Self-help guide
Disciplinary action
It is not the role of regulatory bodies to investigate concerns which might be serious but do not call into question a health professional’s fitness to practise. If you are seeking an explanation and apology about dental treatment, you need to make a complaint using the relevant complaints mechanism. You can find more information in our specialist guides:
- Making a complaint about NHS health and dental care
- Making a complaint about private health and dental care
Issues which may require action by a regulatory body include:
- serious professional misconduct,
- criminal offences,
- repeated poor performance calling competence into question, and
- health problems such as addictions or mental illness.
If you consider that a dental professional’s conduct goes to his or her fitness to practice or raises patient safety issues, you can consider reporting them to their professional body, the General Dental Council (GDC). You should usually have raised your concern or given your feedback to the dental professional or practice using the appropriate complaints system before contacting the GDC.
Which professions does the GDC regulate?
The GDC regulates all dentists, as well as clinical dental technicians, dental hygienists, dental nurses, dental therapists, and orthodontic therapists.
They can also deal with cases where someone is providing dental treatments but is not registered with the GDC (which is illegal). This includes teeth whitening, which is defined by the courts as dental treatment.
What type of harm would the GDC deal with?
The GDC can deal with instances of:
- serious or repeated mistakes in clinical care, for example mistakes in diagnosis or dental procedures which cause significant harm. An example would be failure to diagnose or treat periodontal (gum) disease and as a result you go onto to lose more than one tooth;
- not obtaining your consent to treatment; and
- failure to respond reasonably to a patient’s needs. An example would be if you had a suspicious lesion in your mouth, the dentist failed to refer you for investigations, and you are later diagnosed with oral cancer.
The GDC cannot:
- help you with a claim for a refund or compensation,
- give you a detailed explanation of what happened to you (this can only come from the dental professional or organisation concerned),
- fine a dental professional,
- make a dental professional give you access to your dental records,
- make a dental professional apologise to you,
- make a dental professional reinstate or add you to their practice’s list of patients,
- make a dental professional change their fees for private treatment,
- make changes to your dental records,
- investigate general concerns about how a dental practice is run,
- change the outcome of a local investigation into your complaint,
- look into complaints about healthcare professionals who are not dentists or dental care professionals, and
- take action against a dental professional if there is no risk to patient safety or to public confidence in the dental profession.
How to report your concerns to the GDC
You can raise your concern on the GDC website. You should give the following information in your concern or complaint to the GDC:
- your name, address and contact details,
- the full name and address of the dental professional(s) concerned and, ideally, their registration number,
- details of the complaint, including dates and events,
- your view on what the dental professional has done wrong and details about any harm that has occurred, and
- the details of any other dental professionals you visited immediately before or after the treatment you wish to complain about.
How does the GDC investigate?
This is intended to be an overview of the process; individual cases may vary.
- Stage 1: Assessment. The GDC will assess whether it is the right organisation to deal with your concern. If it is, you will go on to Stage 2. If not, it will write to you to tell you why it is not proceeding
- Stage 2: Casework. The GDC will ask your consent to send a copy of your complaint to the dental professional for a response. It may gather other information, such as your dental records if appropriate. It may also obtain clinical advice at this stage and you need to be aware that your personal information will be shared with such third parties. The GDC will then decide whether the matter needs to go to Stage 3. If not, they will write to you to inform you of this. From when your concern has been received, this stage should take no longer than four months.
- Stage 3: Case examiners. Once all the relevant information is received, case examiners will review the allegations. They should send you a copy of all documentation they are considering and give you an opportunity to add any additional comments. The case examiners will then decide whether to refer the allegation to a practice committee for a full public inquiry or agree a set of undertakings with the registrant. From when your concern has been received, this stage should take no longer than six months. The case examiners can decide to:
- take no further action,
- give the dental professional advice or a warning, or
- ask the dental professional to agree a series of undertakings on their registration.
Practice committee hearings
If a decision is made that a hearing will be held, you may have to attend to give evidence. The GDC will provide you with further information on the process.
The committee can:
- give the dental professional a warning (private or published),
- restrict, through conditions, the type of work carried out or how the dental professional works for a period up to three years,
- stop the dental professional from doing any dental work for a fixed period up to 12 months by suspending them from the register, or
- take the dental professional off our register (known as erasure), which means they can no longer work in dentistry in the UK.
You will be given a written record of the decision.
