MDDUS dental adviser Sarah Harford shares her golden rules for responding to a GDC investigation.
GDC – three letters that make many a dentist nervous. An unexpected envelope or email from our regulator can generate a feeling of impending doom.
We dutifully pay the ARF each year, with the understanding that it is the General Dental Council’s role to regulate the profession and protect patients.
On its website, the GDC states: ‘If there are concerns that shortcomings in a dental professional’s conduct or competence are so great as to put patients at serious risk, or seriously damage public confidence in dentistry, we will investigate.’
Fortunately, MDDUS is here to guide our members through the GDC’s initial assessment and investigatory process. We urge you to contact us without delay if you receive a letter or email from the regulator.
Most importantly, you should keep calm and not panic. The last thing you want to do is act in haste and potentially damage your chances of a favourable outcome.
We often see dentists make the same mistakes in those early days after they’ve been notified of an investigation. Below are some golden rules to remember.
Clear complaints process
Patients often send a complaint directly to the GDC, without telling their dentist. This is often because they’re unaware of the practice complaints process.
It is wise to ensure all your patients know how to raise any concerns directly with your team.
Don’t ignore it
The first step in an initial assessment is usually a written request from a GDC case worker.
The letter, which you might receive by email and/or post, generally begins: ‘We are writing to ask you to provide us with some information. This will help us in the early stages of considering a concern we have received about you.’
At this point, call your indemnifier for advice. The proverbial ‘head in the sand’ technique really won’t help anyone at this stage.
The GDC is seeking some specific information from you, by a deadline. This usually includes your employment details, proof of indemnity and, depending on the nature of the concern raised, possibly patient records.
Resist an angry response
Receiving a notice like this is a shock. It is hugely important that you resist the temptation to make any comment to the GDC on the concern raised at this initial assessment phase. Dashing off a furious: ‘How dare you accuse me’ email, or even a lengthy warts-and-all account of everything that ‘went wrong’ is very damaging to your case and is difficult to row back from later.
Indeed, it is preferable to conduct all correspondence (even a simple acknowledgement) via your MDDUS representative; that is, after all, why you pay your subscription.
Don’t badger the complainant
You will gain nothing from contacting the complainant. Once the GDC has sight of the concern, it will continue to investigate it if warranted. Even if the complainant tries to retract their concerns.
A last-minute change of heart to suddenly offer a refund to the patient, once it is evident that the GDC has become involved, could be perceived as an attempt to ‘buy them off’.
Conversely, you should not receive continued correspondence about a case from a patient who has already involved the GDC.
In such circumstances, MDDUS can help you prepare a letter to explain that it is not appropriate for you to correspond with the patient directly while the GDC initial assessment or investigation is ongoing. And that you will respond either during the course of that process or once it is complete.
Be cautious when sharing with the NHS
If you work under an NHS contract, the GDC will likely communicate with your NHS area team or health board regarding the concern raised.
If your area team or health board contact you for comment at this early stage, please do not respond without first seeking advice from your indemnifier.
Keep in mind that any information you share with the NHS could also be sent to the GDC. If the wording of your comment is not carefully considered, this risks compromising your GDC case.
Do not amend the clinical records
It is tempting to ‘tidy up’ or somehow alter clinical records before sending the requested copy to the GDC. It is extremely important that you do not do this.
When under the spotlight, we will always wish we had written a clinical note in a slightly different way. But you will put yourself in a far worse position if the GDC determines you amended the records retrospectively.
We can often address a simple criticism of your record keeping by completion of targeted CPD. But a retrospective amendment of records can lead to an allegation that your behaviour was ‘misleading’ and/or ‘dishonest’.
This can transform an investigation from one that might otherwise be closed at the case examiner stage to instead being referred to a full professional conduct committee hearing, with an adverse outcome such as suspension or erasure from the register being a significant possibility.
If you feel that there is information missing from the notes that may assist the GDC’s investigation, MDDUS can submit a letter detailing this information on your behalf. Together with an appropriate explanation as to why it was not included in the clinical record at the relevant time.
Wait before offering your side of the story
The GDC and MDDUS will tell you if and when they are seeking your side of the story. This is usually only if your case progresses to a formal investigation and is referred for consideration by case examiners.
At this next stage, the GDC will request your ‘observations’. MDDUS can help you draft your carefully worded response.
Target your CPD
The time taken for the GDC to perform its initial assessment can vary depending on the nature of the case and its administrative processes.
MDDUS advises its members to make use of this time (and their nervous energy). Target their professional development to any areas relevant to the case.
Even if the case does not progress, there is nothing to lose ensuring that your PDP and CPD records are up to date.
While the prospect of a GDC investigation is daunting, bear in mind that almost a third of cases (29%) are closed by the regulator before the dentist is even notified because they do not meet the threshold for initial assessment.
In 2019, more than half of cases (59%) were closed with no further action, advice or a warning. Or in a few cases by agreeing formal undertakings with the registrant.
Of all the cases considered by the GDC at the various stages, only 15% end up going to a full hearing. This includes cases relating to all types of concerns about a registrant’s fitness to practise, not just clinical concerns.
There is a possibility that at some point in our career, the GDC will contact you about a concern.
Don’t panic or ignore it. Instead let us guide you through the process and help you achieve the best possible outcome.
To find out more on how MDDUS can protect you, please click here.
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