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Fitness to Practise performance

14 July, 2021
When concerns are raised with us, we consider these and, if necessary, investigate to assess whether the issues involved may indicate that a registered professional’s fitness to practise is impaired. 

Closure rate at each stage of the Fitness to Practise process in 2020

This graphic shows the average closure rate at the different stages of the fitness to practise process (this is the average of cases actioned in 2020 rather than the number of cases received). This is illustrative of where the decisions to close cases were made and includes cases that started in previous years, rather than reflecting the outcomes for concerns received in 2020, many of which are yet to be resolved.

Infographic showing average closure rate at each stage of the Fitness to Practise process in 2020

We received 1,134 new concerns in 2020, compared to 1,362 in 2019 – an 18% reduction. We made 1,117 initial assessment decisions, some of which were from cases received at the end of 2019. A small number of cases were received too late for us to make an initial assessment decision in 2020. Of all the cases reviewed at initial assessment, 81% were referred for assessment. We referred 1% of cases to the NHS and closed 18%.

After further investigation, we made 904 assessment decisions in 2020, compared to 886 in 2019. This reflects a small build-up of work towards the end of 2019 that carried forward into 2020. Due to the time it takes to investigate, many of the assessed cases completed commenced before 2020. We referred 46% of the cases reviewed at assessment stage to Case Examiners and closed 54% of cases at this stage. This equated to 37% of total cases received progressing to Case Examiner review. Following Case Examiner review, 10% of the total were closed with no further action, 12% closed with advice, warning or undertakings and 15% were referred to a Practice Committee. Of this 15%, 11% resulted in sanctions and 4% resulted in no further action.

Case Examiners made 455 decisions in 2020. These included cases that have been referred back to them by either the GDC or the dental professional’s defence team before the case is heard by a Practice Committee. This was a 34% decrease in decisions made compared to 2019 (691), which reflects the fall in fitness to practise cases received since 2018. Of the 455 cases, the Case Examiners closed 60% of them, referred 39% to a Practice Committee and agreed undertakings in a further 1% of cases.

This resulted in 176 Case Examiner referrals to the Practice Committees, a 38% decrease compared to 2019. Case Examiners also referred 23 of these cases to the Interim Orders Committee. This represented as an increase from 7% to 13% of cases that were referred to both the Practice Committees and the Interim Orders Committee.

In 2020, the percentage of cases closed at the initial assessment stage fell from 29% to 19% (including those referred to the NHS) while the percentage of cases resulting in a hearing remained about the same as 2019, at 15%. We believe these changes are, at least in part, as a result of our efforts with the profession and the public to avoid inappropriate matters being raised with us and reflect the lower overall volume of cases received.

Further details of our performance can be found in the Fitness to Practise statistical report, published separately.

Fitness to Practise hearings

Cases referred by case examiners are heard by one of three statutory Practice Committees. Each panel comprises a dentist, a dental care professional and a lay member. The Practice Committees completed 92 initial hearings in 2020, a reduction from the 141 initial hearings held in 2019. This reduction is due to the COVID-19 pandemic, which led to the postponement of initial hearings between March and July.

These postponements also led to a significant drop in performance. The median time for initial hearings to start was 296 days (9 months and 22 days) from referral by case examiners, compared to 263 days (8 months and 18 days) in 2019. 44% started within 9 months of referral, compared to 60% in 2019. The average length of an initial hearing was 5.3 days, compared to 4.9 days in 2019.

In 2020 we held 61 hearings for dentists (67%) and 31 for dental care professionals (DCPs).  21% of dentists and 39% of DCPs who had cases heard by a Practice Committee were erased from the register (27% overall). In contrast, 32% of dentists and 13% of DCPs did not receive a sanction as a result of their hearing (26% overall). 30% of cases resulted in suspension and 8% in conditions being imposed. The proportions for these sanctions were the same for dentists and DCPs.

The following table shows the outcomes of all FtP initial hearings in 2020.

OutcomeNo. of outcomes% of total
Erased and immediate suspension2527%
Suspended with immediate suspension (with a review)2325%
Suspension (with a review)44.5%
Suspension11%
Conditions with immediate conditions (with a review)55.5%
Conditions (with a review)11%
Fitness to practise impaired. Reprimand910%
Fitness to practise not impaired. Case concluded1415%
Facts found proved, did not amount to misconduct. Case concluded66.5%
Facts not proved. Case concluded33.5%
No case to answer11%
Total92100%

Fitness to Practise interim orders

At any stage in the fitness to practise process, we may apply for an interim order to restrict a registrant’s practice until their case is resolved. We do so when we conclude there is a real risk of significant harm to a member of the public, it is in the public interest to protect public confidence in the profession, to maintain professional standards, or where it is in the registrant’s own interest.  In 2020, the Interim Orders Committee delivered 142 initial outcomes. They imposed no order in 52 cases, imposed interim conditions in 47 cases and an interim suspension in 43 cases.

For a more detailed overview, you can download our full Annual Report and Accounts 2020.