The scene
While the colleague was away on holiday, the dentist covered her patients and saw what appeared to be missed diagnoses of advanced caries and periodontal disease in patients who were regular attenders. Knowing that his colleague had some problems at home, he was reluctant to add to her difficulties, but believed that keeping the information quiet could compromise patient safety.
The dentist, a DDU member, rang the DDU for advice as to if, how and to whom, he should raise his concerns.
DDU Advice
The DDU adviser explained that a dentist has a professional and ethical duty to raise concerns about an issue if he or she believes patients may be at risk. The General Dental Council (GDC) advises in Standards for Dental Professionals (2005) that patients' interests must come first and override personal and professional loyalties, and that you should take action if you believe patients might be at risk because of a colleague's professional performance.
The DDU adviser added that the decision to speak out is rarely taken lightly and a dentist would need to be sure that he or she could justify raising the concerns if called on to do so at a later date. However, a dentist may be investigated by the GDC if he or she chose to turn a blind eye to poor performance which may potentially be of harm to a patient.
Having taken the decision to raise concerns, there are several steps dentists may choose to take, the DDU adviser explained. The GDC's guidance booklet, Principles of Raising Concerns (republished October 2009), sets out the obligations of a dental professional and the legal protection under the Public Interest Disclosure Act 1998 given to those raising concerns.
In the first instance, it may be appropriate to raise any concerns directly with the dentist in question or within the practice - for example with a senior colleague, or, for NHS practices, with the primary care organisation - and keep a record of the concerns and any steps taken to resolve them.
Other options could include seeking the advice of the local dental committee chairman or secretary or the PCT dental adviser. Finally, the GDC can be alerted. It should be borne in mind that bringing an issue of poor performance, or other concerns, to the GDC could result in a fitness to practise hearing for the dental health professional involved and that the dentist reporting the issues may be called as a witness. This may be a daunting prospect but should not deter a dentist from taking appropriate action.
The member decided to report his concerns to the GDC. At a subsequent professional conduct hearing the member was called as a witness together with nursing staff from the practice, which they found an extremely intimidating experience. It must be remembered that dental nurses, now they are registered with the GDC, have a similar professional and ethical responsibility to raise concerns. The dentist's fitness to practise was found to be impaired and conditions were imposed on her continuing practice. The entire process took several years.
It is the DDU's advice that concerns about a colleague's performance should be addressed as soon as possible and every effort made to resolve them at a local level. The level at which concerns are raised should be given due consideration and members should contact the DDU to seek advice as early as possible.
This page was correct at publication on 21/12/2010. 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.