Dental Protection member to fight high court decision on vicarious liability and non-delegable duty of care

Dental Protection member Mr Raj Rattan has said he will appeal the decision of the High Court that he, as a practice owner, is liable to Mrs Hughes for the treatment carried out by associate dentists at his former practice. He did not carry out any of her treatment and sold the practice six years ago.

Mrs Hughes, represented by the Dental Law Partnership (DLP), pursued a claim against Mr Rattan under vicarious liability and non-delegable duty of care, despite the fact that the treating dentists have been identified and are willing to respond to the claim. DLP and their client refused to engage with them and instead pursued Mr Rattan as practice owner.

The vicarious liability claim focused on the relationship between Mr Rattan (as the practice owner) and the self-employed treating dentists, to ascertain whether it could be considered by the Court to be “akin to employment”. The non-delegable duty of care claim focused on Mr Rattan’s relationship with the patient and whether he owed her a duty that was of a nature that could not be delegated.

In relation to vicarious liability, the Dental Protection legal team argued that the associates worked in and for their own business and at their own risk as to profit or loss, and that their relationship with Mr Rattan was therefore not akin to employment.

In considering the preliminary issue of non-delegable duty of care, the judge focussed on the wording of the (2006) Standard General Dental Services contract between the then Primary Care Trust and Mr Rattan’s practice.  This was challenged by Dental Protection on the basis that Mr Rattan, as the practice owner, had not assumed a positive duty to protect the claimant from harm which means the requirements of the decision in the 2014 Woodland v Swimming Teachers Association & Others case were not satisfied.

The Preliminary Hearing judgment made clear that Mr Rattan’s conduct as a practice owner is not being criticised in any way. However, it ruled that he is vicariously liable for the self-employed associate dentists working at his former practice, and that he owed Mrs Hughes a non-delegable duty of care when she attended his practice for dental treatment.

Mr Rattan, who is also Dental Director at Dental Protection, took the decision to fight this case in the High Court as a matter of principle given the potential repercussions for the dental profession.

Dental Protection recently extended its benefits for current and new practice principal members to include additional protection against vicarious liability and/or non-delegable duty of care claims relating to treatment provided by self-employed, contracted dental practitioners. But it said it would continue to challenge the principle of these often-unnecessary claims.

Geoff Jones, Executive Director, Member Protection and Support at Dental Protection, said: “We have supported Raj Rattan in fighting this case both for himself and for his fellow practice owners. Its potential impact cannot be understated and we will continue to support him in an appeal.

“The self-employed dentists who were involved in the patient’s care were willing to respond to the claim, but DLP and their client refused to engage with them. Mrs Hughes had nothing to gain by refusing to engage with the treating dentists and pursuing Mr Rattan personally. 

“Sadly, there seems to be a growing trend in DLP pursuing claims like this against the practice owner rather than the self-employed dentists who provided the treatment and against whom negligence is alleged. It is disappointing as they cause real distress for the practice owner and pose a risk to the long-established arrangements that exist between practice owners and their associates.

“We remain committed to fighting the principle of these often-unnecessary claims on behalf of members and the wider profession, but we also want to reassure practice principal members that they can request assistance from Dental Protection with these types of claims and are as protected as they can be in a rapidly changing dental landscape.”

Dental Protection: Government reform to dental regulation must be meaningful and timely

Dental Protection has called on the Government to make meaningful reform to the regulation of dental professionals, ensuring the nuances of the practice of dentistry are adequately accounted for in any reforms undertaken.

The comments were made in response to DHSC’s consultation: ‘Regulating healthcare professionals, protecting the public’, which covers all regulated professions.

As well as granting the GDC discretion on when to investigate fitness to practise concerns, the dental defence organisation called for reforms to the 1984 Dentists Act as a matter of priority. Dental Protection is urging the Government to clarify the timetable for GDC legislative reform. Currently, only reform of the medical regulator has been confirmed to take effect by spring 2022.

Dental Director, Raj Rattan, said: “Dental Protection has long argued for reform to the regulation that underpins the GDC. Vital changes to the 1984 Dentists Act, which governs the GDC, are seriously overdue. Despite several amendments over the years, the Act remains outdated, requiring the regulator to conduct some of its operations in ways that are not always in the best interests of patients or professionals.

“Much needed reform will enable the regulator to streamline its processes, improve efficiency, and reduce the number of investigations into less serious allegations, requiring the conclusion of investigations in a timely manner.

“Following this consultation, we would urge the government to clarify the timescales for passing secondary legislation to amend the Dentists Act.

