Unlocking the potential of GDC fitness to practise data

The fitness to practise process is an essential part of the regulatory system that ensures patients are safe and public confidence in the professions is maintained. It can be a lengthy and difficult process for those involved. We are working to modernise our fitness to practise processes within our current legislative framework and to understand how we can unlock the potential held in the fitness to practise information and data we record.  

The work was commissioned to underpin two important workstreams. The first to inform ongoing work to improve our fitness to practise processes and performance, and the second to understand what steps we need to take to ensure we can infer meaningful learning from the process that can be shared with stakeholders and inform prevention strategies.  

We commissioned the University of Plymouth to: 

• examine case file data recorded over a five-year period (these cases involved around 2% of our registrant population) 
• speak with those who work in fitness to practise at the GDC and at other healthcare professional regulators, and interview some of our key stakeholders
• review published evidence on how fitness to practise data is analysed and used to support learning for regulators and stakeholders.  

How has the work supported case progression? 

We have benefited from learning events facilitated by the researchers while the research was conducted. These touch points have meant we had early sight of issues relating to the collection, storage and management of fitness to practise case file data. We have used the findings shared with us to support improved case progression and performance, which has included the development of performance measures and the initial inquiries pilot.  

The researchers’ analyses of risk factors have identified a trend of persistent overall reduction in the number of cases that escalate through the fitness to practise process and a decrease in sanctions resulting from investigations.  

The findings may indicate early signs of improved efficacy and proportionality in decision making within the process, but there is more to do for us to do. 

What learning can we infer from our data?   

We want to understand what learning can be inferred from the fitness to practise data we record. Researchers analysed the data provided to extract broad themes and related considerations and risk that provide us with a starting point for further development.  

The themes that emerged from the analysis were professional practice, clinical complaints and substantive criminal actions and/or convictions, each with subthemes that provide further detail about the considerations in these cases. Researchers have recommended opportunities for further data management improvements to support further work in this area.   

Researchers also identified factors or characteristics of dental professionals that are overrepresented in fitness to practise data when compared to the registrant population. These included being male, with an ethnicity category other than white, being a dentist and holding a qualification gained outside the UK. At later stages of the process, these narrowed to being registered as a dentist and those who qualified outside the UK or EU.  

The findings point to the complexity of cause and effect, as found elsewhere in healthcare professional regulation. We know that any analysis of risk is complex, and should not be used in isolation to draw conclusions, as other factors may be relevant.  

We will use the outcomes of this research to conduct further work, including further analyses of why certain groups are overrepresented in the registrant population. 

What will happen next?