Supplementary advice for GDC decision makers on factors specific to COVID-19

We made a commitment to the dental profession that in the context of the COVID-19 pandemic we would not penalise well-grounded professional judgment about how best to meet patients’ needs, including where that judgement is to reduce or stop activity.

This supplementary advice has been developed to support decision makers in considering factors relating to the impact of COVID-19 on a professional’s ability to deliver care, and to provide a lasting point of reference.

Under our legislation, context is usually considered at the Case Examiner stage. Case examiners are appointed GDC staff members with a statutory duty to make decisions on cases that have been referred to them for more detailed consideration. It is at this stage that a concern or complaint in the context of COVID-19 would be examined in more depth.

The factors set out here must be considered in tandem with our overarching objective to protect the public.

Protection of the public includes:

  • Protecting, promoting and maintaining the health, safety and well-being of the public.
  • Promoting and maintaining public confidence in the dental professions.
  • Promoting and maintaining proper professional standards and conduct for members of the dental professions.

This supplementary advice is to be considered alongside existing guidance for decision makers.

Factors for decision makers to consider resulting from the impact of the COVID-19 pandemic

There have been multiple challenges during the pandemic for dental professionals. Listed below are some factors brought about by COVID-19 for consideration when deciding whether there is a real prospect that a registrant’s fitness to practise is currently impaired. This is not an exhaustive list of factors but highlights some of the common issues faced by the dental professions and patients. 

Personal protective equipment

  • Availability of, and access to, personal protective equipment (PPE) including issues with fit testing.
  • Inability to carry out treatment due to lack of PPE/appropriate PPE.
  • Discomfort from wearing PPE for extended periods of time and the impact of PPE on communication with patients and colleagues.

Managing new guidance

  • Pressures of managing new guidance and protocols, often produced and communicated quickly sometimes through unusual channels.
  • Uncertainty in identifying which form of guidance was most appropriate.

Availability of services

  • Services unavailable due to COVID-19 and closure of dental practices.
  • Staff shortages due to COVID-19 infection, concerns about the risk of infection, or self-isolation requirements.
  • Service capacity limited by infection prevention and control measures, including social distancing and the effect of adhering to fallow time requirements for aerosol generating procedures.

Restrictions on treatment

  • Inability to offer a wide range of treatments (e.g. aerosol generating procedures).
  • Inability to fully assess and diagnose patients through remote appointments.
  • Inability to refer to services.

Delay in treatment

  • Delay in treatment due to the backlog caused by COVID-19 leading to greater issues in patient care and treatment.

 Other factors

  • Work pressure from employers/practice management, which may be financially driven.
  • Working outside of normal routine, or requirements to work in unfamiliar roles, teams and/or environments at short notice.
  • Personal circumstances (e.g. distress or emotional trauma caused by the pandemic).

In view of the challenges and pressures dental professionals were facing during the COVID-19 pandemic, they should be able to demonstrate how they sought to:

  • provide the best and safest care they could, in line with the best evidence available at the time as well as any other relevant guidance
  • communicate effectively and work cooperatively with colleagues to keep patients safe
  • identify and apply other reasonable means to address any issues and concerns 
  • keep records of the decisions they made and the actions they took
  • inform patients of all treatment options available to them.