By Dr George Wright, Deputy Dental Director at Dental Protection
One year ago, Dental Protection launched its campaign to improve the GDC investigation process, following some worrying survey results showing the impact that investigations have on dental professionals’ mental health.
Eight in 10 respondents to the survey said their experience of an investigation had a detrimental impact on their mental health. More than one in 10 quit dentistry due to the investigation, and a further two in five considered leaving. Over a quarter (28%) said they experienced suicidal thoughts during the process. Many left comments about how their experience would have been less traumatic if the investigation had been handled differently.
Our campaign set out several calls for action to the GDC – to bring about a more compassionate tone in communications, improve signposting to mental wellbeing resources, ensure correspondence is accessible across all devices, discourage complaints that clearly do not require regulatory action, and to publish data on registrants who have died by suicide during an investigation without further delay. The to-do list we set for the GDC was extensive and exposed many shortfalls in the regulator’s processes and communications.
We also set out a raft of recommendations aimed at tackling the chronic delays to fitness to practise investigations. In our survey, 82% of respondents said the duration of their GDC investigation affected their mental health the most, with some cases lasting many years.
Of course, reform to the GDC’s outdated legislation could play a key role in reducing delays, as amongst other things this could give the regulator greater discretion to not take forward investigations where allegations clearly do not require action. The regulator could then focus on the most serious allegations and process them faster. The next Government must progress with GDC reform with urgency, but we have always felt that the GDC can and must make changes of its own volition in the meantime.
Now, one year on from the launch of our campaign, I have been reflecting on the progress made to reduce the impact of GDC investigations on mental health. There have been several positive developments.
First, in response to our feedback, the GDC reviewed and then revised the contents of the letters sent to registrants during an investigation to ensure a more empathetic tone and include signposting to health and wellbeing support. This alone is a positive step and we believe the new letters are much improved. In our survey, 74% of dental professionals said the tone of communications from the GDC affected their mental health most, with one respondent describing it as unnecessarily ‘cold and harsh’.
Second, the GDC has launched a fitness to practise pilot, expediting the conclusion and closure of simple cases. The pilot, which has recently been extended, deals solely with single-patient clinical complaints where there is no history of fitness to practise concerns. We welcome this move, and hope it brings faster resolution for these cases. We also hope the pilot demonstrates the potential for the GDC to do more to bring about speedier, more informed and robust decision making across all cases.
A bigger concern for the dental professionals we represent at Dental Protection is the lack of proportionality and timeliness in handling cases that are not closed at the initial assessment stage.
Third, the GDC is undertaking a review into the level of detail that is put into the public domain when the Interim Orders Committee is considering fitness to practise concerns, and the allegations have not been determined one way or another.
This follows the unfortunate case of a dentist who took their own life while under investigation, prompting the Coroner to direct the GDC to take actions to prevent future tragedies.
Albeit in response to the Coroner’s request, the GDC is taking steps, and in a March 2024 update on this also confirmed that it is working to build a framework to report the causes of death of dental professionals where there is an active fitness to practise case, guided by an evidence review and engaging with experts including the National Suicide Prevention Strategy Advisory Group. A report covering the period 2019-2022, is due to be published in 2024.
This report is long overdue, and it is important that the GDC keeps to this commitment. When it is eventually published, I anticipate it will make for difficult reading, but it will provide some much-needed transparency and will expose the full extent of this issue. This is the first real step in tackling the issue.
These are just a selection of examples of where we have seen some recent progress. We know some of the problems, particularly around delays, cannot be solved overnight, and we know there is much more that could be done.
But the GDC did engage with us constructively when we presented them with the findings and recommendations from our campaign, and my colleagues and I at Dental Protection –who support members through GDC investigations and witness the effects on mental health first-hand – feel the GDC finally seems to be in ‘listening mode’.
So, is there a light at the end of the tunnel for the GDC’s fitness to practise processes? Perhaps – a glimmer at least. Our quest for improvements continues unabated.
