GDC fitness to practise hearings

The concerns can come from any source, including members of the public, employers, other regulatory bodies, the police and patients, and they generally fall into four categories:

• Misconduct — that could relate to allegations such as the incorrect claiming of UDAs from the NHS or the manner in which the practice is run;
• Performance or capability concerns — for example, a patient complaining about the treatment they received, concerns expressed by colleagues or issues reported by an NHS body;
• Health problems — there are occasions when the health of the dentist affects their ability to practice, which may include problems with alcohol or substance abuse; and
• Convictions and cautions — outcomes from criminal processes will generally be referred to a Conduct Committee hearing to maintain the public confidence in the professional and to maintain and declare professional standards.

We are experts in defending dentists who are involved in GDC investigations — our highly experienced professional regulatory team have decades of experience of defending dentists who are confronted with a GDC investigation. Our team of legal experts in healthcare law are nationally known for our specific expertise in this area, and we are recognised as a top tier team of experts in the Legal 500 and Chambers directories.

We have unrivalled experience acting for dentists who are referred to an Interim Orders Committee and given a hearing date by Dental Hearings or those who have been referred to a final hearing before one of the GDC Committees.

Our expert knowledge of the NHS dental contract and the manner in which it is applied, the business of dentistry and orthodontics, both in the NHS and in private practice and the law that governs the practice of dentistry means that we can provide holistic advice about any allegations that the General Dental Council is investigating.

Over the decades we have specialised in this area of the law, our expert defence lawyers have acted for practice owners, associates and employed dentists, including a leading claim relating to the non-delegable duty of care owed by practice owners to patients treated by associates.

What is the role of the GDC?

The overarching purpose of the GDC is to protect the public and to uphold the public interest. The public interest includes maintaining the reputation of the professional as well as upholding and declaring proper standards of conduct as set out in the GDC’s standards. Dentists are expected to abide by those standards in return for the privilege of practising their profession. Where concerns arise that a dentist may not be adhering to the required standards, the Council has legal powers to investigate and take action where necessary.

The GDC investigation process

GDC fitness to practise investigations can be deeply worrying and can often take a long time. If handled appropriately, most will close without referral to a hearing. Your first awareness of the complaint or concern will usually be a Rule 2 letter from the GDC asking you to provide information to inform its initial consideration of the concern they have received. In 2020, the most recent year of published figures, 81% of cases went through to the assessment process, which is when the GDC investigates the concerns that have been raised.

At this early stage of the investigation, it is possible that your case will be referred to an interim orders committee hearing, which will be undertaken by Dental Hearings. At an interim order hearing, the committee will not make any findings of fact (that is who is right and who is wrong). Rather it undertakes a risk assessment of allowing the dentist to continue in unrestricted practise. The Committee can take no action, impose interim conditions or suspend your name from the Register.

It is important to seek prompt advice as the very nature of these hearings means that they take place with little notice, whilst the outcome of the hearing can have a significant effect on the dentist and their dependants.

An interim order will usually remain in place until the case is concluded, with review hearings taking place at least every six months.

At the conclusion of a GDC fitness to practise investigation, the case will either be closed, or the GDC will disclose the information it has gathered about the concerns along with draft allegations setting out the basis on which it is alleged that the dentist’s fitness to practise is currently impaired — this is called the Rule 4 stage.

The dentist will be invited to respond to the draft allegations and bundle of documents, although the dentist does not have to comment at this stage. This is a key point in the case, as the content and tone of any response can make all the difference to the outcome. For example, in 2020, some 54% of cases were referred to the Case Examiners for a decision, but only 15% of the cases were referred to a fitness to practise hearing. Our team of expert lawyers can use our experience to help you provide a response that addresses the issues in a way that enhances the prospects of a good outcome.

The GDC material and any response from the dentist will be referred to the Case Examiners, who are the key decision makers who will determine whether the case will be referred to a hearing, if some other steps should be taken that are short of a referral to a hearing, such as a warning, advice or undertakings, or if the case will be closed with no further action.

GDC fitness to practise hearings

If a referral to a GDC fitness to practise committee hearing is made, then a hearing date and a timetable of case management directions will be set at a preliminary meeting.

We have represented dentists in GDC hearings in relation to allegations such as alleged dishonesty, concerns about the dentist’s health, where the quality of the treatment provided to patients has been criticised and alleged behaviour that may damage the public trust in the profession.

A GDC fitness to practise hearing takes place before a committee made up of lay members and dentally-qualified members. The GDC’s case will be presented by a lawyer and the registrant is also entitled to legal representation.

The regulator will present its case to the committee with reference to the documentary and oral evidence the Council has gathered. The burden of proving the case against the practitioner rests with the Council.

Having considered the evidence and submissions, separate decisions are reached covering factual findings, whether a registrant’s fitness to practise is impaired, and if so what, if any, sanction to impose. The possible outcomes of a hearing are:

• No further action;
• Issue a reprimand;
• Give a warning — where there has been serious misconduct found but no impairment of fitness to practise;
• Impose conditions that restrict the dentist’s practice and a period of monitoring. A review hearing will usually be listed towards the end of the period of conditions at which compliance with the conditions, and progress towards remediation is assessed. Non-compliance with the restrictions may result in a further investigation in some cases, and even a minor breach of the conditions may have to be explained;
• Suspension for up to 12 months — a dentist who is suspended from the register will be prevented from practising. That may result in loss of employment, loss of income and reputational damage. A suspended practitioner will usually be required to attend a review hearing towards the end of the suspension period when an assessment will be made of whether they have shown insight, complied with the conditions and are fit to practise and therefore to be returned to the register;
• Erasure — the most serious sanction that can be imposed. Erasure removes a practitioner’s name from the register altogether and is reserved for the most serious of issues, such as dishonesty, serious misconduct and conduct fundamentally incompatible with professional registration. In considering erasure, the committee will prioritise the interests of the profession, patients and the public over the interests of the individual dentist. Although the Committee must act proportionately, in our experience, little weight is given to the obvious personal consequences erasure will have for a dentist who has been erased and their dependents.

GDC fitness to practise investigations can have very serious consequences for practitioners but, if handled carefully and sensitively, a hearing can often be avoided and a satisfactory outcome achieved.

We are industry-recognised experts in advising dentists throughout GDC fitness to practise investigations and hearings. Our team is Tier 1 ranked in both the UK legal directories and we know the GDC, how they think and how they react to information and submissions provided at each point in the process.

Our experienced lawyers know what approaches are most likely to be effective, and we deploy that knowledge and experience to our clients’ advantage throughout a GDC fitness to practise investigation. We are ready to present a robust defence, but also know when demonstrating insight and remediation may be the best means of bringing an investigation to a swift and satisfactory conclusion.

Taking early expert advice is crucial, as an early intervention can make the difference between a short process and a protracted one, with the personal and financial impacts that entails.