Improvements to Fitness to Practise Announced by GDC
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- Published: Wednesday, 22 March 2023 08:32
- Written by Peter Ingle
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When it comes to their management of Fitness to Practise (FTP), the GDC are a remarkably defensive organisation, with an aptitude for deflecting and ignoring criticism. Their recent promotion of claimed improvements in the FTP process should be seen in this context.
The Professional Standards Authority (PSA), the super-regulator that the GDC is supposed to answer to, has been consistent in its assessments. In every single one, the GDC has failed to meet the PSA’s standards for FTP. The GDCs response has been ingenious.
The Authority’s reports typically refer to the improvement plans volunteered by the GDC for the areas where it has failed to meet the PSA standards. Until recently this has kicked the can down the road until the next PSA report. However in its Periodic Review for 2021/2022 the PSA took action under its escalation policy.
The GDCs preferred excuse for poor performance is that it is limited by legislation, and both parties may have been banking on the promised new legislation for regulators, solving their problems. This would have given the GDC a breathing space waiting for the legislation to be enacted, and then a further period to fail, before the PSA needed to put any further pressure on it.
The failure of the government to set any date for the GDC legislative update, means that it will not now happen until after the next election. The GDC has been working to fill the gap. This goes some way to explaining a flurry of announcements and statements from the regulator. John Cullinane has been executive director of FTP at the GDC since 2020. He has referred to the recently announced changes which, “aim to improve our fitness to practice processes and systems, where we can within our current regulatory framework.”
The first change is that the GDC are now closing any open cases that mirror an active investigation by another authority, such as the NHS and MHRA. If those organisations then find any patient safety or public confidence issues that may need its intervention, they will inform the GDC. However, cases involving an ongoing police inquiry, interim order, or where there are other open fitness to practise investigations, will not be closed in this way. The GDC have trialled this, with 18 cases being closed. Subsequently they have not been contacted by any of the relevant authorities in these cases with information calling the dental professional’s fitness to practise into question.
A second change is that the GDC will no longer automatically open a case referred to them by the NHS, where it is investigating the matter, or dealing with concerns at a local level. This will reduce the number of multiple investigations opened against the same dental professional, and the number of new cases opened. However, an investigation will still be opened following an NHS referral where there is a serious and immediate risk to public safety or confidence (where the dental professional also practices privately, for example) and, if appropriate, refer the matter to the Interim Orders Committee.
The last change is that the GDC are now reviewing and closing cases “where there is no prospect of establishing that a dental professional’s fitness to practise is impaired. These cases are being reviewed and closed on approval by the Registrar.” As with the other changes, one might ask why this was not already happening.
Writing about these changes the executive director of FTP concluded with the statement that the GDC have “come up with” improved systems to help progress cases and identify any “operational issues hindering our performance.”
The response to these changes from indemnifiers has been mixed.
Yvonne Shaw, Deputy Dental Director at Dental Protection, said: “We have long made the argument that reform to professional regulation is needed and we welcome the announcement by the GDC about the reforms they plan to introduce. The extent to which these reforms can make a positive impact for dentists and dental care professionals depends on the detail of how they are implemented and we look forward to working with the GDC on this.
“There are other areas where the GDC could make further progress and we continue to urge the GDC to take these forward. These include improvements to the tone of communications, IOC sanctions, decision making and decision timelines in Fitness to Practise processes.
At MDDUS, Stephen Henderson, head of dental division, said: "MDDUS is keenly aware from our advice, legal and support services how overwhelming fitness to practise investigations can be for dental professionals. They often take far too long to resolve and can lead to individuals feeling distressed, disengaged or leaving the profession altogether.
"We welcome the GDC’s commitment to continue to improve how fitness to practise investigations are managed. Our dentist members and their teams are dedicated, highly skilled professionals, and it is vital that they receive fair and timely treatment by the GDC as well as the support they need to deliver a high standard of care to their patients.”
Both experts also called on the Government to keep its promise to reform the fitness to practise legislation.
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