approval or otherwise of the applicant’s eligibility for training. This decision will be final. The Regional DPGDPE will give feedback to all unsuccessful applicants and rejection will not prohibit future application. Arrangements for appointment will be a matter for the DPGDPE for your region.

9

Selection and Obligations of VDPs Trainers will select VDPs using the National Trainer-VDP matching system. The VDPs will be employed as assistants within the practice/clinic from 1st August for a period of one year, or 2 years in the case of Longitudinal Dental Foundation Training (LDFT). VDPs will be required: -

• To enter into and abide by the terms of a legal contract for full-time employment with the trainer, or for an agreed part-time equivalent. The Trainer-Trainee contract issued will define the part-time nature of the employment where applicable.

• To attend the day or block release course or other courses as set out in the published programme. Absence from the course for any reasons will be authorised only in exceptional circumstances. VDPs must apply for leave from day or block release course to the DPGDPE or VT Adviser in writing and in advance. All missed days must be made up with suitable education, which is agreed with the Adviser.

• To take holidays outwith the educational programme. Unexplained absence from the course would imply withdrawal from the scheme by both VDP and trainer.

• To complete such educational studies as may be required. • To inform the VT Adviser of any alteration in the circumstances of the practice/clinic, the trainer

or self which might alter the contract of employment as a VDP.

The Training Programme

The main purpose of Vocational Training is to allow the VDP to learn under the supervision of an experienced general practitioner. This learning will be complemented by an educational course, which is arranged on a day or block release basis. The programme will be equivalent to at least 25 working days educational activity over the training year, and include a mixture of seminar presentations, workshops and hands on courses. The programme is arranged by the VT Adviser in consultation with trainers and VDPs. Legal Obligations VDPs will be employed as assistants in the trainer's practice/clinic and the trainer will be responsible for their work. It should be emphasised that all assistants, including VDPs, work under their principal’s list number, so the principal is responsible to the NHS for all acts or omissions of their assistant. The principal will have to answer to any complaints and receive the penalties imposed. Poor DRO grades will be placed on the principal’s record. Finance A Training Grant will be paid to the trainer. The VDP will receive a salary administered through NHS Education for Scotland. This salary will be paid by NES directly to VDPs in the GDS and via the Health Board’s payroll system for those in the SDS. All fees earned by the VDP will accrue to the training practice/clinic (GDS) or Health Board (SDS). The financial arrangements, set by Scottish Government Health Department, are: -

• (As of December 2012), Trainer's grant of £13,164 for GDS trainers, and £3500 ** for SDS trainers. (**Note that no trainer grant is available for Senior Salaried GDPs)

• (As of December 2012), VDP's salary of £30,468 • 100% of the VDP’s gross earnings will accrue to the training practice/ clinic or Health Board in the

case of an SDS post.

10

Criteria for Appointment and Role of the Trainer A trainer should be an experienced dentist with high clinical and ethical standards, currently practising at least 21 hours per week, or less if a part-time trainer, and providing a wide range of treatments under General Dental Services. A trainer, on initial appointment, should have been in general dental practice for not less than 4 years following the completion of his/her own training, (i.e. after VT or DFT). The principal should have managerial responsibilities and would be either a practice owner or an equity participating principal. Associates with managerial responsibility and part-time practitioners are also acceptable. A trainer ranking process will run in conjunction with the recruitment and selection process for all trainers. Scores will be awarded to trainers in several fields which relate to best practice as a trainer and the overall score will allow the applicant to be ranked alongside fellow applicants. Should the number of dentists applying to be trainers exceed requirement for a particular year, this ranking score will be considered when trainer selection is carried out. Normally this score would not affect a dentist’s appointability and individuals’ scores will not be published, however a ranking position may be discussed with an individual trainer with a view to encouraging trainer development. Occasionally, a particularly low score may impact on the decision to appoint a trainer. Guidance on which areas contribute to a ranking score is available at Appendix 4. Upon application a dentist will be expected to demonstrate a commitment to Continuing Professional Development, and following appointment would be liable for involvement in 14 sessions of appropriately organised educational sessions during the year; reduced pro-rata for part-time or shared trainers. Trainers would be subject to the Trainer/VDP contract, a copy of which is attached to this document as Appendix 5. A full list of Trainer and Trainee Obligations is contained within this contract. These obligations should be read and fully understood before the contract is signed. Determination X Practice Improvement Grants for tho se in GDS Determination X of the Statement of Dental Remuneration allows for grants to be made to: Dentists wishing to establish new vocational training surgeries (Part II of Determination X); and existing vocational training practices (Part III of Determination X); where improvements are required in order to meet or continue to meet vocational training standards. Determination X funding is not available to trainers in the SDS.

• New to Vocational Training Practices As stated in the Determination, grants under Part II require NES to provisionally assess the suitability of those wishing to become Vocational Trainers. Therefore, in order for NES to be able to provide support for your application for Determination X funding, you should already have met the other requirements for trainership relating to CPD, DRO references and Equal Opportunities training. A practice inspection must also have been carried out, resulting in a conditional acceptance as a training practice where the shortcoming is one of equipment relating to a new surgery for the trainee. The purchase of equipment to correct such shortcomings can be supported with the Determination X funding.

• Established Vocational Training Practices In the case of existing practices, you may find that due to wear and tear, breakdown etc you need to upgrade/replace equipment in order to maintain a minimal standard for a training practice. Periodically (once very 5 years) existing trainers will be eligible to access Det X funding to support purchases which have been approved by a NES representative. Priority will be given to the purchasing of certain items of equipment. Allowances can now only be approved for replacement/upgrading of equipment in the trainee’s surgery.

• All Practices Should funding through Determination X be sought, your regional director will write to you enclosing a report for you to submit along with the appropriate form, in support of any application for a Practice Improvement Grant. An example of the report and accompanying guidance can be found in Appendix 6

11

of this document. These forms are available from your regional NES office on request. Practice visits may be required before approval can be granted. The necessary forms for reimbursement can be obtained from your regional NES office and are Form GP220 (Application for a Practice Improvement Grant – New to Vocational Training Practice) or form GP221 (Application for a Practice Improvement Grant – Existing Vocational Training Practice).

Practice Improvement Grants are not administered or funded by NHS Education for Scotland; we are only providing documentation to support your application for funding. Any questions regarding Determination X of the SDR should be directed to your NHS Board. ** Please note that all purchases of equipment under D etermination X funding must be appropriate. Dental chairs, units and cabinetry int ended for use by a trainee should be adaptable so as to meet the needs of a left –handed operator. Decontamination equipment must be purchased from the national procurement list. Advi ce and information regarding these requirements can again be obtained from http://www.scottishdental.org The National Procurement list can be accessed through https://www.scotcat.scot.nhs.uk/cdsnet/cdsnet.asp?WCI=Home&WCE=Home Applying to be a Trainer Once eligibility to be a trainer has been confirmed by your regional office, you can then apply to be a trainer via the nationally managed process by electronic submission of an application through the NES Portal which can be accessed directly at www.portal.scot.nhs.uk You will be asked initially to create an account if you have not already done so. This will enable you to enter the site and complete the application form. Details of the application process and a direct link to the portal can also be obtained via the NES website at www.nes.scot.nhs.uk Alternatively, queries regarding trainer recruitment can be emailed to dental.recruitment@nes.scot.nhs.uk If you are a new Trainer you will be invited to interview and details of this will be forwarded. Interview panels are drawn equally from different regions in Scotland. This format is intended to make the selection procedure fairer and less open to regional variation or bias. A review process of applications from existing or returning trainers will take place. This process may result in a recommendation of exemption from interview, should the panel decide that certain applicants with previous experience, a satisfactory eligibility score and a satisfactory history of training can be re-appointed without interview. A complaints process exists for anyone dissatisfied with the trainer recruitment system. Future Developments for VT Trainers Requirements for trainership are constantly changing to keep in line with VT developments and recommendations on best practice. In order that trainers may plan ahead, it is suggested that, although not currently, the following may be requirements in the future:

• CPD on Oral Cancer is required as part of the CPD history for a trainer • Periodic training in Child protection is required as part of the CPD history for both the trainer and

all members of the practice team. • A practice development plan. • A member of the practice has undertaken either the Cleanliness Champion or Decontamination

e- learning programme.

12

Selection Flowchart

Note that being appointable does not necessarily gu arantee appointment if number of appointable trainers exceeds the requirement for VT or the funding available to NES.

Eligibility check - minimum criteria met for CPD and scored etc.

Trainer status

Existing/returning

Not eligible at present

START application

Online Application Form

Mentoring Visit

Contact by Director or HR to check if redeemable

Practice Inspection if needed

ST

AR

T course

DRO checked and scored

Interview and score

Regional Pre-Screening

Appointable

No

Exit

Yes Eligible

Review panel and score

Acceptable

Not appointable at this stage

Contact by Director to check if redeemable

Not acceptable

Criteria met retrospectively

Not acceptable

Not appointable

Appointable

Appointable

Recommend appointment

Publish practice profile

Matching process + clearing if needed

Check new applicants progressing with

START

VDP appointment, provisional contract signed

Trainer induction for all trainers

Check on any outstanding requirements for R&S, E&D

training

Additional requirement for new trainers – runs concurrently

On request or recommendation

New

App

lican

t con

tact

s re

gion

al D

irect

or fo

r fe

edba

ck

13

Section 2 Guidance on VT Requirements

14

The combined Health Board / VT practice inspection is now managed and carried out by health boards and the inspection document can be accessed and downloaded at http://www.scottishdental.org/index.aspx?o=1019&new sitem=1106 The table below provides guidance on standards appropriate for a practice aiming to become a VT training practice.

