Most dental professionals are dissatisfied with the fitness to practise process and the outcome of their case, according to the General Dental Council (GDC).
Released by the regulator today (20 November), a new survey found that both informants making fitness to practise complaints and registrants facing proceedings were unhappy with the process and its outcomes.
A higher proportion of registrants than informants were satisfied with the communication around and outcome of their case, and felt it was treated appropriately and proportionately. Only one quarter of informants felt that their case had been taken seriously by the GDC.
The research identified several potential areas of improvement for fitness to practise processes. For example, the length of the investigation, the support given to both registrants and informants, and the response time to informants’ queries. One third of respondents named the latter as a problem requiring improvement.
Is the fitness to practise process too punitive?
The GDC additionally commissioned further research into communication and support surrounding the fitness to practise process. This found that unclear expectations, infrequent updates and impersonal language were major sources of anxiety and mistrust.
The process was also seen as punitive, which the GDC suggested may cause defensiveness and disengagement rather than early resolution or remediation.
Another key finding was that many patients misunderstand what the aim of the fitness to practise process is, attempting to seek financial reimbursement rather than disciplinary action. One GDC worker reported frequently hearing feedback such as: ‘But I just wanted my refund and I didn’t get my refund. Suddenly I was in this fitness to practise process, not what I wanted to do.’
Another added: ‘People think you’re just a complaints service that will remove someone’s license… Suspensions are reported as strike-offs in the media… there’s no nuance.’
‘A tremendous effect on my mental health’
One of the most frequent concerns named was around communication after a complaint is made. An informant said: ‘I was told on a few occasions I’d have a final result within a few weeks, each time several months went by without any update.’
Several informants called for more frequent updates, for example: ‘Just being kept up to date regarding the progress of the complaint, any investigation ongoing and the detail of the outcome.’
Registrants also felt that the way they were informed of the fitness to practise case against them was detrimental. One said: ‘An email regarding FTP during the work day whilst I am at work, I felt was completely inappropriate and should be carefully considered time-wise as to when these emails should be sent.’
They also highlighted that ‘the length of time allowed for the registrant to respond was very short, especially given the very long wait for a response from the GDC’. They felt that time to get records together and have them checked by an advisor was not accounted for, which ‘seemed unfair’.
Both registrants and informants also questioned the tone of communications received. For example, a registrant said: ‘Wording of initial letter claiming I was liar before I had a chance to respond has had a tremendous effect on my mental health and my ability to fully engage and defend myself.’
An informant had similar concerns: ‘No communication. No explanation. Treated with contempt for raising a complaint. Not listened to or believed.’
‘Fitness to practise investigations can take too long and feel overly complex’
In response to these findings, GDC executive director of regulation Theresa Thorp said: ‘While we have made significant improvements in recent years, this research makes it clear there is more we need to do.
‘We know that fitness to practise investigations can take too long and feel overly complex, often leading to feelings of mistrust and negatively impacting the mental health and wellbeing of those involved. We’re committed to making evidence-based changes that will have the greatest impact on improving the process.
‘We’re already taking action to improve how we communicate with participants, provide better support, and reduce the time investigations take. We want to work collaboratively with dental professionals and our partners to ensure the process is fair, transparent and supportive, while protecting the public.’
The two research reports commissioned by the GDC were led by the University of Manchester.
The registrant and informant experience survey can be found here.
The full communication and support report is available here.
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