Elizabeth Gonzalez Malaga, a dentist and the Clinical Fellow at the GDC, explores some of the key findings from the recent publication of our cross-regulatory research into the concept of seriousness in fitness to practise cases.
Despite being aware that only a very small number of registrants face fitness to practise (FtP) hearings, as a dentist I know well the worry that an FtP investigation can cause to dental professionals. The General Dental Council (GDC) recognises that it can be stressful and seen as confusing when a concern is raised, hence its commitment to making improvements to its processes to ensure it is efficient in protecting the public. The GDC also needs a better FtP process and is pressing the government to introduce the legislative reforms which would allow changes to be made.
As part of its commitment to a proportionate and targeted FtP system, the GDC, together with the Nursing and Midwifery Council (NMC), commissioned research to investigate how seriousness in FtP is understood and applied by UK health professional regulators.
The research provides valuable findings for all in the sector to consider, including individual dental professionals such as myself.
How should you engage with the FtP process?
Whether or not we agree with the concern raised, it’s worth considering what learning it has identified. Tailoring our continuous professional development (CPD) priorities around this might help to show how we’ve considered the concern and started remediation if the concern is referred to case examiners. CPD will help us to improve our practice regardless of the outcome of the concern.
Legal advice and representation
If you don’t have legal representation, the GDC can signpost to other organisations that might help with representation or other forms of support.
Environmental and contextual factors
However, the research highlights that these factors are more likely to be accepted as mitigation if there is evidence that the registrant had raised concerns within the workplace, for example in emails, and if it can be corroborated by other witnesses. This finding is a reminder to us registrants of our professional duty to raise concerns when something poses a risk to patients, members of the public or colleagues, and for employers to act upon feedback and concerns raised by their staff.
Differences across regulators
One of the first things that struck me when joining the GDC as a Clinical Fellow was the realisation that all functions and activities undertaken by the GDC are governed by its legislative framework. Each healthcare regulator operates under its own legislation, bringing differences to FtP procedures and outcomes across regulators. The risks to patients posed by each profession and public views and expectations of different professions also varies.
The research showed that there are some fundamental differences between regulators in how and when seriousness is considered during an FtP process, partly due to the differing legislative frameworks each operate in. However, there is some similarity and consistency in how seriousness is generally understood and used, especially for cases involving dishonesty, sexual misconduct, violence and some criminal convictions.
Although the GDC is continuing to make improvements to the FtP process, current legislation is outdated and restrictive, limiting the ability to make significant changes. However, the findings from this research will inform work to develop a more consistent and proportional FtP system when regulatory reform makes this possible. This will ensure that patients continue to have recourse when something goes wrong, and regulation continues to build public confidence in the dental profession.