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 2021
We received 1,349 new concerns in 2021, compared to 1,134 in 2020 – a 19% increase. We made 1,341 initial assessment decisions, some of which were from cases received at the end of 2020. A small number of cases were received too late for us to make an initial assessment decision in 2021. Of all the cases reviewed at initial assessment, 87% were referred for assessment. We referred 1% of cases to the NHS and closed 12% (compared to 18% in 2020).
After further investigation, we made 869 assessment decisions in 2021, compared to 904 in 2020. This reflects some resourcing issues we experienced in 2021, which resulted in fewer investigations being completed than we had expected. Our caseload in this area increased significantly, from 657 at the end of 2020, to 991 at the end of 2021, an increase of 51%.
To address this, we increased the capacity and capability in our casework team through additional recruitment, providing permanent roles for existing experienced caseworkers and improving how we train new starters, so they became confident more quickly at progressing complaints. We increased the number of casework staff by around 20 FTE (40%), including some who started in early 2022. Although this has provided additional capacity, stability and resilience, we know from previous experience that it takes around 12 months for the team to settle, gain experience and get on top of the excess caseload.
However, this meant that we did not improve the time it takes for cases to be assessed at this stage throughout 2021. Due to the time it takes to investigate, many of the assessed cases completed commenced before 2021. We referred 50% of the cases reviewed at assessment stage to case examiners and closed 50% of cases at this stage. This equated to 43% of total cases received progressing to case examiner review. Following case examiner review, 10.5% of the total cases were closed with no further action, 13.5% closed with advice, warning or undertakings and 19% were referred to a Practice Committee. Of this 19%, 14% resulted in sanctions and 5% resulted in no further action (compared to 11% and 4% in 2020.)
Case examiners made 304 decisions in 2021.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 33% decrease in decisions made compared to 2020 (455), which reflects the resourcing issues. Of the 304 cases, the case examiners closed 55% of them and referred 45% to a Practice Committee. In comparison, in 2020 out of the 455 total cases, case examiners closed 60%, referred 39% to a Practice Committee and 1% had Undertakings.
This resulted in 136 case examiner referrals to the Practice Committees, a 23% decrease compared to 2020. Case Examiners also referred 16 of these cases to the Interim Orders Committee. This represented 5% of cases that were referred to both the Practice Committees and the Interim Orders Committee, in line with the percentages seen in 2020.
In 2021, the percentage of cases closed at the initial assessment stage fell from 19% to 13% (including those referred to the NHS) while the percentage of cases resulting in a hearing increased to 19%, compared to 2020 (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.
Fitness to Practise hearings
Cases referred by case examiners are heard by one of three statutory Practice Committees. Each panel comprises two dental professionals, one of whom must be a dentist, and a lay member. The Practice Committees completed 115 initial hearings in 2021, an increase from the 92 initial hearings held in 2020.
|Outcome||Number of outcomes||% of total|
Erased and immediate suspension
|Suspended with immediate suspension (with a review)||34||30%|
|Suspension (with a review)||5||4%|
|Conditions with immediate conditions (with a review)||12||10%|
|FtP impaired. Reprimand||6||5%|
|FtP not impaired. Case concluded||18||16%|
|Facts found proved did not amount to misconduct. Case concluded||7||6%|
|Facts not proved. Case concluded||5||4%|
|No case to answer||1||1%|