Understanding GDC Case Examiners

General Dental Council case examiners consider if there is a real prospect that a fitness to practise allegation could be proved.

GDC Case Examiners

General Dental Council (GDC) case examiners are the second stage of the GDC’s fitness to practise process after the initial triage stage.  Case examiners will investigate fitness to practise complaints and allegations in more detail and depth. Each case is considered by two case examiners, one lay and one a dentist or dental care professional.

It is important to remember that case examiners do not decide the facts of the case, in other words, they do not consider if the allegations made are true or not true. Case examiners are required, instead, to consider if there is a real prospect that the allegation in the case could be proved and, if so, would it suggest that the rdentist’s ability to practice as a dental professional may be impaired.

In coming to that determination, case examiners consider:

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

The case examiners have a number of outcomes available to them when making a decision:

• To adjourn the case for further information
• To close the case and take no further action
• To issue a letter of advice to the registrant
• To issue a warning to the registrant
• To refer the case to the Interim Orders Committee
• To ask the registrant to agree a series of undertakings on their registration
• To refer the case to a fitness to practice committee

Examples of cases likely to be referred to a Practice Committee

Case examiners are guided by legislation and guidance.  Circumstances likely to give rise to the need to refer the matter to a General Dental Council fitness to practise committee include (not exhaustive):

• dishonesty or deliberately misleading behaviour
• Serious criminal convictions or cautions
• Sexual impropriety and/or indecency
• Serious, deliberate or repeated breach of confidentiality
• Failing to maintain safe standards of premises, equipment or other aspects of the clinical environment
• Failing to maintain appropriate indemnity
• Working outside scope of practice
• Failure of duty of candour

Real Prospect Test

The real prospect test means that the case examiners have to decide if there is a genuine, not remote or fanciful, possibility of establishing at a fitness to practise committee would reach a conclusion that a dentist’s, or other registered dental professional, fitness to practise is impaired.

In considering whether there is a real prospect of the facts being established, the case examiners will consider any documentary evidence, whether or not that evidence would be admissible in any proceedings in a court8F.  However, case examiners can only reach their decision based solely on the material they have been provided with.  They cannot, for example, use the internet or other sources to locate additional information about a registrant, or attempt to themselves “fill in the blanks” where the information or evidence before them is incomplete.

Providing your comments or observations (Rule 4 observations)

Under what is known as GDC Rule 4, if the investigating officer determines that a complaint or concern amounts to an allegation, they must send a written notification to the dentist setting out:

1. a summary of the allegation; and
2. any evidence which relates to the allegation.

The purpose of this is to give the dentist and opportunity to respond to the allegation.

GDC Rules provides5F that Case Examiners must not make a determination as to whether or not an allegation ought to be considered by a fitness to practise committee unless they are satisfied that the registrant has been provided with a reasonable opportunity to submit written representations commenting on the allegation and the evidence relating to the allegation.

The “Rule 4” observation stage is an important stage in the process for a number of reasons:

1. It gives the registrant an opportunity to provide an explanation and the right to defend themselves against an allegation or complaint.
2. The information provided can influence the outcome of the investigation at this stage, potentially resulting in the matter being resolved without any further action or a resolution without the need for a full hearing before a fitness to practise committee that is often stressful, protracted and expensive for dentists.

According to the GDC, four in every ten (40%) concerns are closed with no further action at the case examiner stage.  There is evidence to show that legal representation results in much better outcomes for healthcare professionals facing fitness to practise proceedings.  The “rule 4 process” is a good example of where expert legal representation and advice can make a real difference because it offers an opportunity for dentists and other dental professionals to address and close fitness to practise proceedings at an early stage in the process.