Fitness to practise: more time for better outcomes

We have now put in place permanent changes to our Fitness to practise process to ensure we are making decisions based on the best quality information, as early as possible in the process. John Cullinane, Executive Director, Fitness to Practise, explains.

We have made some changes to our processes that will allow more time for dental professionals to submit comments or observations about fitness to practise allegations and ensure the early disclosure of clinical assessment reports provided. We have now put these changes on a permanent footing.

It was suggested that providing a little more time for the submission of comments or observations could deliver beneficial outcomes for patient safety and professionals. That it could lead to improved observations, alleviate some of the time pressures faced by dental professionals, and help to ensure that we were fully informed of all relevant facts, as early as possible in the process.

But we needed to know more and agreed to test the hypothesis. We did this through a public consultation exercise, as well as a pilot, which ran from January to October 2020. Since then, we have been evaluating the results and considering stakeholder views.

Although the number of cases examined through the pilot was small, the results of the evaluation indicated that the changes led to more cases being closed by case examiners, and fewer cases progressing to a hearing. Providing more time for responses also resulted in better quality observations, leading to a broader range of case outcomes.

The feedback we received on the early disclosure of clinical reports was that it often prompted dental professionals to consider early remediation. This potentially leads to improvements in patient safety through early insight and learning into clinical practice, and timelier disposal of cases.

As a result of these findings, we’re now providing an additional 14 days, on request in certain cases, for dental professionals to submit their comments or observations when we make allegations about their fitness to practise. The changes apply to cases where there is no other fitness to practise matter being actively considered by us, and which fall into the following categories:

• Single patient concern – relating to clinical care and treatment provided by a dental professional. Primarily clinical, but may include concerns about conduct.
• Dental care professional performance concern.
• Maintenance of practice, equipment and material concerns – relating to practice maintenance, including equipment in the practice, cross infection control, and out of date medicines.

We will continue to monitor these changes to ensure the additional time allowed does not impact on the timeliness of case progression, but the indicators are that by giving a little we can potentially gain a lot. You can find out more on the Facing a concern webpage.