Lean and Inexperienced – The GDC’s FtP Team In 2020

Lean and Inexperienced – The GDC’s FtP Team In 2020

The General Dental Council’s Fitness to Practise team was “Too lean and lacked the necessary experience to maintain performance” towards the end of 2020, the FtP’s Executive Director has said.

In a blog written in response to the recent revelation that overall opinions held by dental professionals of the GDC were more negative (58%) than positive (21%), John Cullinane has said on the GDC website that towards the end of 2020 the GDC “Began to see performance slipping in how we progress cases.”

Mr Cullinane wrote “The pandemic was a difficult time for everyone, and it did reduce our capacity, but that alone does not explain what was happening.”

“The team was too lean and lacked the necessary experience to maintain performance in these challenging circumstances.”

“The volume of excess cases, beyond what we expect to be managing at any one time, started to creep up.”

Mr Cullinane said that the GDC “Applied things we’d tried before, such as rigorously improving and embedding internal processes and identifying and addressing skills gaps.”

“But what we tried didn’t work because of a lack of capacity and experience in the team.”

“It also took too long to identify that it wasn’t working and by the time we recognised that, the excess caseload had grown even further.”

The head of FtP said that the current excess caseload is around 30% higher “than it should be.”

“For a number of reasons, we were not managing FtP effectively enough and did not see the early warning signs when performance was dipping.”

The FtP head’s post was echoed in a recent post on the GDC’s website written by Executive Director of Strategy, Stefan Czerniawski.

Mr Czerniawski wrote “The combination of capacity pressures experienced during the pandemic, a relatively inexperienced team, and overly rigid legislation has tested our ability to manage fitness to practise cases effectively.”

Mr Cullinane said that in recent months, the GDC has been exploring why performance had dipped and introduced changes to improve the situation. He said more improvements were to come.  

“We’re redesigning how we monitor performance, to give us a better early warning system when things start to go wrong and to help us to understand why.”

The GDC has a target of ten working days for all cases to be processed by the regulator’s initial assessment team.

Mr Cullinane said that the FtP statistical report for 2020 showed that 99% of cases were meeting the target. He said the statistic showed “Consistency in performance at this stage of the process.”

“Cases involving dental professionals working outside their scope of practice, or with health issues or complaints that affect a single patient, take less time than complex cases involving, for example, conduct, more than one patient, or another healthcare regulator,” Mr Cullinane said.

In the last three months of 2020, 53% of the most serious cases referred to a Practice Committee took longer than nine months to reach the hearings stage after being referred by a case examiner.

Mr Cullinane said that the GDC is increasing capacity and capability in the FtP team, through recruitment, as well as  providing permanent roles for existing experienced caseworkers.

He also said the GDC is improving how it trains new starters, “So they quickly become confident at progressing cases to reduce delays.”

“Although this will provide capacity, stability and resilience, we know from previous experience that it takes around a year for the team to settle, gain experience and get on top of the excess caseload.”

“However, the groundwork we’ve done to better understand our FtP performance means that we’ll get earlier visibility of progress and be able to take action sooner,” Mr Cullinane said.

A retrospective analysis of the GDC’s performance against its newly-approved fitness to practise guidance, was published in the British Dental Journal in 2015.  

The study, carried out by CT Gallagher and AI De Souza, concluded that “The GDC do, in general, consider relevant factors at all stages of their deliberations into practitioner misconduct, and act in a manner that is consistent with their own guidance when determining sanction.”

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