“Dental Protection is particularly calling for reform to be prioritised in Fitness to Practise investigations, in order to reduce fear across the dental profession and increase confidence in the GDC. This includes giving the GDC discretion to decide whether and how to investigate a fitness to practise concern to avoid thousands of dental professionals going through an unnecessary investigation each year.

“We are also concerned at the proposal for the GDC to be provided with just two grounds for investigation – ‘lack of competence’ and ‘misconduct’, with the currently separate ground for action relating to ‘health’ removed from the legislation. Concerns relating to a dentist’s health would instead be investigated under ‘lack of competence’ grounds.

“At Dental Protection, we understand how stressful it is for dental professionals to be under investigation by the GDC and we believe that categorising those with health concerns as having a ‘lack of competence’ could exacerbate their health issues, and discourage registrants from seeking help earlier. We strongly believe health should be retained as a separate category.”

Dental Protection provides additional protection for practice principal members

Dental Protection has announced that it will extend its benefits for current and new practice principal members to include additional protection against vicarious liability and/or non-delegable duty of care claims relating to treatment provided by self-employed, contracted dental practitioners.

Dental Protection says there has been growing concern about these claims and that the dental claims environment is becoming ever more complex. As a member first organisation, it says it wants to ensure the protection it offers responds to the changing external challenges.

The additional layer of protection is included at no additional cost with effect from 1 June 2021 for current and new practice principal members who own, or have previously owned, up to three dental practices. Membership will be updated automatically. 

The enhanced protection enables these practice principal members to seek assistance with vicarious liability and/or non-delegable duty of care claims arising during both their future and past membership with Dental ProtectionMembers who own four or more practices can apply for an extension to their membership to include this additional protection.

Further details on the extended benefits for practice principal members can be found at:

Geoff Jones, Executive Director, Member Protection and Support, Dental Protectionsaid: “Sadly, there is a growing and unnecessary trend in some dental law firms pursuing claims against the practice owner rather than the self-employed dentists who provided the treatment and against whom negligence is allegedThis has resulted in practice owners feeling vulnerable.

“We are disappointed to see these claims being brought as they can cause real distress for the practice owner – they also pose a risk to the long-established dental practice model and the traditional arrangements that exist between practice owners and their associates.

The law requires that individual practitioners hold appropriate indemnity to ensure patients have access to compensation in the event of a successful claim. There is no legal requirement for practice owners to also hold indemnity for treatment carried out by other practitioners, the majority of whom work as independent contractors.

“Dental Protection exists to protect the careers, reputations and financial security of our members. We remain committed to challenging the principle of these often unnecessary claims on behalf of members and the wider profession, but we also want to reassure practice principal members that they can request assistance and are as protected as they can be in a changing dental landscape.”

Dental Protection welcomes vital report setting out commitment to equality, diversity and inclusion in dentistry

The ‘Equality, Diversity and Inclusion within Dentistry – a profession wide commitment’ report, released last week by the Diversity in Dentistry Action Group (DDAG), is highlighted by a commitment to collaborative action and shows the dental organisations that have pledged to some key principles for change, including actively committing to addressing racism and discrimination, exploring and developing opportunities for representation and inclusion, and organisational commitment to change at all levels.

Welcoming the report, Raj Rattan, Dental Director at Dental Protection and a member of the DDAG stakeholder group, said: “We welcome this vital report and are pleased it has been supported by a wide range of dental organisations. There is a duty on all of us in the dental profession to ensure we play our part in creating a culture of equality, diversity and inclusion.

“An ongoing commitment is needed if we are to reap the many benefits of cultural competence within the profession and reduce the risk of ethnocentricity. This can affect the patient experience and may also have a detrimental effect on treatment outcomes.

“We know that inclusivity lies at the heart of progress and at Dental Protection we are committed to taking active steps in this area – that’s why we have set up a Diversity and Inclusion forum within MPS to drive this forward, reflect on our own diversity and inclusion, and ensure we are providing the best possible support to all healthcare professionals.”

GDC pays damages to Dental Protection member

The General Dental Council (GDC) has paid an undisclosed sum of damages to a clinical dental technician after Dental Protection successfully secured an admission by the regulator to having acted ‘unlawfully in undertaking an under-guise operation without reasonable justification’.

Dental Protection defended the member, who had been the subject of an anonymous complaint to the GDC that he may be working without registration, and that his laboratory was in a bespoke setting in his home. The GDC instructed an under-guise operation creating a fictitious scenario with two private investigators posing as relatives of “Evelyn”, an elderly relative who needed dentures but was too ill to attend in person.