Guidance on Standards at Practice Inspection

OUTSTANDING

VERY GOOD – ABOVE AVERAGE

FAIR MINIMUM REQUIREMENTS MET MINIMUM REQUIREMENTS NOT

MET Documentation and Certification 100% of policies and certificates present, signed, dated and with a date for the next review. Policies are accessible to staff and filed in an orderly manner. Policies aren’t generic but have been modified to relate to the practice.

Just one or two certificates out of date, or requiring modification and there’s evidence that this has been addressed. Still a good example of governance displayed.

More than 2 certificates out of date or requiring modification. E.g. Recently appointed staff have not signed core policies, HepB records incomplete. No evidence this has been addressed by the time of inspection.

Most documents present and produced by deadline on demand when requested if missing. May require updating or reorganisation to allow staff to access more easily. Organisation of policies suggests that they are only accessed for inspections.

Significant omissions in certification or core policies missing entirely. Inadequate systems, patient safety is potentially at risk due to administrative omissions.

Emergency Drugs & Equipment Full kit available and in-date Evidence of system of maintenance and ease of access. Staff knowledgeable regarding whereabouts of all elements of kit and re-ordering process for drugs. Defibrillator present and log of check up to date.

One or maybe two drugs recently out of date but evidence this has been addressed by time of inspection. Eg receipt produced while awaiting delivery. Also no second O2 cylinder available only because Det X funding sought.

One or maybe two drugs recently out of date and not noticed at time of inspection. Pledge to re-order asap and evidence of action produced at earliest possible time. No second O2 cylinder available at time of inspection because of confusion over the requirement for VT.

More serious omissions or no evidence of these being addressed. E.g. O2 missing or empty e.g. airways missing, eg essential drugs missing

Supportive and Trained Staff All qualified staff up to date with core topics and have an impressive broad range of other verifiable training, ideally carried out as a practice team. Number of staff currently in training is proportionately small. Staff members have PDPs for learning. All staff records complete. Appraisal documentation comprehensive, completed and in use for some time.

Most staff up to date with core topics and have some other verifiable training. Appraisal now carried out and recorded.

Most staff up to date with core topics and have some other training although the quality of this training is undetermined. Staff training driven by practice directives with little evidence of involvement in development plan from individual staff members. Appraisal process in place but not yet in use.

Several staff have limited training and experience. No evidence of appraisal process for staff.

Staff levels of training are poor and staff are deemed unsuitable for supporting a VDP in the initial stages of training

Trainer’s Surgery(ies) Meets best practice in all areas. Exemplar

clinical environment with all equipment functioning fully. Minimal breakdown history. Provides an ideal environment for provision of wide range of treatment. Minimal sharing of

treatment kits required. Specific treatment kits comprehensive.

Meets essential criteria and many areas of best practice.

Meets essential criteria and a few areas of best practice.

Meets essential criteria. Some areas Of concern e.g. difficult access in Emergencies. Widespread sharing of kits, eg ultrasonic

scalers, endo kit etc.

Fails to meet essential criteria and not simply due to items which can be purchased to meet VT standard if conditional PI pass was awarded.

VDP Surgery Meets best practice in all areas. Exemplar clinical environment with all equipment functioning fully. Minimal breakdown history. Provides an ideal environment for provision of wide range of treatment. Minimal sharing of treatment kits required. Specific treatment kits comprehensive. Close to trainer’s surgery.

Meets essential criteria and many areas of best practice

Meets essential criteria and a few areas of best practice. Surgery may be less than ideal in respect of size, décor, lighting, ventilation etc.

Meets essential criteria. Some areas of concern e.g. difficult access in Emergencies, distant from trainer. Widespread sharing of kits, eg ultrasonic

scalers, endo kit etc.

Fails to meet essential criteria and not simply due to items which can be purchased to meet VT standard if conditional PI pass was awarded.

15

Decontamination / Infection Control Complies fully with all current guidance. Exemplar LDU with no compromise due to size, sinks and setting down areas etc Consistent decontamination processes evident. Compliance with Decon action plan.

Minor omissions or out-of-date processes. Evidence they are being addressed. LDU environment good but compromised by size, surface availability etc

Meets minimal health board requirements only. Little evidence of issues being addressed in action plan

Serious omissions or LDU environment which doesn’t meet HB requirements .No evidence of action plan or requirement for NES decontamination team visit having been met.

Facilities and Equipment

Exemplar modern environment for provision of wide range of treatment and to support training e.g. camera available. Fresh fabric and décor throughout practice.

High standard, suitable for good range of treatment. Well above minimum standards but a few areas where practice falls just short of exemplar status.

Good standard of facilities, above the average practice.

Meets VT criteria but would benefit from change which may or may not be within the control of the applicant. Eg cramped facilities, tired fabric and décor, barriers to open door policy, awkward access to facilities.

Fails to meet essential criteria

Administration and Preparedness for Inspection Excellent admin systems throughout the practice. Well-organised efficient appointment system, and policies accessible to staff and signed by all. Evidence of careful approach to VT application. Pre-population and submission of requested documents. Knowledgeable on content of “Becoming … “ doc Time set aside to host inspection by senior DCP and dentist. Documentation ready to view in an order which facilitated visit. Comprehensive patient records with current, updated Med Histories, BPEs and Soft Tissue Exams Significant number of patients with many aspects of OHA items and patient estimates.

Good admin systems, well-organised appointment system, and most policies signed. Preparation for inspection good. Pre-populated requested documents available . Time set aside to host inspection. Documentation ready to view but order and filing could be improved. All patient records with up to date Med Histories, BPEs and Soft Tissue Exams.

Administration of practice satisfactory but not ideal. Evidence of plans to improve where necessary. Sub-optimal preparation for visit. Documents not gathered and ready, but applicant available and staff aware of visit. A small number of documents rudimentary Med Histories, BPEs and Soft Tissue Exams up to date in most patient records.

Adequate admin system. No risk to patient safety but efficiency could be improved. Staff aware and on-hand for inspection, but applicant unavailable for periods during visit. Little evidence of much preparation for the inspection. Sub-optimal recording of Med Histories, BPEs and Soft Tissue Exams in dental records.

No evidence of preparation for visit. E.g. Documents not on-site, Insufficient knowledge of requirements for VT. Inadequate, poor patient records where the majority of records have major omissions..

Appropriate Workload Ideally suited to VT. Trainer’s book not too crowded. High trainer presence with a range and number of NHS patients suitable for VDP. Practice has a healthy number of new patients and no new dentists are starting in the practice around the same time creating a competition for patients. VDP workload can be spread so as not to create days or sessions that are long for a new graduate

Good range and number of NHS patients for VDP, albeit not absolutely ideal. But :- -Trainer very busy -New book being created for VDP - Expansion in practice means the VDP patient base is previously untested but patients numbers would suggest ok - Relocation of a previously suitable training practice.

Difficult to determine appropriateness due to completely untested situation with estimates of patient numbers based solely on conjecture. However trainer has plans and reasonable back-up to support these to suggest the workload might be satisfactory.

Despite trainer an assurance that plans are in place which would provide a suitable training workload for both trainer and trainee, inspector has reservations over range of treatment available or the number of NHS patients available within the practice. Example could be a new practice which has just been set up and is new to VT.

Inappropriate to needs of trainee. Past history suggestive of inappropriate workload and nothing appears to have changed. No changes are planned and workload for VDP is too light or heavy.

16

Combined Practice Inspections – New Requirements

All practices will now have to periodically undertake the new combined practice inspection. The combination of different inspections has undoubtedly increased the number of requirements. Health Boards will manage the process but will not be in a position to accept or reject practices for vocational training. Health boards may request immediate correction of certain shortcomings and allow a period of grace to comply. In line with previous VT inspections, there are a number of shortcomings which, if present on the day of inspection, are of such significance that they will result in a dentist being rejected for trainership on these grounds. The following omissions or absences would result in a potential trainer being unable to progress his/her application.

• Failure to comply with post-2012 decontamination fa cilities and process standards

• Failure to have in-date emergency drugs and an oxyg en supply with a valid test certificate

• Significant record keeping shortcomings Applicants for VT should also note that a second ba ck-up autoclave is a requirement for VT although this may not necessarily be required by yo ur health board. VT applicants should note that there are several new requirements in the CPI checklist which are additional to previous VT and health board inspection checklists. Examples of these are noted in the table below.

27 Additional child mask 48 PVG /disclosure for all staff 53 Protocol for staff support 56 Staff induction 57 Public protection policy 58 Business Continuity Plan 81 Back-up for computerised records 83 Freedom of Information Publication Scheme 86 Disability Policy 87 Written policy for child protection 88 Contact information for local Child Protection Team easily

accessible 89 Policy on obtaining consent 93 Protocol for patient notification if practice closes

110 NHS facility or accredited laboratory used for biopsy/pathology tests

111 Standard Operating Procedure for Controlled Drugs 137 full set of Employer’s Written Procedures in place

Applicants are advised to familiarise themselves with the new inspection document well in advance of the date of their inspection. As all practitioners will have to undergo the new inspection within the next 3 years, early familiarisation will provide more time to address new requirements such as those pertaining to IRMER etc.

