Changes to Dental Fitness to Practise Investigations

When there are concerns relating to a dental professionals conduct and fitness to practise, the General Dental Council (GDC) will often be made aware. If the GDC share the concerns, they will undertake their own investigations into the individual. These are often referred to as fitness to practise investigations. You can read more about this process and how JMW can help here.

It is no secret that regardless of the profession, fitness to practise investigations can be an extremely stressful process. At the start of 2022, it was reported that a number of dentists have taken their own lives while they have been under investigation. However, the GDC said that they were unable to quantify the total number of deaths. In order to try and rectify this issue, it has been proposed that the cause of death ought to be recorded when there is an ongoing fitness to practise investigation. This will consist of the following categories:

• Death due to natural causes
• Deaths from external sources (including suicide)
• Deaths from other or unspecified causes

Further, things are being put in place that mean that when a dental professional has died while being subject to a fitness to practise investigation, it will trigger a serious incident review. However, when the information might lead to an individual being identified, it will not be published.

Following an inquest last year, a Coroner raised concerns with the GDC about the level of detail which is published when an allegation is being considered by the GDC. As a result of this, there has been calls to change the process.  

There is no doubt that this is a tricky balancing act. The fundamental purpose of the GDC is to protect patients and the wider public when failures to observe professional standards risk physical harm as well as undermining public confidence in dentistry. Despite this, many dental professionals do not think the balance is set in a way which is fair to them.

In a survey undertaken by Dental Protection last year, 82% of respondents said the length of the GDC investigation impacted their mental health most. Some investigations last several years. 74% said the tone of communications from the GDC was their main concern.

The following changes have been made to try and reduce the impact of investigations in the dental professional’s private lives:

• Updating the letters that dental professionals receive during the investigation. This is to ensure that an empathetic tone is used, and the individuals are signposted to health and wellbeing support.
• Try to ensure that more hearings proceed on time, reducing the overall length of the investigation.
• Providing training to panellists and legal advisers who hear fitness to practise cases, to support vulnerable individuals in the hearing process and a Participant Support Office who supports unrepresented registrants by explaining the hearing process.

In our experience, a more collaborate approach can make a very significant difference to the levels of stress. Very confrontational proceedings rarely enable the parties to advance their case clearly, particularly in complex clinical complaints where expert evidence is required.

At the beginning of the process, dentists are often frustrated by the GDC’s attitude to vexatious or malicious complaints. Whilst complaints have to be taken seriously, a sufficient amount of investigation should be done to establish the cogency of evidence behind the complaint before the dentist is obliged to engage with a formal and very stressful process. After all, the GDC is not solely in existence to prosecute. If one considers the obligations placed upon a police officer when investigating a criminal allegation, there is a statutory duty to consider all reasonable lines of enquiry, including issues tending to demonstrate innocence. This obligation arises from the very beginning, not just after a suspect’s interview or charge. The same rigour should be applied by the GDC before they engage with the dentist, especially where an investigation could have a real impact on the wider practice. Our experience with criminal investigations and interventions by a broad range of regulators is that if the investigators are put to proof in relation to their due diligence, they often come up short and this can be crucial in opposing interim order applications or the substantive proceedings.