The Interim Orders Committee concluded that any evidence from the investigation was flawed and unfair, and the GDC Fitness to Practise Committee halted any further action on grounds of an abuse of process.

Dental Protection, instructing Lee Biddle of legal firm BLM, sought an order against the GDC to recover legal costs, which the GDC conceded in August last year.

Most recently, the GDC accepted a declaration by the court that it has acted unlawfully by undertaking an under-guise operation without reasonable justification. This is in breach of the clinical dental technician’s rights under Article 8 of the European Convention on Human Rights, the Data Protection Act 1998 and Data Protection Act 2018.

While the exact number of covert investigations undertaken by the GDC has not been established, a Freedom of Information request revealed that it spent a minimum of £15,416 on this in 2017 alone. 

Raj Rattan, Dental Director at Dental Protection, said: “The GDC targeting its own registrants without a sufficiently justified cause is extremely concerning for dentists. The use of an entirely contrived scenario about a sick pensioner in very difficult circumstances was designed to trigger an emotional response and lure a registrant into acting outside of their scope. This is hardly an ordinary opportunity for wrongdoing, and it is unfair and invasive.

“Throughout this case, the GDC asserted that under-guise investigations are essential to carry out its statutory function. However, in an unprecedented step, it has now admitted acting unlawfully when using under-guise investigations in this case and has agreed paying damages to our member. This has been a harrowing time for our member, and we hope that no one else needs to suffers in the same way.

“We have very strong concerns about the use of undercover investigators. Dental professionals should be able to be confident that any investigation into them is based on their real-life practice and interactions with others, and not on concocted situations with operatives actively seeking to gather evidence that could be used against them. I am pleased that we were able to go above and beyond in supporting our members, using our discretion to provide additional assistance and successfully securing financial damages”.

GDC response

Responding to a question about the use of ‘undercover’ investigations in fitness to practise, General Dental Council Executive Director, Fitness to Practise, John Cullinane, said: “The General Dental Council has used undercover investigators in fitness to practise cases extremely rarely. Where there is potential risk to the public, and where there is no other way to investigate a specific allegation that has been made, we will consider use of undercover approaches. A robust process is in place to assess risk to public health, safety and wellbeing, which is designed to balance public protection with the rights of the individuals concerned. We take this responsibility extremely seriously.”

The GDC has previously disclosed how it uses undercover investigators here, and has reportedly not used any since 2019.

Dental Protection: Uncertain timetable for GDC reform is disappointing

Dental Protection has welcomed the arrival of a long-awaited consultation on reforming the healthcare regulators, but fears reforms to the GDC will not be prioritised in the legislative timetable.

The comments follow the publication of a new consultation – Regulating healthcare professionals, protecting the public  which sets out detailed proposals for legislative changes that will apply to all the regulators. Following the consultation, draft legislation will be bought forward to implement these changes in relation to the GMC, and these will come into force in spring 2022 – but only then will the Government bring forward legislation to implement the changes for the other regulators. It has not been decided which regulators will be next to receive legislative reform after the GMC.

Dental Protection is calling on the Government to ensure that ‘long overdue reforms’ to the GDC – particularly to its fitness to practise function – are prioritised, and provide greater clarity on the legislative timetable beyond spring 2022.

Dental Director, Raj Rattan, said: “The GDC continues to be governed by the 1984 Dentists Act which, despite several amendments over the years, is outdated. The Act requires the GDC to conduct some of its operations in ways that are outmoded and not always in the best interest of patients or professionals.

“Dental Protection has long argued for reforms to the Act to enable the regulator to streamline its processes to improve efficiency, reduce the number of investigations into less serious allegations, and to require the GDC to conclude investigations in a timely manner.

“We welcome the arrival of this long-awaited consultation, and will be considering the details carefully and providing feedback with the aim of ensuring these reforms lead to tangible improvements for members.

“It will however be some time before any legislative changes come into effect for the GDC – even if the GDC was to be next in line after the GMC. This is disappointing.

“We have a real opportunity to improve the GDC’s Fitness to Practise function, but reform needs to be progressed as a priority. We hope the Government will soon provide greater certainty on this, through a more detailed legislative timetable.”

Government reforms of GDC are too slow and going in wrong direction, says Dental Protection

Responding to a Government White Paper published today, Dental Protection has called on the Government to get on with reforming the General Dental Council’s Fitness to Practise processes, and shelve plans that could see dental professionals under some form of ‘super regulator’.

In recent years the Government has consulted on reducing the nine health professional regulators down to three or four, a move which many expected would lead to the abolition of the GDC in its current form and dental professionals being regulated alongside many other health professions by the same body.