17

Guidance notes on Documentation and Policies.

Important Note for SDS Clinics – NHS Boards are responsible for SDS clinics within their region and therefore many of the documents and policies which cover individual clinics are held centrally by their Facilities Department. It is therefore acceptable for the region’s Clinical Director to confirm the presence of the documents listed below and thereby accept responsibility for these documents and policies.

• Staff/Employer. Practice/Clinic Equal Opportunities Policy • Staff/Employer. Practice/Clinic Recruitment & Selection Policy • Staff/Employer. Staff Contracts • Staff/Employer. Discipline, dismissal and grievance procedures • Staff/Employer. Data Protection documentation (if applicable) • Staff/Employer. Public Protection Policy • Staff/Employer. Business Continuity Plan • Health & Safety /Radiation. Practice/Clinic Health & Safety Risk Assessment • Health & Safety /Radiation. Electrical Safety Compliance. (PAT test) ) • Health & Safety /Radiation Fire Risk Assessment • Health & Safety /Radiation Pressure Vessel, maintenance, cert. & insurance • Complaints Complaints Procedure Documentation • FOI Freedom of Information Act Publication Scheme • Records Back-up protocol for computerised records • Records Protocol for Patient notification if clinic closes.

Providing confirmation is received from the Clinical Director, who thereafter accepts responsibility for adherence to the policies, the above documents do not need to be produced for inspectors.

18

Documentation - Guidance Notes for the GDS

The following guidance does not cover all the requi rements for documentation but merely provides a brief descriptor of what would be expect ed of a VT training practice. (Note that any differences for SDS VT requirements a re noted in italics at the end of each paragraph.)

Practice/clinic Information Leaflet – This should incorporate all the information required by NHS Boards for PILs. These are listed on the inspection document. (SDS -This document should also be available.) Staff / Employer Note that all policies should be identifiable as pertaining to the practice/clinic and a system should be in place to record that staff have access to the policies and have read them. Employers Liability Certificate - In accordance with employment legislation, this should be clearly displayed within the practice/clinic. (SDS - A copy should be displayed within the building, although this may not necessarily be within the dental department or clinic.) Staff Contracts - These should include terms and conditions for all those employed within the practice/clinic. Contracts should also be available for associates. All contracts should be available for perusal by the inspectors, and should be signed by both employer and employee. Staff Appraisal System - This should provide both a note of the process employed, (including any paperwork used) and records of staff development. It is suggested that appraisals be carried out at least annually. (SDS - Although staff appraisal may be carried out centrally, inspectors would expect to be able to view evidence of local engagement in the process, e.g. PDPs. ) Practice/Clinic Equal Opportunities Policy, Practice/Clinic Recruitment & Selection Policy, Practice/Clinic Confidentiality Policy, - These policies should outline the procedures adopted as routine in these fields. They should include a statement of declaration that the practices are committed to these policies, in accordance with legislation pertaining to these areas. Staff Training Record - Each member of staff should have evidence of training, including dates. Details of CPR and radiology training should be recorded and a note of decontamination training should be accurately recorded to reflect any updates due to changes in regulations, recommendations or best practice. Training should complement the content of the decontamination policy for the practice and should ideally reflect the practice development plan. (SDS – As for staff appraisal) Practice/Staff Meetings - Minutes & action points should be available for all practice meetings. (A minimum of 6 meetings a year is suggested.) (SDS- May be notes of full clinic staff meeting.)

19

Data Protection documentation (if applicable) - All practices/clinics with any sort of electronic data should be registered with the Information Commissioner. This would include any data held electronically, eg staff records, payroll, patient appointments etc. Currently, if a practice/clinic has no electronic data relating to individuals, the practice/clinic is exempt from registering. (Note that associates in a GDS practice have to register separately, i.e. as a separate company, if they are self–employed). Discipline, dismissal and grievance procedures - These may be incorporated into the staff contracts. A contact name and deputy where possible should be stated for grievances. This document(s), preferably in e-format, should be available to add as an appendix to the trainer VDP/VDHT contract Health & Safety/Radiation Practice/Clinic Health & Safety Statement - This should include the Code of Practice for the premises and offer a declaration of aims for the practice. Practice/Clinic Health & Safety Risk Assessment - This should be updated annually. Evidence of correction of unwarranted risk may be requested. COSHH Assessment - While a COSHH assessment for all materials used in the practice would be best practice, as a minimum, materials identified through the Risk Assessment as being hazardous must have a full COSHH assessment. Evidence should be present confirming that staff members are aware of the hazards. (SDS- It is expected that COSHH assessments would be available locally for the most relevant items in order to prove that staff could access and/or refer to them as required.) Electrical Safety Compliance certificates/ confirmation - Portable Appliance Testing (PAT) should be carried out every 3 years. Fire Policy and Fire Risk Assessment - This should cover the local policy with respect to fire safety. (Emergency fire instructions should also be in place at appropriate positions throughout the practice/clinic as should regularly maintained fire fighting equipment.) An individual assessment of the risks to the practice/clinic should be carried out and reviewed periodically. Accident Book & compliance with RIDDOR (Reporting of Injuries, Diseases and Dangerous Occurrence Regulations) – Practices/clinics must adhere to legislation and possess the relevant documentation which can be obtained from HMSO. SDS - The Departmental Incident Book (IR1) may act as an accident book in SDS clinics. Pressure Vessel maintenance, inspection certificate & insurance - Documentation must provide evidence of both maintenance and inspection at the regulatory periods, and of current insurance to cover accidents and injury from pressure vessels. Separate cover may be required over and above normal practice/clinic insurance although nowadays this cover is often included within the policy. Note however if this is the case, the policy must state specifically that pressure vessels are covered, or alternatively a letter to this effect should be available from the insurance company. (SDS – Local evidence of maintenance will be required to be seen on site. Insurance and inspection evidence may be signed off by the Clinical Director.)

20

Infection Control/ Decontamination Decontamination/Infection Control policy. - This may include some or all of the following, or these may be presented as separate policies. Written protocols for all of the following must be clear irrespective of how the policies are produced:

• Hand hygiene • Environmental cleaning • PPE (Personal Protective Equipment) • Sharps and disposal • Needle stick injury • Instrument transportation and storage • Cleaning, transporting and storing re-usables – including details of manual cleaning

processes if used and how to use ultrasonic cleaners and washer-disinfectors • Procurement for re-usables and single use • Waste Disposal– Certification should be available from registered waste collectors,

including Duty of Care notices and contracts. This should cover all types of waste produced, e.g. clinical waste, waste amalgam, fixer and developer, sharps etc.

Practitioners may find it helpful to refer to the SDCEP publication “Decontamination into Practice” when considering these policies. Copies of Decontamination infection control policies and protocols may be required to be forwarded in advance of the visit. Practitioners will be informed if this is the case in their region. These policies will be accompanied by an observed demonstration of implementation of policies and protocols on the day of visit. Complaints Complaints Procedure Documentation - NHS documentation should be available together with a record of complaints received.

Medico-legal Regular updates of medical histories, soft tissue examination, periodontal charting - A selection of patient record cards will be requested to check on the level of updating of these records.

21

Guidance on Practice Equipment and Materials for DV T trainers

The following lists are supplied as a suggestion as to the equipment and materials that a VDP would expect to have access to during the VT year. As all practices are different this list is not meant to be prescriptive, but provided to give you some idea of what it would reasonable for a VDP to request. It is recognised that the equipment in some SDS clinics may reflect the profile of the clinic’s typical patient and subsequently the type of treatment primarily offered at the clinic. There should always however be sufficient equipment to allow the VDP clinical freedom. Handpieces There must be sufficient handpieces to permit autoclaving between patients. Minimum requirement per surgery:

• 3 High Speed • 3 Contra Angled • 2 Straight It is anticipated that many practices will have significantly more handpieces than the minimum requirement to ensure availability if washer-disinfector cycles are lengthy.

3 in 1 Syringe These must have disposable tips. Prosthetics Kit Wax Knife and wax sheets Willis bite gauge, dividers, or other means of measuring the vertical component Bite plane (Fox’s or equivalent) Shade guides Periphery wax / Compo / Lab putty for modifying stock trays Range of disposable stock trays and tray handles Alginate with powder and water measures, spatula & mixing bowls Tray adhesive Lab putty for replica technique Patients hand mirror/chair mounted mirror Tissue conditioners Bunsen burner or equivalent or hot air burner Self cure acrylic for pivots Impression material for relining dentures Pressure indicating paste for denture easing MOS Kit Scalpel with No. 11 & 15 blades Cheek retractors Periosteal elevators Needle holder and sutures

Surgical scissors Sterile saline Narrow bore aspirator tips Haemostatic agent Means of irrigating sockets Medicament for treating dry sockets

22

Endodontic Kit Rubber dam sheets and frame Rubber dam punch and a range of clamps Rubber wedges Gates Glidden burs Endo file box / endo ring

An adequate number of sets of endodontic files 25mm 8 – 90 in stock to ensure constant supply for single use

Lateral condensers - finger spreaders or hand-held lateral condensers Measuring gauge Rubber measuring stops Selection of paper points Selection of GP points including accessory points Endodontic luerlock irrigation syringes and needles Irrigating solution Non-setting CaOH intra-canal medicament Ledermix paste or equivalent Paste Sealer - Grossmans, Tubliseal, Roth, Sealapex or equivalent Crown & Bridge Kit Gingival retraction cord or equivalent Haemostatic agent Putty/wash or mono phase impression material Material for temporary crown and bridge construction / preformed temporary crowns Porcelain shade guide Suitable trays & adhesive Light body syringe Material for placement of temporary crowns (tempbond, etc) Posts Post preparation burs Preformed post system

Burn-out post system, e.g. Opo or Para posts Temporary posts

Perio Kit Minimum of 3 untrasonic or air-scaler tips (see comment above re handpieces)

CPITN probes Selection of hand scalers Prophy cups & brushes – single use.

