Transparency, trust and improving the fitness to practise process

We know that Fitness to Practise (FtP) is a stressful and difficult process. We can’t make the stress go away altogether, but we want to do what we can to minimise stress and anxiety and ensure that the small number of dental professionals who are involved in an investigation each year are supported by us and others and that their wellbeing and mental health is a priority.  

There are two important issues that we’d like to explain at this point: the level of detail published from Interim Orders Committee (IOC) hearings, and how we plan to report deaths during an FtP investigation. 

Overriding both of these are issues of transparency and trust, which I’ll return to later in this update. 

Reviewing the level of detail published from IOC hearings  

We know that the impact of an FtP investigation can be far-reaching and stress can be caused by both the experience and the information which is published or made available around it. Last year, following an inquest, a coroner raised concerns with the GDC about the level of detail which is published regarding allegations being considered at an IOC hearing. 

First and foremost, it was with great sadness that we learned about the death of a dentist whose case was under investigation and our deepest sympathy and thoughts are with their family.  

We recognise the concerns raised by the coroner and at the time, work was already underway to review the policy in relation to the publication of IOC outcomes, taking account of the constraints of the current rules and legislation. The recommendations will be reviewed by the Registrar in the coming months, before a decision is made on any changes. 

In carrying out this work, we have: 

• considered the challenge of balancing the level of published information which might be necessary to fulfil our role in protecting patient safety and public confidence in the dental professions with the interests and impact on the registrant 
• engaged with Chairs of the independent FtP committees to understand their views 
• engaged with the Nursing and Midwifery Council (NMC) and the Health and Care Professions Council (HCPC) as the other UK regulators with a starting point of public IOC hearings, to understand their approach to more limited publication.

Reporting causes of death during FtP investigations

We have shared the work we have done so far to understand and report the causes of death of dental professionals where there is an active FtP case, the sensitivities with gathering the information required, and our commitment to reporting this data in line with the GMC’s approach. We have further work to do to bring together a report that covers the period 2019 to 2022, which we will publish in 2024. Future reports will cover a three-year period. 

The work we have done will enable us to put in place the necessary processes to allow us to record the cause of death of dental professionals who die while subject to an FtP investigation. 

We will use the same categories of the cause of death as the GMC, namely:

We will report this information no sooner than two years after the reporting period, to allow time for the cause of death to be formally recorded and for the certificates and conclusions to be gathered and analysed. Again, similarly to the GMC, we will not publish data where small numbers in a particular category means that there is a risk of identifying individuals, in consideration to their families and colleagues.  

Reducing stress in the FtP process  

Driven by our own research into people’s experiences of FtP, we have made changes to the FtP process where we can and where legislation doesn’t restrict us. Some examples are:  

Further work is underway to explore the practical support that would be useful for all participants in our regulatory processes, including the effectiveness of our Hearing Support Coordinators and the timing and type of communications we provide to witnesses. This includes a learning programme for staff at all levels involved in FtP, so that we better understand the impact of regulatory processes on mental health and stress in those we regulate and are equipped to recognise the signs of stress on an individual. We are also developing a process to undertake a serious incident review when we find out that a dental professional has died while subject to an FtP investigation.