The White Paper says the Government plans to remove the need for a Bill to be introduced to Parliament each time it wants to abolish a regulator. Instead, under the proposals, the Government would be able to abolish the GDC or other regulators – as well as add or remove whole professions from regulation – by using secondary legislation, which can be passed more quickly and with less scrutiny by Parliament.

The White Paper also states that other proposals will be taken forward separately that aim to ensure regulators’ processes are proportionate and not overly bureaucratic. Details of these wider proposals are not however, set out in the paper.

Dental Protection has urged the Government to focus on introducing reforms that would improve how dental professionals are regulated, rather than an amalgamation exercise which could result in a lack of expertise, familiarity and understanding of the distinct professions, in those responsible for the regulation.

Dental Director, Raj Rattan, said: “The GDC continues to be governed by the 1984 Dentists Act which, despite several amendments over the years, is outdated. The Act requires the GDC to conduct some of its operations in ways that are outmoded and not always in the best interest of patients or professionals.

“Dental Protection has long argued for reforms to the Act to enable the regulator to streamline its processes to improve efficiency, reduce the number of investigations into less serious allegations, and to require the GDC to conclude investigations in a timely manner.

“There is now a real opportunity to improve the GDC’s Fitness to Practise function and ensure the regulator follows a fair process in which patients, dentists and the governments of the UK can have confidence.

“The creation of a ‘super regulator’ or a similar large-scale amalgamation could result in an organisation that does not have expertise and understanding of the distinct professions. There is a strong case for the GDC to remain the regulator for dentists and dental care professionals. All registrants carry responsibility for the care and treatment of patients within a clinical setting and, consequently, require a regulator with experience, expertise and a contextual understanding of everyday dental practice.”

Dental Protection and Chairsyde announce partnership as dentists say technology access is barrier to teledentistry

Dental Protection has announced an exciting new partnership with Chairsyde, a system which helps dental professionals consult with patients interactively. 

Developed by dentists, for dentists, it is designed to educate patients about their oral health both virtually through teledentistry and alongside supporting face-to-face discussions in practice. It offers visual aids that can be annotated to explain diagnosis and treatment plans, and enables patients to log in and view their treatment plan, replay the animations linked to their consultation, and contact their dentist directly to ask questions.

Chairsyde records the patient journey right from their first consultation and includes date stamped evidence of visuals shown and information communicated to patient’s as part of the consent process.

The innovative partnership comes as a Dental Protection survey of nearly 200 UK dental professionals found that the majority of dentists have been using teledentistry, with 88% believing the changes would continue beyond Covid-19. However, technology was a barrier for many, with 62% finding that their patients do not have access to the technology. 48% of the dental professionals surveyed were also unsure if they were protected for virtual consultations.

The partnership will provide Dental Protection Xtra members with access to the Chairsyde  platform at no additional charge, as part of their package. Dental Protection members who work at a Dental Protection Xtra practice are also eligible for a Chairsyde license at no additional cost.

Dental Protection Director, Raj Rattan, said: “Teledentistry is not a new concept, there is evidence of remote dental consultations taking place as early as 1994, treating soldiers all over the world. However, it is gaining traction as it provides an innovative solution to support dental practices and their patients during Covid-19, as well as beyond. Indeed, 88% of members say they want the changes they have made to their practice in relation to telemedicine to continue beyond the pandemic.

“Dentists tell us however, that the main barrier to them undertaking teledentistry is that patients do not have access to the technology. We want to support members and respond to the challenges they face now, and beyond the pandemic I believe this innovative partnership with Chairsyde will help members navigate the rapid change Covid-19 has presented, by providing a secure and accessible way to conduct virtual consultations. 

“Members are not charged any additional subscription for using Chairsyde, or indeed another remote consulting platform, to assist in the provision of remote care and advice to their dental patients within the UK.  Members will be able to request assistance for any matters arising from this work.

“Chairsyde are a fitting partner for Dental Protection as we hold many of the same values; we are both run by dentists for dentists, and we are both working to support dentists in managing their risk of cases, claims, and complaints whilst fighting to reduce the cost of indemnity.

“Chairsyde has many applications and its content and design helps to address many aspects of patient communication, consent, record keeping and clinical risk management. A lot of dentolegal cases identify shortcomings in one or more of these areas. The functionality of the platform should significantly drive down the risks associated with these shortcomings.”

Loven Ganeswaran, Dentist and Founder at Chairsyde, added: “We’re delighted to announce this exciting and innovative partnership with leaders in indemnity, Dental Protection, to help our community of dentists by reducing stress and mitigating risk associated with claims through our unique and interactive smart technology.

