The General Dental Council (GDC) has been officially ticked off for its shoddy handling of fitness-to-practise cases – including one incident in which Post-it notes were used to record important case details.
The criticism follows a recent audit of the UK’s healthcare regulatory bodies by super-regulator, the Council for Healthcare Regulatory Excellence (CHRE).
Other examples included one case that had two files – one marked ‘closed’ and the other ‘open’, and another case where investigation correspondence was missing.
The catalogue of disasters included poor record keeping, missing files, confusion over the status of cases, long delays and the closure of a case without a countersignature – something for which the GDC was pulled in a previous audit.
The super-regulator looked into a sample of 100 GDC fitness to practise cases during the period of September and October 2010.
• Three cases in which investigation correspondence was missing – in one case,
this was because of incomplete cross-referencing with a linked file
• One case where there was no record on file of the closure decision
• One case that had two files – one marked ‘closed’ and the other ‘open’. When the CHRE
audited the ‘closed’ file and asked why the matter had been closed, the GDC said that this was an error and that there was another ‘open’ file
• One case with two files, both of which were marked as ‘closed’. When asked why the audited file had important documents missing, the GDC said that another complete file existed
• One file in which documents were missing and where some important case information was recorded only on Post-it notes.
Time delays were another cause for concern.
In one case, there was a five-month delay between receipt of the complaint and its initial assessment by the GDC.
The case concerned an alleged breach of conditions that had been imposed on the registrant by the GDC’s professional conduct committee.
The CHRE felt the matter should have been treated as a priority but instead it took two months for the GDC to acknowledge receipt of the complaint.
In a second case, there was a period of eight months before an enquiry was made of a PCT.
The need to make the enquiry had been agreed by staff soon after the complaint had been received but there was no explanation for this delay on the file.
Other areas under fire included:
• Cases where there had been inadequate risk assessment before the case was closed
• Investigating committee decisions that were insufficiently detailed, creating a risk that complainants would not understand why their complaint had not been referred for a final fitness to practise panel hearing
• Weak record keeping, with documents missing from some files, and unco-ordinated
duplicated files for some matters
• A closure of a case by one caseworker without the authorisation or countersignature of a colleague – something for which the GDC had been criticised in its last audit
The GDC is now being called upon to improve consistency of standards achieved in casework to minimise any risk to public protection or public confidence.
The audit, released in March, says: ‘We were concerned about several weaknesses in case management, investigation, decision making and communication at the GDC.
‘We found evidence that the GDC takes a helpful approach to complainants. However, we were concerned about the standard of the GDC’s fitness to practice casework in a number of areas.’
It went on to say that, despite the fact the GDC fitness to practise team ‘went through a period of structural and management changes’, it was ‘disappointed that the GDC still displays
weaknesses in this area despite the assurance given to us when we raised the issue in last year’s audit’.
The CHRE is now recommending the GDC consider introducing a computerised casework management system that links into the regulator’s computerised registration system.
The GDC now intends to introduce changes to its fitness to practise processes that will address the concerns raised.
Its Corporate Plan 2011-2013 (available online at www.gdc-uk.org) sets out a series of objectives for the future and states that it will ‘implement a systematic process to evaluate fitness to practise procedures and outcomes. Part of this work includes carrying out audits’.
In January, the GDC began hearing appropriate Fitness to Practise cases with panels of three rather than five as has been the norm since 2003, enabling more cases to be heard more quickly, so reducing the backlog.