Prophy paste Interproximal finishing strips DHE teaching aids Dental floss/tape and interdental brushes Ortho Kit

Adams universal pliers Spring formers Wire cutters

Ortho wax

23

Oral Surgery Instruments

Upper and lower universal forceps Upper and lower root forceps Lower deciduous molar forceps Upper and lower molar forceps Cowhorns and/or eagle beak forceps Selection of other forceps for unusual or difficult cases Selection of elevators / luxators Radiographs Small & large periapical fast films (minimum of E-speed) Occlusal films Rinn or similar aiming devices for paralleling technique Good storage of both intra and extra oral films Immediate access to X-Ray machine and developing facilities Materials Amalgam Glass Ionomer / Compomer filling material Light cured composite. Range of shades Dentine bonding agent Acid etch gel or equivalent (e.g. combined acid etch/bonding agent) Luting cements Glass ionomer Zinc phosphate Composite Duo Cure and / or Panavia Silane coupling agent CaOH lining Resin Modified Glass ionomer or compomer lining material Clear matrix strips Siqveland / Tofflemire matrix clamps - large & small Stainless steel matrix bands - large & small Wedges Cervical matrices Articulating paper / occlusal indicating paste Ethyl chloride spray Fissure sealant Aspirating syringes & LA cartridges (with and without Adrenaline) Dentine pins Tray System Sufficient trays to allow decontamination between patients. May include: Mirror, probe, tweezers Excavators Plastics Condenser Burnisher Carvers

24

In addition, sets of mirrors and probes for examinations, and a range of additional amalgam carvers should be available, but not from bulk storage. Burs A selection of burs to be agreed with your VDP suitable for all clinical procedures, to include latch, fiction grip burs and acrylic trimmers. There must be sufficient sets of burs. An adequate supply of new, single-use stainless steel burs for each patient is the preferred option.

25

Guidance on Decontamination Observation Part of V isit As part of the Practice/Clinic Inspection we will be observing some simple aspects of the decontamination processes carried out at the practice/clinic. This will help us to provide you with feedback on your current practice and, potentially, suggestions for improvements. One member of your team will be asked to demonstrate their normal procedure for decontamination, as a simulation, which will involve:

1. Laying out a kit of instruments and handpieces as for routine conservation, to include burs, a matrix band, an aspirator tip, and 3 in 1 syringe tip. It is strongly recommended that this equipment is laid out in the surgery prior to the visit.

2. The visitors will suggest two of the following additional items to be included: • impression tray • endodontic file(s) • saliva ejector • any item you may use marked “single use”

3. The DCP will be asked to follow all the procedures they would normally carry out to

decontaminate the equipment from the point where the patient leaves the surgery until the autoclave is loaded and switched on.

During the process, the DCP will be asked to follow their normal regime for this situation including glove wearing and hand hygiene. There will be the opportunity for feedback afterwards. It is recognised that the some DCPs may find the process daunting but inspectors will reassure them that their performance will not be judged on a pass/fail basis. Inspectors will acknowledge any pressure involved and will take this into account when assessing their actions.

4. Following the demonstration, the visitors will:

• Thank the DCP involved for the demonstration and provide positive feedback. • Ask the DCP if they would normally do anything differently. • Ask any specific questions they feel are necessary for clarification. • Provide feedback to the dentist and listen to comments.

5. Depending on the outcome of the above, the DCP may be asked to repeat the

procedure.

It is emphasised that the procedures to be observed are those which would normally be carried out between patient appointments and, as such, the process should not significantly increase the time required for the pr actice inspection. Should you have any questions with regard to this element of the inspection, please contact your local VT administrator. (See the following page for contact details.)

26

Useful Contacts and Address

Administrator for VT Recruitment and Selection All enquiries in the first instance should be directed to the HR Officers at:- NHS Education for Scotland, 2nd Floor, Hanover Buildings, 66 Rose Street, Edinburgh, EH2 2NN. or emailed to : dental.recruitment@nes.scot.nhs.uk Tel: 0131 220 8074 North Regional Office Elaine Hodgson Dental Office, Centre for Health Science Old Perth Road Inverness. IV2 3JH Elaine Hodgson Tel: 01463 257720 Email: elaine.hodgson@nes.scot.nhs.uk North-East Regional Office Fiona Rennie Aberdeen Dental Education Centre Argyll House Foresterhill Cornhill Road Aberdeen AB25 2ZR Tel: 01224 559707 Email: fiona.rennie@nes.scot.nhs.uk East Regional Office Diane Young Broxden Dental Centre Tweed Place, Perth PH1 1RE Tel: 01738 450554 Email: VTadmin.East@nes.scot.nhs.uk South East Regional Office Anita Doi / Andrew Ball Edinburgh Postgraduate Dental Institute (EPDI) Level 4, Lauriston Building Lauriston Place Edinburgh EH3 9HA Tel: 0131 5362408 / 0131 5362409 Email: anita.doi@nes.scot.nhs.uk andrew.ball@nes.scot.nhs.uk West Regional Office Julie Cunningham/Janice McEwan 1st Floor, Clifton House Clifton Place Glasgow. G3 7LD Tel: 0141 352 2919 / 0141 352 2844 Email: julie.cunningham@nes.scot.nhs.uk janice.mcewan@nes.scot.nhs.uk

Contacts for Submissions of Determination X Claims

North Regional Office Elaine Hodgson Tel: 01463 257720 Email: elaine.hodgson@nes.scot.nhs.uk North-East Regional Office Fiona Rennie Tel: 01224 559707 Email: fiona.rennie@nes.scot.nhs.uk

East Regional Office Leigh Alexander Tel: 01382 740963 Email: VTadmin.East@nes.scot.nhs.uk South East Regional Office Andrew Ball Tel: 0131 5362409 Email: andrew.ball@nes.scot.nhs.uk

West Regional Office Amanda Dean Tel: 0141 352 2862 Email: amanda.dean@nes.scot.nhs.uk

27

Decontamination training contacts Natalya Zhernakova Dental Administrator 1st Floor Clifton House Clifton Place Glasgow G3 7LD Tel: 0141 352 2863 Email: Natalya.zhernakova@nes.scot.nhs.uk Christine Young Infection Control Nurse Adviser 1st Floor Clifton House Clifton Place Glasgow G3 7LD Tel: 0141 352 2851 Email: Christine.young@nes.scot.nhs.uk For the submission of DRO grade requests, email your eDROref form to: Lorna Anderson at Lorna.Anderson2@nhs.net

28

Section 3 Appendices

Appendix 1 - CPD Guidance for Vocational Trainers Appendix 2 - Salaried Dental Service Declaration in relation to CPD Requirements Appendix 3 - email attachment eDRO ref form Appendix 4 - Guidance on scoring for ranking process Appendix 5 - Example of VDP/ VDHT-Trainer contract. (Note the contracts used in the cases of trainers who are joint trainers or trainers

working in the SDS will vary slightly form this standard contract.) Appendix 6 - Determination X Application Form and Guidance

29

CPD Guidance for Dental Vocational Trainers for 2013/14

NES Dental Vocational Trainers (including Dental VT and LDFT GDS Trainers) are expected to comply with the following CPD requirements:

Core Subjects The following subjects are mandatory:

1. Medical Emergencies. NES requires that Trainers undertake verifiable annual training, of at least 2 hours duration and ideally involving the whole dental team in the dental practice setting, including CPR. This must have been done in the calendar year prior to when the training year starts.

2. Infection Control and Decontamination. As well as lecture-based education which may have

been attended, NES requires that NES in-practice infection control training has been undertaken at least once within the five years up to the end of the calendar year prior to when the training year starts. Note - SDS clinics should contact Christine Young from NES (christine.young@nes.scot.nhs.uk) who will then contact the Health Board Infection Control Nurse to request the aims and learning outcomes to determine whether any local training was equivalent to NES training.

3. Radiography and Radiation Protection. NES requires Trainers to have attended an appropriate course, complying fully with the IRR/IRMER regulations within the five years up to the end of the calendar year prior to when the training year starts. Note that compliance with IRMER regulations requires more than a simple attendance at a radiography course. Advice and guidance on IRMER requirements are available on the BDA’s website at http://www.bda.org/dentists/advice/practice-mgt/health-safety/rp/is.aspx

Additionally, NES requires that Trainers undertake training in the following subjects, at appropriate intervals, to be determined from time to time by NES, to take into account legislative changes and current best practice:

4. Equality and Diversity – using a NES approved online training programme. Trainers on the START course will be issued with a login for Same Difference and advised of the three modules which must be completed by the 31st January 2013. Current and returning trainers who have previously completed the three modules must complete the updated module, “Equality, Diversity and the Law” by 31st January 2013 and must specify when they completed these modules, including the update module, in their application form.

