GDC Addresses Suicide Prevention Conference
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- Published: Monday, 25 November 2024 10:52
- Written by Peter Ingle
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The Canmore Trust was set up by John Gibson and his wife Isobel following the devastating loss of Cameron, their son, to suicide in 2019. GDPUK readers may be familiar with the Gibsons, Isobel having been a medical GP and John currently Emeritus Professor of Oral Medicine in the University of Aberdeen and Honorary Consultant in Oral Medicine to the UK Army.
The Trust works to prevent suicide by influencing Government policies and lobbying for change in all sectors of society. At its recent Wellbeing Conference, it had a speaker from the GDC, Theresa Thorp.
She explained her role as Executive Director of Regulation, which was established in September 2023. It includes Registration, Fitness to Practise up to and including Case Examiner decisions, the Dental Professionals Hearings Service, and the Dental Complaints Service.
She provided an overview of the GDC’s understanding of the pressures affecting dentistry, including the mental health of dental professionals. This was followed by describing what the council was doing to reduce the negative impact of regulation. She told her audience: “We have much more to do.”
Turning to their understanding of the issues, Theresa Thorp spoke of the acute pressures within NHS dentistry and access, saying “we recognise that this has an impact on the wellbeing of patients and dental professionals.” There followed a summary of the problems faced by the public in getting access and the particular difficulties faced by younger patients as well as ethnic minorities and urban residents. This in turn she explained, created pressure for the dental team.
There was also reference to the GDC’s research into the experiences of early career dental professionals. One finding that appeared to have surprised the GDC was that dentists felt less prepared than dental nurses, hygienists and therapists. This was described as, “a worry.”
Only after observing that, “We are committed to learning and building our understanding of the issues that affect everyone in the dental sector – that includes the people who work in it – and patients and the public who rely on their work,” was Fitness to Practice (FtP) mentioned. The GDC were according to Theresa Thorp, “committed to understanding more about the impact of fitness to practise upon registrants, informants and witnesses.”
Reference was made to more GDC commissioned research: “Because we knew there were issues with fitness to practise which we needed to understand better so that we can address them more effectively.” Registrants’ experiences of fitness to practise proceedings that emerged, were that while most of those involved perceived the outcome to be fair, they also said that the process itself had negatively impacted their health, wellbeing, behaviour and practice.
The GDC had also found that the ‘fear’ of regulation driven specifically by experiences and perceptions of FtP impacts on registrants’ decision-making and practice, “in a way that we are told contributes to what is known as defensive practise.” This actually represents a sea change at the GDC, given that the previous Chair did not accept that there was such a thing.
The presentation to the Canmore Trust came in the week that the GDC published its report on dental professionals who died while involved in fitness to practise between 2019 and 2022.
After recognising of the tragic nature of such deaths and their impact on loved ones friends and colleagues, Theresa Thorp said: “Without a shadow of a doubt, regulatory proceedings are a cause of stress for many people, but also the cause of Fitness to Practise proceedings may itself be a challenging and complex set of factors. In addition to acknowledging that the GDC must do better, the GDC’s report serves as a call for everyone in the dental sector to reflect on the environment, systems and processes involved in being a dental professional.”
Looking ahead, the conference was told that the GDC’s direction of travel was moving towards supporting positive professional practice and away from an enforcement culture.
One way the GDC already did this was by setting and assuring the standards for undergraduate education and then providing guidance on the professional standards required throughout a dental professional’s career.
Ultimately within fitness to practise, the GDC want to: “Get faster, without compromising quality outcomes and make sure the process is fair to witnesses and registrants.”
The GDC were committed to making improvements, but delivering all the changes needed was likely to take some time. Priorities were to improve support for dental professionals during the process, and ensure that the GDC identify learning from any serious incidents that occur.
Improvements made to date were then listed. These included, the amended publications and disclosures policy relating to the Interim Orders Committee. The Executive Director failed to mention that this had only followed a Coroners letter requesting action.
Caseworkers and managers in FtP have received training from a mental health charity, as have the panellists and their legal advisers.
Communications have been revised, adopting a more empathetic tone, and better signposting.
In addition, FtP decisions now give additional weight to the impact of investigations on health and wellbeing when considering requests for voluntary removal from the register.
The claim was made that the Hearings Service has updated case management procedures to reduce administrative delays to the listing of hearings, and improve timeliness of proceedings. As Stephen Henderson has explained in his recent blog there are still many unacceptable delays in FtP that the GDC seem unable or unwilling to fix.
Possible future changes were also described, including a rolling programme of mental health training for those dealing with fitness to practise cases.
The GDC had also announced in the same week that they are making a permanent change to how single patient clinical practice concerns are assessed. Clinical dental advisers can now make an early request for the patient records and give their opinion, about the seriousness of the concern. One of the casework managers then reviews the case, and if the treatment is of an appropriate standard, can close it with no further action.
It is worth re reading the previous three sentences and then asking why it has taken so long for this simple change to come about.
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