GDC to introduce case examiners as part of fitness to practise reforms

From 1 November 2016, the GDC is introducing several important reforms to its fitness to practise (FTP) procedures that are intended to make them less protracted and more proportionate.

This is encouraging news. The DDU actively supported the GDC's efforts to reform its FTP procedures and has contributed in detail to its consultations. Additionally, well over 100 members also made their voice heard by joining our campaign. 

The reforms mean that many concerns can be addressed earlier in the process, without dental professionals being subject to a stressful and costly FTP Committee hearing.

Here is a brief overview of some of the GDC's reforms:

GDC NHS concerns handling

Low level concerns about dental professionals that do not significantly affect their fitness to practise can be addressed by the NHS or through the complaints process, rather than through a GDC investigation.

This means the GDC can focus its efforts on serious allegations of malpractice or poor performance where there is a risk of harm to patients. The new process has already been tested during a successful year-long pilot which ran until February 2016.

The GDC's triage team will be able to refer low level concerns about a dental professional to the NHS if they fall into one or more of the referral criteria. These might include single, isolated incidents, evidence of poor record keeping or failure to explain dental charges. 

The GDC will tell the informant the GDC is taking no further action and will be closing the case but the concerns they have highlighted have been referred to the NHS regional team.

The dental professional concerned will be required to cooperate with local NHS performance procedures and respond professionally to any patient complaint.

Case examiners

Case examiners will decide how a case should proceed following an investigation. The GDC currently has 14 case examiners listed on its website. In each case, two (one lay and one a dental professional) will review all relevant evidence in each case and consider:

  1. whether there is a real prospect of the facts, as alleged, being found proved, and if so,
  2. whether or not there is a real prospect of the statutory ground being established (eg misconduct), and if so,
  3. whether or not there is a real prospect of a finding of current impairment being made.

Cases will be referred to one of the three practice committees if there is a genuine possibility of establishing that the registrant's fitness to practise is currently impaired and the issues cannot be addressed by the undertakings set out below. 

Cases can be referred to the interim orders committee for it to consider whether a dental professional's registration should be suspended or made subject to conditions while an investigation is ongoing.

The case examiners also have the power to adjourn the case for further information. Most significantly, they can close the case with the following outcomes:

  • close the case and take no further action
  • issue a letter of advice to the registrant
  • issue a warning to the registrant (and determine whether this should be published on the GDC website) 
  • ask the registrant to agree a series of undertakings on their registration.


Case examiners have the discretion to offer registrants the opportunity to give specific undertakings which would avoid the need for a case to be determined at a stressful hearing and should enable cases to be dealt with more proportionately.

Undertakings will only be appropriate if the case examiners are satisfied that they are sufficient to protect patients and the public, and that they are an effective way of addressing the concerns about a dental professional's fitness to practise.

They cannot agree undertakings if there is a realistic prospect of erasure or if the allegation was found proved by the practice committee. Possible undertakings might include agreeing not to carry out a particular treatment or accepting medical supervision.

Practitioners will usually have 28 days to agree the undertakings. If agreed, the GDC will inform their employer and will ordinarily publish the undertakings on its online register for the duration, unless they relate to health concerns or to any identifiable third party.

Undertakings will be regularly reviewed and can be changed or removed if appropriate.

The DDU welcomes the GDC's reforms but we will continue to be vigilant in monitoring the impact to make sure they have the desired effect of making the FTP process more efficient, proportionate and fairer for all involved, without compromising safety. 

We are also keen to ensure the fair handling of such matters by the NHS to ensure that the problems faced by practitioners in recent years are not simply transferred from one body to another. Members with specific concerns about FTP investigations should call our advice line on 0800 374 626.

This page was correct at publication on 24/10/2016. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.

John Makin

by John Makin BDS PgDL PgCDE FHEA Head of the DDU

John spent almost 30 years in NHS and private general dental practice. From an early stage in his career he became involved in Vocational Training and developed an interest in the dento-legal aspects of the profession. He has postgraduate diplomas in law and dental education and served on the GDC’s Fitness to Practise Committee before becoming a dento-legal adviser at the DDU. He is currently Head of the DDU.



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