What if I am unhappy with how my concern is handled?
Rule 9 review of a decision
The Rule 9 review process allows you to challenge the way a decision has been made. It looks at whether the original decision maker correctly applied the law and followed the right procedures. It is not an opportunity for the same concern to be presented to a new decision maker with a view to obtaining a different decision.
What decisions can be reviewed?
The following decisions can be reviewed in a Rule 9 review:
- a decision not to refer a concern (or part of a concern) to the case examiners (stage 3), and
- a decision by the case examiners/investigating committee that an allegation referred to them ought not to be considered by a practice committee (i.e. a case is closed with no further action).
How long do I have to ask for a Rule 9 review?
You should request this within two years of the original decision. In exceptional circumstances, this can be extended. Whether a review will be carried out for a concern submitted later will depend on factors such as whether evidence is still available, how serious the concern was, whether there is a continuing risk to the public, and if you have sought other remedies such as legal action.
What are the grounds to request a review?
The following are the grounds on which a Rule 9 review can be requested:
- the decision to close the case may be materially flawed, either in whole or in part,
- there is new information which may have led to a different decision, or
- a review is necessary to protect the public, prevent injustice to the respondent, or it would be otherwise necessary in the public interest to conduct a review. You need to provide all the information you can in support of your request, as the GDC’s decision at this stage is final and you cannot ask for a second review.
Stage 2
If the GDC decides that a review is necessary, the person who made the application and other relevant people will be made aware in writing and given an opportunity to make written representations. The Chief Executive and Registrar of the GDC will then conduct a review.
If a review is conducted, the registrar will ask:
- Was the decision for any reason materially flawed, in whole or in part?
- Is there new information which probably would have led, wholly or partly, to a different determination?
- Is a fresh determination:
- necessary for the protection of the public?
- necessary to protect the interests of the respondent?
- otherwise necessary in the public interest?
There are only two possible outcomes at this stage:
- the decision is upheld and no further action is taken, or
- the decision is not upheld and a fresh determination is ordered.
How do I ask for a review?
Before you complete a Rule 9 application, you should read the information factsheet and guidance documents available on the GDC website.
What if I am not happy with the outcome?
The Registrar’s decision is final and there is no appeal against this.
What other remedies may I have?
Judicial review
Judicial review is a legal process by which the courts assess whether a public or quasi-judicial body such as the GDC has reached or failed to reach a decision fairly. The grounds for this can include:
- there has been an unfair or biased process, such as failure to review evidence presented by one side or to give a fair hearing on the basis of the written information, or
- the decision is irrational.
The most important point about judicial review is that it must be sought very quickly after the decision has been made. Seek legal advice as quickly as possible if you are considering this route. The latest that an application can be made is three months, but this should not be taken as meaning you have three months to seek advice, as you may be too late by that stage.
Judicial review proceedings can be very expensive if you lose your case. You can find out more about the process in our guide to judicial review.
Professional Standards Authority
The Professional Standards Authority (PSA) is the body which oversees the work of the GDC. It does not have legal powers which would allow it to investigate complaints about the health and care professional regulators and is not a complaint handling organisation. It does, however, invite feedback from the public on how the GDC has handled your concerns to inform its work.
The PSA may send certain concerns raised with it about a regulator to the regulator concerned and ask for its comments. You will usually need to have to have taken your concern through the GDC’s complaints process and given it the opportunity to respond. If this has not happened, the PSA will advise you to do this first. The following conditions will also apply:
- your concern cannot be dealt with by another organisation, and
- dealing with your concern could help to improve health and care professional regulation and public protection.
Concerns the PSA may take forward:
- delays in the handling of fitness to practise referrals,
- failures in the management of a fitness to practise case,
- poor customer service, and
- failures in the process of quality assuring educational institutions.
Concerns that the PSA will not take forward:
- those relating to business or financial arrangements (e.g. setting of fees or charges set by the regulator),
- decisions not to refer a complaint for a formal hearing in front of an investigation committee or fitness to practise committee,
- decisions to refer or impose an interim order on a registrant’s practice,
- support for clinical techniques, and
- registration application decisions.
How can Avma help me?
Typically, Avma may be able to:
- help you to understand whether to raise a concern to the GDC, such as whether your concern is a fitness to practice issue,
- help you to understand any response the GDC gives to your concern or any decision the GDC reaches, and
- Help you to understand how to request a review of the GDC’s decision.