If something goes wrong when treating a patient, dental professionals can rightly expect scrutiny of what happened, and most will take responsibility. But what if you know you did nothing wrong and the allegations were unfounded?
This is the situation one DDU member found herself in after an unblemished 35-year professional career, which had included a long-standing practice partnership, being a training programme director for HEE and then a clinical adviser for NHS England. Although all the allegations against her were eventually dismissed, the member was subjected to a protracted three-year investigation process that left her "in a cold, dark and lonely place."
The member's ordeal began when she took over an established high street NHS dental practice when relocating to be closer to her elderly parents. She agreed that the former practice principal could stay on for three years, believing this would provide a sense of stability and continuity for existing staff. But this was a decision she would quickly come to regret.
"When I bought the practice, I knew that there was a lot of work needed to reach the standard the CQC would expect," she says. "I recruited an experienced practice manager and we both went in and tried to reassure everyone. But from the get-go, the animosity was like nothing I had experienced in my life."
Despite her best efforts to build a collegiate and supportive environment, our member faced daily microaggressions, rolled eyes and derogatory comments when changes to the practice were announced.
The former principal would go into huddles with the staff they had employed, excluding new members of the team, and our member remembers returning to the surgery unexpectedly to find one of the dentists looking through clinical notes of patients she had treated. A few months after two of her four associates left, the remaining two handed in their notice at the same time, which inevitably caused the maximum amount of disruption to the practice.
As well as this, there were further attempts to undermine our member's professional reputation. A few months after she had taken on the practice, and before she had been able to get the necessary systems in place, CQC inspectors visited the practice after concerns were raised. A follow-up inspection a few months later found the practice fully compliant, but by this point the member had been notified of another complaint, this time to NHS England. She was asked to step back from her role as a clinical adviser until the allegations - which concerned multiple contractual and clinical issues - could be investigated.
"I was angry and upset, but I decided it was going to be business because I was a professional and wasn't going to stoop to that level. In January 2020, I increased my clinical hours and employed two new associates, but then COVID put a stop to everything for three months."
I'd been accused of everything but the kitchen sink, but after going through 1,000 documents over three months, they found no evidence for any of the allegations.
On her return, she put all her energy into turning things around at the practice with the help of her practice manager. "We started to recruit our own staff and we've gone from a rundown four-surgery practice to a thriving eight-surgery practice with four dentists and two full-time therapists that receives amazing feedback from patients."
And yet nearly 18 months on, she still didn't know where she stood with the NHSE complaint. "I felt left in the wilderness, " she says, "and it has been like pulling teeth to get any information." In an effort to break the silence, the member contacted first the Advisory, Conciliation and Arbitration Service (ACAS) and then the BDA and the DDU, who assisted with the contractual and clinical performance strands of the complaint in tandem.
Then, two years after the member had been informed of the allegations, the NHSE Local Area Team suddenly requested 120 of her patient records for review. "To scrutinise that many records at once is unheard of," she comments. "I'd been accused of everything but the kitchen sink, from making fraudulent NHS claims to failing to make the right diagnosis, but after going through 1,000 documents over three months, they found no evidence for any of the allegations. That was what my DDU adviser had predicted and reaffirmed what I knew all along, but of course that didn't make the process any easier."
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Even after passing this test, the member's case still had to be considered by Performance Advisory Group (PAG), in line with current NHSE performers' list procedures. She credits her DDU adviser with helping her prepare her response. "The adviser's help was invaluable," she says. "I knew what they would be looking for, but it was key to have another pair of eyes because I think my anger and frustration were probably coming through. This was the first time I had needed the DDU for anything more than dento-legal advice since I joined in my final year at dental school and I had really fantastic support."
In summer 2022, the member's case was finally considered by the PAG, which closed the file with no further action, commenting that "this appeared to be a vexatious whistleblowing complaint" and there "was no evidence to support the allegations made."
She recalls: "I knew they were meeting at 10 and about midday I heard a ping to signal an email, but I had to wait until I had finished that morning's patient list. My feelings were a mix of relief, vindication and frustration that it had taken so long."
While the cloud has lifted and her practice is a far happier workplace, she remains upset by the protracted investigation and the way it was conducted. "There were sleepless nights and in my darkest moment I did consider taking my own life," she reveals. "When you are in this situation self-doubt starts to creep in. I knew the allegations were concocted but there are days when your mind plays tricks on you and you think, 'Is this it?'"
"I did tell my practice manager, but the hardest part was that for a long time I felt I couldn't share what I was going through with anyone else," she continues. "Because of COVID, the only people I saw for months and months were at the practice. My parents are elderly so what could I say to them that wasn't going to cause them anguish? And I was afraid that if I told someone they might say I had failed in my communication or would ask how I could have let it get to this stage."
Eventually it became too much, and the member broke down in front of her daughter. "It was coming up to her birthday and she said to me, 'What's wrong, mum? You just haven't been yourself lately.' I think I cried for the first time and told her what had happened. She was livid with me for trying to live with it on my own, and on reflection, it's one thing I should have done differently," she remembers.
The hardest part was that for a long time I felt I couldn't share what I was going through...I was afraid that if I told someone they might say I had failed in my communication or would ask how I could have let it get to this stage.
While she has been completely exonerated on all counts, the member says she doesn't want one other person to go through a similar experience. "In many ways I was lucky," she reflects. "If this had to happen, at least I was at a point in my career when I had gained enough knowledge and experience to get out of a hole and I could call on the BDA and DDU. But imagine you don't have access to that expertise? Where would you be?
"My focus now is to help other dental professionals who find themselves in this kind of situation because it happens more than we might think, judging by the forums and the clogged GDC and NHSE complaints procedures. Just recently I was in contact with a young dentist who had been reported to the GDC by another member of the dental team in their first few days in the job.
"Of course, everyone in healthcare has a right to make a complaint and if a patient has been harmed or something has gone wrong during treatment, I'd be the first to agree that we need to be accountable for that. But if a dental professional makes malicious or trivial allegations against a colleague, they need to take a long, hard look at themselves. And I believe there should be consequences if a dental professional is proven to have made a vexatious complaint. Dentistry is already on a slippery slope and we are finished if we practice in fear of our own colleagues."
Interview by Susan Field.
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