Employment Legislation – New Trainers on the START course will undertake this on their first training day in January 2013. Current and Returning Trainers must specify the date they undertook this training in the last 3 years on their application form and must read the update document which will be issued in due course. Returning trainers who did this training prior to 2010 must attend the session on employment legislation which is run as part of the START Part 1 course in January 2013 and should discuss this with their regional Director or at their mentoring visit.

APPENDIX 1

30

General Guidelines

• Balance: Trainers should undertake an appropriate range of CPD topics that are fit for purpose in their roles both as a GDS/SDS practitioner and as a Trainer. If a dentist has the vast majority of his/her CPD relating to a specialised subject, such as Endodontics or Implantology, this may be viewed as unbalanced and may therefore be deemed unacceptable.

• NES recommends that Trainers should document their learning needs, including those related

to their training role, within a Personal Development Plan. Support for PDP planning is available within all regional postgraduate centres via CPD/PDP Tutors.

• Learning Methods: Whilst we accept that blended learning can be beneficial, and that there are

many ways in which CPD can be undertaken, if there is a gross imbalance (e.g. 100% online/journal learning) this will normally be deemed unacceptable by a Review/Interview Panel, as peer contact and face-to-face interaction during educational events is considered beneficial. It is expected that Trainers will have undertaken a minimum of 37.5 hours of CPD by attendance at recognised courses.

• NES accept 75 hours of verifiable CPD as a minimum commitment on the part of Trainers, but

would, in general, expect Trainers to significantly exceed this level. • No single subject area (e.g. Implantology) including the START course, shall be recognised for

a contribution of more than 15 hours towards the minimum 75 hour CPD total.

• If the total hours of NES CPD, after discounting as above, are less than 75 hours, evidence for all non-NES CPD must be uploaded to the Portal.

• If the total hours of NES CPD exceed 75 hours, the only certification that must be uploaded to

the Portal is for Medical Emergencies. The above guidelines relate to the minimum requirements for trainer applicants. It should be noted however that the scoring system for trainership, provides credit for varying types and formats of CPD. Applicants wishing more detail on this should refer to the information on scoring in Appendix 5

The GDC currently require dentists to undertake a minimum of 75 hours of verifiable CPD over the dentist’s five year CPD cycle. Trainers should be familiar with current GDC educational requirements which are similar, but not identical to NES requirements. For example, in addition, the GDC recommend that all clinical registrants undertake CPD covering legal and ethical issues and handling complaints.

31

eDROref I, (Name of applicant) of (address), with List No (List No.) have applied to be a Vocational Trainer and, as part of the recruitment and selection process, I am required to demonstrate fulfilment of the following criteria: • No disciplinary action or significant numbers of complaints against the practitioner in the last 3

years. • No applicant should have :-

• No applicant should have within the 3 complete calendar years preceding the relevant VT year.:-

a)more than three Grade ‘3’ post treatment DRO reports, b) more than three Grade ‘C’ pre-treatment DRO reports, c) more than a combined total of 3 grades at Grade 3 or Grade ‘C’, d) any grade ‘D’ or ‘4’ DRO reports

• Applicants should have minimum NHS earnings of £27800 in the financial year up to April 2012. (20% of notional TAGI).

I would be grateful if you could check my record and confirm that I comply with this requirement. ……………………………………………………………………………………………… (Please delete one of the statements below before forwarding to PSD) • I give permission to copy the PSD response to NES, so please send a copy to (Region’s

VT administrator email address)

. • I do not give permission to copy the PSD response to NES and understand that this will

result in a hard copy being forwarded by post which I will be required, in turn, to forward to NES. I further understand that this may cause delay and accept that it is my responsibility to ensure it arrives at NES by stated deadline.

The hard copy should be sent to :- (applicant to type in desired address below) No. and Street… Town/city……… Postcode………

APPENDIX 2

32

eDROref(SDS) I, (Name of applicant) of (address), with List No (List No.) am employed in the SDS and have applied to be a Vocational Trainer and, as part of the recruitment and selection process, I am required to demonstrate fulfilment of the following criteria: • No disciplinary action or significant numbers of complaints against the practitioner in the last 3

years. • No applicant should have :-

• No applicant should have within the 3 complete calendar years preceding the relevant VT year.:-

a)more than three Grade ‘3’ post treatment DRO reports, b) more than three Grade ‘C’ pre-treatment DRO reports, c) more than a combined total of 3 grades at Grade 3 or Grade ‘C’, d) any grade ‘D’ or ‘4’ DRO reports

As an SDS Trainer, I am not required to confirm my NHS gross earnings. I would be grateful if you could check my record and confirm that I comply with this requirement. ……………………………………………………………………………………………… (Please delete one of the statements below before forwarding to PSD) • I give permission to copy the PSD response to NES, so please send a copy to (Region’s

VT administrator email address)

. • I do not give permission to copy the PSD response to NES and understand that this will

result in a hard copy being forwarded by post which I will be required, in turn, to forward to NES. I further understand that this may cause delay and accept that it is my responsibility to ensure it arrives at NES by stated deadline.

The hard copy should be sent to :- (applicant to type in desired address below) No. and Street… Town/city……… Postcode………

APPENDIX 3

33

GUIDANCE ON TRAINER RANKING PROCESS 2013

The Areas to be Scored The following areas will be scored:- CPD Max 15 DRO grades Max 0 Adviser report Max 30 Review / Interview Max 25 Practice inspection Max 30 ** During the 3013 transition year, a national average score will apply. Total Max 100 1. CPD History. (Range 0-15 points.)

• Pre-attendance at core topics. Range = 0-4 points. (1 point for each of the subjects from a list of CPR, IRMER, Decontamination and E&D which was completed prior to application)

*This will be confirmed at review from information (and certificates) submitted at application • Postgraduate awards. Range = 0 or 3 points. (Relevant p/g qualification will score 3

points. *This will be confirmed at review from information submitted at application and review of NES CPD records. • CPD delivered by NES. Range= 0-4 points. (1 point for every 25 hours to a max of 4

points.) *This will be confirmed from Portal CPD records and will be automatically included in the overall score • Education attended in person. Range 0-4 points. (1 point for 50-75; 2 points for 75-100;

3 points for 100 - 125; 4 points for 125+ hours) *This will be confirmed at review from information (and certificates) submitted at application • In addition a corrective score of -3 to +5 may be added to, or subtracted from a

trainer’s CPD score. This would be applicable in the following circumstances:- o if it can be demonstrated that he/she has been disadvantaged by way of

location from scoring in the area of “CPD delivered by NES”, eg the trainer had moved to Scotland from England and the level of historical CPD provided by an English deanery was sufficient to have altered the banding awarded, not justly represented the attendance level at quality CPD events and therefore provided an inappropriate CPD score.

o Where an applicant had “doubled-entried” NES courses by adding them manually when they were already recorded in the NES CPD history, and thus elevated the band awarded.

o Where “NES courses” had been attended but these had not been categorised as I-booklet courses for example, Same Difference, Cleanliness Champion etc

Any such award, negative or positive, should be justified by the DPGDPE in the associated text box in the pre-screening form. This will be confirmed at review from information submitted at application and review of NES CPD records.

APPENDIX 4

34

2. DRO References (Range = -35 -0 points.) Compliance with the requirements around DRO grades will score 0. Where the requirements have not been met the trainer will score minus 10 points where a DRO grade was awarded vicariously which resulted in the trainer no longer complying with the requirements. Where a Grade 4 DRO grade was awarded for work or treatment submissions which were directly attributable to the applicant him/herself, a score of -35 will be awarded. * The circumstances of adverse grades notified by PSD would require to be further clarified by PSD in order to confirm which of the above categories is appropriate. 3. Adviser Report (Range 0-30 points.) The adviser will complete a supplemental scoring sheet (on following page) at the time of writing the adviser report. An average (mean) score will be applied in the case of new trainers. See page 60 for an example of the Adviser Scoring Sheet 4. Review / Interview (Range = 0-25 points.) Applicants who are not referred for interview will have the average score retrospectively applied to their overall score. Each of the three panel members allocates a score up to 30, so applicants who attend for interview will be awarded a score of 25/90 of the aggregate panel score in this section. 5. Total Score (Range = -35 – 100 points.) An overall score for each applicant will be calculated as the sum of the previous scores.

35

Adviser Report Scoring Supplement

Trainer Assessment Using your adviser statement as a guide, please consider your responses to the boxes below. This report will remain confidential and for the purposes of the study only. The content of this page will not be forwarded to the trainer for agreement.

Trainer attribute Possible sources of

evidence Sample scoring guidance Score

(1 – 5) 1.Ability as a Trainer This should cover how well the trainer relates to the VDP, how well they impart their knowledge and how effectively they allow the VDP to learn.

Tutorials carried out weekly Support for the VDP in preparation for ToK Discussion with the VDP around open door policy/ availability of support when required.

1. Advisor required to contact trainer over Trainers unacceptable and poor performance. 2. Tutorials not always for a full hour, or not always in protected time. VDP often has to ask several times before trainer comes to help 3. Weekly tutorials. Trainer comes through whenever required. 4. Tutorials weekly, and at a regular time. Tutorial topics notified in advance, and VDP given work to prepare for tutorial. Trainer regularly pops into VDP surgery during quiet times, to ensure all is well. 5. As above but in addition the trainer dedicates an entire session to LEP’s tutorial and VDP training.