“As a member myself, it is inspiring to see the measures Dental Protection have taken to keep their community of dentists safe.

“Our joint mission, to protect dentists and ignite practice growth whilst transforming patient health is an exciting proposition that will not only have a positive impact on daily practice but will also help shape the future of dental consultations for the better.”

For  more on how Chairsyde can support you and your practice visit

Dental Protection urges Government to support dental professionals struggling with impact of Covid-19 pandemic

Dental Protection has called for a number of specific measures to help ensure that dental professionals are well supported following the impact of Covid-19, and that dental patients have access to safe treatment.

In a briefing for yesterday’s Commons Debate on the effect of Covid-19 on dental services, Dental Protection said dentistry has been deeply affected during the pandemic, with patients and dental professionals suffering from significant restrictions on access to dental treatment. It has identified five main areas where action is needed to support dental professionals:

  • Wellbeing: Government policies relating to dentistry must recognise and reflect the significant challenges that dental professionals have faced and continue to face.
  • Complaints: Dental Protection has previously called on the GDC to consider guidance for its staff detailing how to take the context of Covid-19 into account when considering complaints. We are pleased that the GDC has responded to our request for more detailed guidance and yesterday published its contextual advice to Case Examiners on reviewing cases arising during the pandemic. 
  • Inappropriate measures of dental activity: Although units of dental activity (UDAs)  for practices in England have been reduced in the fourth quarter of the contracting to reflect the current working protocols,  they do not sit comfortably within the wider Government strategy to control the spread of Covid-19 and place dentists and their teams under added and unnecessary financial pressures. Dental professionals should remain focussed on treating patients according to clinical need in a safe environment and nothing should distract them from this in these challenging times. Dental Protection is urging the Department of Health and Social Care (DHSC) to reconsider recent requirement to impose UDA targets.
  • Protecting dental professionals from the virus: We welcome the NHS announcement that Covid-19 vaccines will be rolled out to dental professionals as a priority and would like to see the details of the strategy to accelerate vaccine delivery.
  • Antibiotics and remote consultations: During the pandemic we have seen a worrying rise in antibiotic prescribing, arising from the restrictions imposed during 2020 when practices were forced to close and apply a triage-based model of care. The limitations of the so-called triple A approach (advice, antibiotics where appropriate and analgesics) increased the likelihood of inappropriate prescribing because dentists in practices were not able to undertake clinical procedures for many reasons including the availability of appropriate PPE at the time. Urgent care should be prioritised and dentists should be able to assess treatment need on clinical grounds alone and not be influenced by output measures.

Raj Rattan, Dental Director at Dental Protection, said: “We are pleased that MPs have debated this important issue. Dentists have faced a range of challenges throughout the pandemic, and many have returned to practise in equally demanding circumstances. Despite this, dental professionals always put the interests of their patients first, and have remained committed to providing high standards of care throughout the Covid-19 pandemic.

“We have highlighted some specific measures we believe could be taken now to help ensure dental professionals are well supported and are able to continue to provide necessary treatment and care for their patients. It is important that government policies and intentions recognise and reflect the immediate needs of patients including the most vulnerable groups, the significant challenges facing dental professional and the need to ensure financial stability to protect the longevity and quality of this essential healthcare service.”

Dental Protection and BADT announce partnership

Dental Protection and the British Association of Dental Therapists have announced a partnership, including a 15% discount for BADT members on their Dental Protection subscription.

Dental Protection and BADT have partnered to offer support to dental therapists and hygienists, many of whom have returned to practise, despite significant challenges including new ways of working, and a significant backlog of patients as routine treatment resumes.

The British Association of Dental Therapists (BADT) was established in 1962, and its first annual general meeting included discussions about protection against personal risk— what is now provided by professional indemnity.  BADT is still run by working dental therapists and hygienists to represent its members. Their work includes raising awareness of members, skills and assets, as well as advising on national policy. 

Dr Raj Rattan MBE, Dental Director at Dental Protection, said: “I am delighted that Dental Protection will be offering a generous discount to members of the BADT. It is a reflection of the value we place on this partnership. It also emphasises the importance of teamwork in clinical practice today and in the future. We look forward to developing some joint initiatives to further support members of the BADT.”

Debbie McGovern, President of the British Association of Dental Therapists, said: “The BADT is extremely happy to be working with Dental Protection to bring discounts to their members. Dental Protection, as part of the Medical Protection Society, were the first organisation to provide access to indemnity to dental therapists, so it is particularly fitting that we have now formed this valuable professional relationship. We look forward to working together to support our members.”