The GDC's Annual Report 2018 shows that the number of concerns it received was down by 14% from the previous year, and was almost half the number of over 3,000 received in 2014. There are a variety of reasons for this reduction, including that the GDC website better explains its role of public protection and, most importantly, clarifies those things that are better dealt with elsewhere – such as patient complaints, claims in negligence and requests for refunds.
Of concern, however, is a significant increase in the percentage of new GDC cases where the informant is another registrant. In 2016 these made up 6% of the total, in 2017 9% and in 2018 it was 10%.
It may of course simply be that as the number of cases notified by the public declines, those notified by dental professionals becomes a larger proportion of the overall number. Notwithstanding this, the numbers are significant, and anything we can usefully do to deal with the issues giving rise to these cases without involving the regulator, while still maintaining public safety, will reduce the current human and financial costs to the profession.
Principle 8 of the GDC's Standards for the Dental Team sets out registrants' duty to raise concerns if patients are at risk. It is important to be aware that wherever possible the issues should first be raised at a local level, with referrals to the GDC itself being appropriate only where action at a local level is impractical, has failed, or the issue is so severe that a direct referral to the GDC is indicated.
Colleagues are understandably anxious to be sure that they have discharged their duty in this regard, but it is important to be proportionate and to seek the advice of their defence organisation before taking any such action.
It is not uncommon for claims reported to the DDU to have arisen following criticism of one registrant by another. When I was a young dental student back in the early 1980s, I was taught never to criticise the work of a colleague, as one could not be sure of the circumstances under which the treatment was provided.
In my view, notwithstanding the duty to raise concerns as set out in Principle 8 above, this remains as important today as it was then. Colleagues should explain their clinical findings to patients in clear terms, and answer any questions honestly, but subjective and inflammatory comments about others' work or treatment should be avoided.
The regulator is not the correct forum to pursue business and contractual disputes, and the threat of a GDC referral and the encouragement of patient complaints are not appropriate means of achieving leverage in such disputes.
Such a course of action can backfire and often ends in tears for all those involved. It is disappointing to have to report that we are seeing an increasing number of cases where this has happened. And because, by definition, those raising such concerns have a knowledge of dentistry, these cases are often the most protracted, costly and distressing for those who become embroiled in them.
Colleagues should explain their clinical findings to patients in clear terms, and answer any questions honestly, but subjective and inflammatory comments about others' work or treatment should be avoided.
We would hope that as professionals within our 'community of practice', we would as a matter of course treat each other fairly. However, as GDC Standard 9.1.1 expressly requires that registrants must treat colleagues 'fairly, and with dignity', and states at 6.1.3 that, 'You must treat colleagues fairly in all financial transactions', this is not optional.
To reduce the risks of personal, financial and business matters spilling over to involve patients or third parties such as NHS commissioners or the GDC, colleagues would be well advised to have robust and equitable arrangements, such as associate and partnership agreements, in place from the outset. These can then be relied upon when, for whatever reason, one or all of the parties moves on.
With this in mind we have recently introduced an additional service whereby DDU members can seek our advice on the wording of associate contracts. Elsewhere within this issue, my colleagues David Lauder and Rupert Hoppenbrouwers discuss some of the key issues that have come to light during this work.
Our template associate contract was developed in association with Hempson's solicitors, and Faisal Dhalla, a partner at Hempsons with a particular interest and expertise in the commercial side of dentistry, has contributed an article on the contractual aspects of buying and selling a dental practice. I hope you will find both these pieces interesting and informative.
Head of the DDU
John Makin BDS PgDL PgCDE FHEA is head of the DDU. He qualified in Manchester in 1983 and has worked as a general dental practitioner in Lancashire and Devon before joining the DDU as a dento-legal adviser. He was involved with foundation training for many years as both a trainer and VT adviser/training programme director with the Manchester and Exeter DFT schemes.
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