2 Suitability of the practice facilities for training.

Although the practice inspection has been carried out, this is a snapshot. Provide here a score from your impression of practice facilities on a day-to-day basis.

Personal visits to the practice Discussion with the VDP at study days

1. VDP reports regularly that materials are absent/equipment is broken and there is no obvious attempt to resolve, The scheme Advisor has to become involved. 2. Significant deficiencies noted during visits to practice for (eg) external LEPs, Trainer is aware and attempting to resolve problems. 3. VDP has occasional missing/absent equipment, or occasional staffing difficulties, but generally facilities are present. 4 – 5. Evidence that the VDP has full access to excellent facilities. System in place to ensure that nursing support is available even in the event of illness.

3. Education and training This score relates to how educationally prepared the trainer is, his/her own knowledge level and their enthusiasm for CPD.

Attendance and facilitation at study days Interaction at trainers days/trainer induction

1. Trainer fails to attend trainer and study days. 2. Trainer arrives late. Trainer does not interact with speakers or contribute to the day. 3. Trainer facilitates study sessions as required by adviser. Trainer attends all required trainer/induction days. 4 – 5. Trainer fulfills all sessional commitments. Trainer leads study sessions/delivers presentations to VT schemes.

36

4. Managerial skills relating to training

Score the trainer on his managerial skills as a trainer as you have experienced them during the year.

Involvement with ePortfolio, and ensuring that VDP does the same Ensuring appropriate nursing cover throughout training. Effective management of any issues involving a VDP (if applicable)

1. Trainer does not engage with ePortfolio VDP issues managed poorly. Scheme Advisor /Director involved. 2. Intermittent engagement with Portfolio, deadlines missed by Trainer. Slow to recognize and resolve VDP issues. 3. Satisfactory entries in ePortfolio, and any difficulties encountered by the VDP resolved effectively. 4 – 5. Trainer sets VDP a good example in terms of ePortfolio use, and actively works to prevent and/or minimize difficulties for the VDP.

5. Assessment Score the trainers enthusiasm and commitment to assisting the VDP with tasks relating to assessment towards satisfactory completion.

Past history of VDPs meeting all targets (if applicable) Good communication with adviser in relation to upcoming targets Comprehensive trainer statements provided at end of training (if applicable)

1. Previous or current VDP(s) have repeatedly missed assessment deadlines, due to administration within the practice. Poor communication with adviser around deadlines. 2. Minimal content in Trainer statement. Minimal use of LEP and PAQ sop’s by Trainer. 3. Assessment deadlines occasionally missed, with no blame attached to the trainer. Trainer statement adequately reflects the VDP’s performance 4. Comprehensive, informative statement. All assessment targets met by VDP. 5. As above but with appropriate comment in all LEP and PAQ sop’s. All reviews completed by trainer within the Portfolio with clear targets for the training year.

6. Professionalism This score should reflect your opinion of the trainer’s honesty, integrity, ethics, and behaviour as a professional role model.

Discussion with the VDP at study days. Observations of processes within the training practice. Observations of behavior at study days. Observations on self reported behaviors of the trainer

1. Advisor or VDP notes deficiencies (eg reusing single use items/wearing gloves between surgeries). Aspects of the practice performance require direct intervention by the advisor. 2. VDP reports and can demonstrate to their Advisor that prior approvals/GP17s are not processed timeously. 3. All discussions with the VDP indicate that the trainer is professional and honest. 4 – 5. VDP reports examples where the trainer has demonstrated high standards of integrity and/or professionalism.

Overall score (max 30)

37

Scottish Dental Vocational Training Trainer/Trainee Contract

For the purposes of this contract and all associate d documentation, the term “Trainee” shall refer to the Vocational Dental Practitioner (VDP) o r Longitudinal Dental Foundation Trainee (LDFT) named below. THIS CONTRACT OF EMPLOYMENT is made BETWEEN _________________________________ of _______________________________________________________________[insert full address] Dental Surgeon (the “Trainer”) of the one part and _______________________________________ of ______________________________________________________________[ insert full address] Dental Surgeon (the “Trainee”) of the other part. Commencement Date: [insert date] (“the Commencement Date”) Term: 1 Year ______________________________________________________________________________ WHEREAS

(A) the parties are both duly qualified and will be appropriately registered with the General Dental Council at the commencement of training, the Trainer providing General Dental Services (GDS) at ______________________________________________________(the “Practice”), which will be the Trainee’s normal place of work;

(B) this contract of employment applies exclusively to arrangements made under the national Dental Vocational Training scheme in Scotland, to which nationally agreed standards apply;

(C) pursuant to The National Health Service (Vocational Training for General Dental Practice) (Scotland) Regulations 2004 (the “Regulations”) the national Dental Vocational Scheme is intended to introduce the Trainee to General Dental Practice in a protected environment while enhancing skills;

(D) the Trainer has been approved as a Trainer in GDS and has been appointed by NHS Education for Scotland (NES) to provide training services to the Trainee;

(E) the Trainee has entered into a Memorandum of Understanding with NES under which the Trainee has agreed to certain conditions to apply to his/her training; and

(F) the Trainer wishes to employ the Trainee and the Trainee wishes to be employed by the Trainer on a Dental Vocational Training programme.

APPENDIX 5

38

NOW IT IS HEREBY AGREED as follows: General

1. The Trainer hereby employs the Trainee, for the fixed term period specified in Clause 2 below, to serve the Trainer as an assistant in the Practice. The Trainee agrees to undertake the role of employee, to perform the services required of him/her to the best of his/her ability, to comply with the specific requirements of this contract of employment, and to do his/her best to promote the interests of the Trainer and to serve the patients of the Practice. This contract of employment contains a statement of the applicable terms of your employment as required by section 1 of the Employment Rights Act 1996.

Commencement of Employment

2. The contract will commence on the Commencement Date. The start date of your continuous employment will be the same date.

Term and Termination

3. The appointment shall be for a fixed term period of one year. This period will commence on the Commencement Date and shall continue, subject to the remaining terms of the agreement, until it terminates on the day prior to the first anniversary of the Commencement Date without the need for notice, unless previously terminated by either party giving notice to the other not less than 1 month’s notice in writing.

Job Title

4. You are employed as a (VDP etc) and your duties are set out in Appendix 2B.

Place of Work

5. Your normal place of work is at the Practice but you may be required to work in other locations as reasonably required by the Trainer.

Hours of Work

6. The Trainee is required to work a 35 hour week (or pro rata if part-time). Specific hours the trainee will work in the Practice are detailed in Appendix 3;

7. Neither emergency cover for another practice, nor out-of-hours services can be undertaken

by the Trainee during the first three months (six months in the case of LDFT), and then with the accompaniment of the trainer during the following three months of the Trainee’s employment (the following six months in the case of LDFT), and during the final six months (final twelve months in the case of LDFT) is not on call more than once for every three times their trainer is on call. All on-call commitments should be in line with local guidelines and must be agreed in writing with the scheme Adviser, with a copy filed in the TRB, or its electronic equivalent and a copy sent to the regional Dental Vocational Training Scheme administrator;

39

Annual Leave

8. The Trainee shall be entitled to four weeks holiday with full pay during each period of twelve months in the Practice, and pro rata for shorter periods or part-time. Such holidays shall be taken at the times agreed between the parties and must be taken outwith the study day programme. In addition the Trainee shall be entitled to 8 days statutory public holiday per year, as per the standard Practice arrangements. The annual leave year starts on the Commencement Date.

Salary and Emoluments

9. During the continuance of this employment, the Trainee shall be entitled to payment of a salary at the rates laid down from time to time in Determination IV of the Statement of Dental Remuneration payable to General Dental Practitioners under the National Health Service. Payments will be made on the Trainer’s behalf by NES. Payments will be made in arrears by monthly instalments on the last Thursday of each calendar month. Trainees will receive a monthly pay slip from the NES payment agent, National Services Scotland.

Pension

10. During the Term the Trainee will become a member of the NHS Superannuation Scheme (if they qualify), unless he/she elects to opt out of the scheme. If a member, the salary payable to the Trainee will be made following deduction of all contributions and other payments for which the Trainee is liable under the NHS Superannuation Scheme.

Sick Leave

11. If absent due to sickness in the first 4 months, the Trainee will be entitled to one month at full pay. After 4 months service, the Trainee will be entitled to one month at full pay and 2 months at half pay. Sickness absence must be evidenced by the paperwork and medical certificates specified by the Trainer and notified in accordance with the appropriate Practice policy. The Trainee agrees that the Trainer may forward copies of medical certificates submitted in line with such policy to NES.

Professional Registration

12. The Trainee is required to be fully registered with the General Dental Council for the duration of his employment.

Membership of Defence Union

13. During the period of the employment, both parties shall at their own expense be members of a recognised Medico-legal Defence Organisation.

Hepatitis B Immunisation Status

14. The Trainee shall ensure his/her Hepatitis B immunisation status is in line with local guidelines and that they are and remain compliant with other blood borne virus policies, if applicable.

40

Work Restriction

15. Unless as part of the training course, the Trainee shall not attend any patient nor work for

any person other than the Trainer, nor on his/her own account either carry on or be engaged in a dental practice, nor accept any part-time or full-time dental appointment, whether paid or unpaid, or give any dental advice, either gratuitously or for reward during the period of their employment with the Trainer unless it be with the prior written consent of both the Trainer and the DPGDPE.

16. For the purpose of protecting the goodwill of the Practice, it is agreed that for a period of one

year following the expiry or termination of this contract of employment (howsoever terminated), the Trainee, unless practising in the Practice or otherwise with the Trainer’s written consent, shall not actively solicit the business or custom of any person who had been at any time within the period of twelve months prior to the termination of this contract of employment a patient of the Practice, with a view to the provision, to that person, of any professional service of a kind normally provided by a general dental practitioner, hygienist, hygienist-therapist or therapist.

Confidentiality

17. The Trainee shall not, whether during or after his/her employment, disclose any confidential information relating to the Practice and patients of the Practice, such confidential information to include patient records, details of appointments, and financial information relating to the Trainer or the Practice, and shall observe and conform to the Data Protection Act 1998, Caldicott principles and the Freedom of Information (Scotland) Act 2002.

Trainer’s Obligations

18. During the continuance of this employment and during the period of appointment as a Trainer, the Trainer shall comply with the obligations set out in Appendix 2A.

Trainee’s Obligations

19. During the continuance of this employment the Trainee shall comply with the obligations set out in Appendix 2B.

Disciplinary Procedure

20. The full disciplinary rules in place in the Practice are set out in Appendix 4. Grievance Procedure

21. Should the Trainee have any grievance in relation to his/her employment then he should attempt to address this informally in the first instance, however if resolution is not achieved he should refer to, and act in accordance with, the grievance policy of the Practice, a copy of which is attached as Appendix 5.

41

General

22. The Trainee and Trainer shall be in a relationship of employee and employer. Nothing herein shall entitle the Trainee to any of the rights or expose him/her to any of the liabilities of a partner or constitute in any way the relationship of partners between the Trainer and the Trainee.

23. In this contract of employment, references to any enactment, order, regulation or other similar instrument shall be construed as a reference to such enactment, order, regulation or instrument as amended from time to time or as replaced by any subsequent enactment, order, regulation or instrument.

By signing below, the Trainer and Trainee confirm their acceptance of this contract of employment including the six attached appendices. Trainer I have read, understood and agree to be bound by this contract of employment Print Name ____________________________________ Signature ____________________________________ Date ____________________________________ Trainee I have read, understood and agree to be bound by this contract of employment Print Name ____________________________________ Signature ____________________________________ Date ____________________________________

Appendix 1 to the foregoing Contract of Employment between Trainer and Trainee 42

APPENDIX 1

Commitments and payments are pro-rata based on basic figures provided for a full-time trainee.

Trainee(s) status

example

No. of hours Trainer(s) must be

present in practice with the Trainee during week

Minimum no. of

sessions Trainer(s)

must attend per year.

No. of tutorials

which must be provided per year per

Trainee

No. of LEPs required in

year per Trainee

No. of PAQs

required in year per Trainee

Trainer

grants paid to

Trainer(s) per trainee

Determination X claims permitted every 5 years in

alignment with practice inspection

VDP (1.0 WTE)

21

14

46

42

1 x 30

1

1 per practice

VDP (0.5 WTE)

10.5

7

23

21

1 x 30 over 2 years

0.5

0.5 per practice

VDP (2.0 WTE)

28

20

46

42

1 x 30

1

1 plus an additional one-off claim to create an

additional trainee surgery, if required

3 VDPs /LDFTs

(3.0 WTE)

28

20

46

42

1 x 30

1

1 plus an additional one-off claim to create an

additional trainee surgery (surgeries), if required

Appendix 2 to the foregoing Contract of Employment between Trainer and Trainee

43

APPENDIX 2

A. Trainer’s Obligations to Trainee: The Trainer shall: 1) work in the same premises as the Trainee in a surgery to which the Trainee has sufficient access to

allow him/her to fulfil his/her obligations under this contract, and act as a tutor to the Trainee during his/her time in the Practice, and be available within the Practice for not less than the number of hours stipulated in Appendix 1 for this type of training.

2) provide “help on demand” within the Practice and hold at least the number of in-practice tutorials

specified in the table in Appendix 1 (or, if part-time, an appropriate, agreed percentage thereof) per trainee, within protected time, each of which will be of at least one hour’s duration.

3) be available to the Trainee for guidance in both clinical and administrative matters, in accordance

with NES documentation on “Trainee Induction and Supporting your Trainee in the Workplace” (attached as Appendix 6 to this contract) as may be updated amended augmented supplemented or replaced from time to time.

4) provide appropriate reference material for use by the Trainee; 5) conduct an initial interview to identify the Trainee’s strengths and weaknesses and draw up an initial

training agreement, which must be filed in the Training Record Book (TRB), or its electronic equivalent;

6) assess and monitor the progress and professional development of the Trainee using the TRB, or its

electronic equivalent, provided by NES; 7) support the Trainee in preparing for their Clinical Audit Project, Case Study and other such exercises

as may be required; 8) allow and require the Trainee to attend the appropriate study day course of at least 25 days (as

determined by the Director of Postgraduate General Dental Practice Education (DPGDPE) and arranged by the NES Scheme Adviser, and to ensure the Trainee takes holidays which do not conflict with that programme. Absence from the study day course for reasons other than sickness will only be allowed in exceptional circumstances and is subject to the agreement of the DPGDPE following written application at least 6 weeks in advance;

9) provide the Trainee with satisfactory facilities to comply with health and safety and decontamination

standards, as advised by the National Dental Advisory Committee (NDAC)/Scottish Dental Clinical Effectiveness Programme (SDCEP) and periodical guidance from the Scottish Government Health Department, including an adequate supply of handpieces and instruments sufficient to allow them to be appropriately cleaned and sterilised between patients;

10) provide the Trainee with relevant opportunities so that a wide range of NHS practice is experienced

and so that as far as is reasonably possible the Trainee is fully occupied; 11) ensure throughout the training year that the Trainee works within his/her levels of competence, thus

complying with GDC standards, and works within fields of treatment as directed by the competencies as stated in the published Competencies for Dental Vocational Training and General Professional

Appendix 2 to the foregoing Contract of Employment between Trainer and Trainee

44

Training document. The administration of sedation should be reserved for the second year of Dental Foundation Training;

12) provide the Trainee with the full-time assistance of a suitably experienced dental nurse who should

be either registered with NES or an equivalent educational provider as being ‘in training’ or registered with the General Dental Council (GDC);

13) provide a suitably experienced person to chaperone the Trainee when they attend any domiciliary

and out of hours work; 14) ensure during the training year, that the percentage of the Trainee’s working time, which involves

NHS work, constitutes not less than 90% of the Trainee’s total working time; 15) ensure that all members of the practice team, including the Trainee, undertake CPR training at least

once per year within the practice; 16) ensure that all GP17 forms submitted for prior approval are jointly agreed and signed by the VDP and

their trainer. (Forms without a trainer counter-signature will be returned by PSD): 17) ensure that the Trainee is reimbursed at the standard NES mileage allowance for travel costs for

out of hours work and for domiciliary work. The Trainee should also be given time off in lieu for such work, i.e. time spent on these activities is counted as part of their standard working week, as indicated in the table in Appendix 3;

18) meet all the conditions of the assessment system required for Satisfactory Completion as set down

by NES and assist the Trainee with the completion of their Record of Progress and Achievement, or its electronic equivalent, and submit supporting evidence for Satisfactory Completion;

19) ensure that the Trainee undertakes the required number of LEPs (as indicated in the table in

Appendix 1) during the year and to guarantee correction of any shortfall in numbers by arranging LEPs at the Trainee’s request;

20) provide the Trainee with the necessary administrative support to facilitate the distribution of the

required number of PAQs as indicated in Appendix 1, and to continue to provide this support if there are low return levels.

Appendix 2 to the foregoing Contract of Employment between Trainer and Trainee

45

B. Trainee’s Obligations to Trainer The Trainee shall:

1) fulfil and obey all lawful and reasonable directions and orders of the Trainer and not at any time during the contracted hours of employment , except in the case of illness or other unavoidable cause or permitted holidays, be absent from the service of the Trainer without the Trainer’s consent;

2) be fully registered with the General Dental Council for the duration of his employment and shall

check in January of the relevant year during the Term that they have a valid certificate of registration for that year. In the case of Longitudinal Dental Foundation (LDF), they will check this again in the following January;

3) work cooperatively with colleagues in the practice, in particular with the Dental Nurse assigned to

him/her;

4) keep proper accounts and records, if appropriate, of all professional visits, fees paid, all patients attended, operations performed including prosthetic work and all other work done by him/her for the Trainer.

5) not accept any monies due to the Trainer, but direct those requiring to make such payments, to the

Trainer;

6) keep all usual and necessary dental charts and appropriate clinical records of the work done for all patients attended to by him/her;

7) devote his/her whole time to the practice of the Trainer during the hours specified in Appendix 3;

8) ensure that during the training year, the percentage of their working time which involves NHS work,

constitutes not less than 90% of their total working time;

9) observe and conform to the provisions of the Dentists Act 1984 (so far as they relate to the Trainee and his/her employment) and all the laws and customs and reasonable standards of practice of the dental profession;

10) in relation to any patient treated by the Trainee, or desiring to be treated by the Trainee under the

National Health Service, comply with the Terms of Service applicable to dentists under the provision of the National Health Service (General Dental Services) Regulations then in force;

11) attend such study day courses as are set out in the published programme and shall not except in

case of illness or other unavoidable cause absent himself/herself from any such course, without the previous written consent both of the Trainer and of the DPGDPE;

12) meet all the conditions of the assessment system, required for Satisfactory Completion of the

Dental Vocational Training Scheme, as set down by NES;

13) maintain and complete the TRB and the Record of Progress and Achievement, or their electronic

equivalents, provided by NES;

14) attend and fully participate in weekly tutorials with the Trainer;

Appendix 2 to the foregoing Contract of Employment between Trainer and Trainee

46

15) undertake such educational studies as may be reasonably advised from time to time by the DPGDPE;

16) inform the DPGDPE and Trainer of any alteration in his/her circumstances which might affect this

contract of employment;

17) fulfil the obligations and responsibilities of trainees in the national Dental Vocational Training Scheme in Scotland as detailed in the TRB, or its electronic equivalent;

18) complete and return, in a timely fashion, all required documentation in relation to their employment

and participation on the Dental Vocational Training Scheme including without limitation documentation relating to payroll, Disclosure Scotland, and the need for any documentation required during the course of this employment;

19) at all times during the year, in the Practice and during the study-days or educational excursions, not

behave in manner which does, or may reasonably be said to, bring the profession, the Dental Vocational Training Scheme, the Practice or the Trainer into disrepute. Such transgressions will be regarded as constituting a breach of this contract;

20) at all times comply with the rules and regulations which are in force in any establishment which

he/she visits or in which he/she works as part of the training programme.

Appendix 3 to the foregoing Contract of Employment between Trainer and Trainee

47

APPENDIX 3

Hours of Work

(To be completed before trainer –trainee contract is signed.)

Trainer: VDP: The Trainee is required to work a 35 hour week (or pro rata if part-time), during the following hours: Monday Tuesday Wednesday Thursday Friday Saturday AM

PM

EVE

While NES supports practitioners by advising VDPs to be flexible with hours so as to fit in with normal practice arrangements it is advisable that trainers try not to make any individual day too long. If there is any deviation from normal working hours, please use this section to illustrate how annualisation of the above hours equates to 35 hours per week (including study days).

Appendix 4 to the foregoing Contract of Employment between Trainer and Trainee

48

APPENDIX 4

Practice Disciplinary Procedures

49

APPENDIX 5

Practice Grievance Policy

50

APPENDIX 6

Dental Vocational Training in Scotland

Guidance on Trainee Induction and Supporting your T rainee in the Workplace.

Induction Inducting a new Trainee into the practice/clinic is absolutely essential to ensure that that the working environment is safe and to allow a quick and easy settling in period and hence incorporate the Trainee into the dental team as an effective member, as quickly as possible. Trainers are expected to set aside a portion of their time in the first day, or days, for the Trainee for this purpose. Alternatively, the Trainer may delegate some of this task to another experienced member of the practice team. Issues which should be covered as soon as possible after the Trainee joins the practice include:

• Health & Safety protocols, e.g. – power switches for dental units, radiography rules, H&S risk assessment.

• Code of conduct, e.g. – expected levels of behaviour, professionalism and ethics.

• Records, e.g. – confidentiality, consent, content, expected protocols for entering notes, storing and

retrieving.

• Introductions, e.g. – team members, cleaners, technicians etc.

• Schedule diary, e.g. – timing of tutorials, LEPs. Supporting your Trainee The purpose of Vocational Training is to provide 12 months supervised experience in General Dental Practice supplemented by an educational programme to help graduates make the transition to unsupervised practice in the NHS GDS. The criteria specified for becoming a trainer are required in order to ensure that Trainees start their dental careers in the workforce in an environment which has achieved certain standards and with a Trainer who similarly has certain qualities. It is envisaged that the combination of these criteria will result in the Trainee being provided with a “protected environment” for the first year of their career. Trainer obligations, as specified within the Trainer/Trainee contract, illustrate many of the managerial requirements of a Trainer, however, Trainers should be aware that it is primarily their talent and ability as a mentor, tutor and role model, from an educational perspective, that is equally, if not more, important in their Trainer role.

• Trainers should monitor workload and take into account the inexperience of the Trainee, the Trainee’s ability to cope with workload and the support available. As workload is a vital element of providing a protected environment, Trainers should take account of advice offered by Advisers in cases where the workload is deemed to be insufficient or excessive when compared with the average workload in Training practices. It is recognised that different practices, however, will have a wide variation in workload and this will be an issue considered by Advisers/Directors.

• As Dental Vocational Training is a learning programme for Trainees, Trainers should be mindful of the

fact that Trainees may need a certain amount of time within their working week, to reflect on their work in order to maximize the educational value of gaining experience.

51

NHS EDUCATION FOR SCOTLAND DETERMINATION X (PARTS II & III) APPLICATION FORM

1. TRAINER INFORMATION (PLEASE PRINT)

Name of GDP:

GDC No:

Type of Training:

Practice Address:

(Including Town/City

and Postcode):

2. PRACTICE IMPROVEMENTS REQUIRED (PLEASE PRINT) FOR NES OFFICE USE ONLY

Practice Improvements Required: Approved? Justification to be completed by Adviser / Director: Receipts Received?

� Yes

� No

� Yes

� No

� Yes

� No

� Yes

� No

� Yes

� No

� Yes

� No

� Yes

� No

� Yes

� No

� Yes

� No

� Yes

� No

3. SIGNATURE OF TRAINER & SCHEME ADVISER

Trainer Signature: Date Signed:

Scheme Adviser Signature: Date Signed:

FOR NES OFFICE USE ONLY

4. APPROVAL PROCESS

Approval Visit Required: � Yes � No Name of Visiting Adviser:

If Yes, Date of Visit: Signature of Visiting Adviser:

If No, Please give reason:

Authorisation to proceed notified by:

Date Notification Sent:

Verification Visit Required: � Yes � No Name of Visiting Adviser:

If Yes, Date of Visit: Signature of Visiting Adviser:

If No, Please give reason:

5. DIRECTOR / ASSISTANT DIRECTOR AUTHORISATION

I have reviewed the Practice Inspection Visit form and support the recommendations of the practice visitors. I can confirm that the above named applicant has been selected as a VT Trainer.

Please accept this form as evidence of the improvements required in order for your practice to meet Vocational Training standards.

Director / Assistant Director Name:

Director / Assistant Director Signature:

Date Signed:

Please return completed form to the appropriate reg ional administrator (see page 47 for details)

APPENDIX 6

52

DETERMINATION X FUNDING – PROCESS FLOWCHART

NES

APPLICANT

CLAIM APPROVED CLAIM REJECTED

Administrator sends authorisation to proceed letter to applicant.

Applicant is informed by Director / Assistant Director

Director / Assistant Director reviews receipted invoices and ticks ‘Yes’ or ‘No’ on application

form for corresponding receipted invoices rec’d.

Administrator arranges return visit by NES Inspector.

NES Inspector signs application to verify return visit carried out.

Director / Assistant Director signs application form to indicate applicant is authorised to claim

funding from Health Board.

Administrator sends copy of application form and GP220 (New Trainer) / GP221 (Existing

Trainer) form to applicant.

Applicant sends copy of application form, GP220 / GP221 and original receipted invoices

to Health Board to claim Det X funding.

Applicant posts copies of receipted invoices to Administrator when works completed.

NEW TRAINERS

Practice Inspection carried out.

Items identified by NES following CP inspection

Applicant requests application form from Administrator.

Applicant returns completed application form to Administrator.

NES Inspector signs off application form.

RETURNING TRAINERS

Items identified during VT visits.

53

Guidance on criteria for Accessing Determination X funding

NEW TRAINERS & RETURNERS > 5 YEARS

SERIAL TRAINERS

RETURNERS 1- 5 YEARS

Ref 1 SDR Determination X Part II paragraph (11)(1)(b)(i) Ref 2 SDR Determination X Part II paragraph (11)(1)(b)(ii)

Ref 3 SDR Determination X Part II paragraph (9)(2)(a)

PRACTICE INSPECTION

PASS FAIL CONDITIONAL

NO DET X NO DET X PURCHASE UNDER DET X

PART II

RECLAIM

DO VT FOR A YEAR

STOP TRAINING

CONTINUE TRAINING

VDP DOESN’T STAY ON

VDP STAYS ON

(Ref 1)

APPROPRIATE CLAIM

INAPPROPRIATE CLAIM

RECENTLY TRAINED

ASSOCIATE EMPLOYED

(Ref 2)

PASS INSPECTION

NO INSPECTION REQUIRED

PRACTICE INSPECTION

NO DET X CLAIM

CONDITIONAL

NO DET X CLAIM

MECHANISM (Ref 3)

ITEMS IDENTIFIED BY NES AS REQUIRED TO MAINTAIN VT STANDARD IN TRAINEE

SURGERY

RECLAIM

DO VT FOR A YEAR

STOP TRAINING

CONTINUE TRAINING

VDP DOESN’T STAY ON

VDP STAYS ON

(Ref 1)

APPROPRIATE CLAIM

INAPPROPRIATE CLAIM

RECENTLY TRAINED

ASSOCIATE EMPLOYED

(Ref 2)

PURCHASE UNDER DET X

PART III