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General Chiropractic Council Offers No Evidence

The GCC have taken the decision to offer no evidence against our client, despite the Investigating Committee finding that there was a case to answer and referring the matter to the Professional Conduct Committee. 

The decision was taken after the GCC obtained expert opinion in relation to the allegations that had been referred.

Unlike many other regulators, the GCC's current rules mean that the matter still needs to go before the 'PCC' for a final determination.  If the recommendations of the Law Commission are implemented, then the matter can be disposed off without the need for such unnecessary hearings (recommendation 76).  To read more about the proposed changes, click here

GCC Investigating Committee find no case to answer, the importance of good notes

Our client is a chiropractor whose patient had complained to the GCC about a treatment given. With our assistance through DAS legal expenses insurance a detailed response was provided to the IC. The IC when finding no case to answer and exhonerating our client commented on the detailed response from our client. They found that the chiropractor's and the GP notes did not support the patient's claim.

John Williams commented

"This case is a good example of how early intervention of lawyers and providing a detailed response can be instrumental in stopping disciplinary proceedings at the IC stage. This avoids all the stress and trauma of a fully blown PCC hearing, not to mention the risk to livelihood and career of an adverse outcome. Last but not least it emphasises how crucial it is in your practice to have full and detailed notes. I cannot stress too highly how important it is to take full and legible notes at all stages of a patient’s  care. These should cover full assessment (including negative findings), rationale for treatment, patient consents for all treatments, not just at the outset but on reviews and changes, SOAP notes,  a clear record of the treatment provided and if more than 12 treatments are provided appropriate reviews and notes thereon. If x-rays are necessary it is vital that the justification for x-rays is clear. Also be careful to consider where you decide against x-rays to record your reasons when x-rays would be expected. Record in your notes in inverted commas a patient’s account of how they are progressing under your treatment.

Good communication between you and your patient is crucial to avoiding complaints but full and comprehensive notes are your best defence to unjustified patient complaints. Not only are poor notes a breach of the COP in their own right but if they are poor it is likely, in the eyes of the GCC Committees, to add weight to a patient’s complaint. Poor notes will also make our job in defending you more difficult. Remember the lawyers’ maxim “if it is not written down it didn’t happen 

Dentists in uproar over advert placed by General Dental Council in the Daily Telegraph.

A full page advert placed by the General Dental Council (GDC) in the Daily Telegraph has caused significant uproar amongst Dentists throughout the entire Country. The advert, a full page spread in the Telegraph’s Saturday Magazine on 5th July 2014 shows a lady’s face with her mouth shaded out under the heading: 

“Not completely happy with your private dental care? Don’t keep quiet about it”.

The advert clearly encourages complaints to be made directly to the Dental Complaints Service (DCS), which is funded as a complaints handling service by the General Dental Council. Placing such a provocative advert is seen by Dentists as an attempt to increase complaints by its Regulator and to some as a back-drop for justification of the significant increase to the annual registration fee Dentists have to pay the GDC. The GDC requires all Dentists to have in place an effective and responsive complaints mechanism to resolve concerns, but critics suggest this advert purports to by-pass this and encourages patients irrespective of the complaint, to complain directly to the DCS. With the use of the words “Not completely happy” many Dentists argue that this encourages spurious complaints which could entail any aspect of a patient’s experience during treatment and is grossly unfair to the vast majority of hardworking, careful, caring and professional Dentists. The advert makes no distinction between mere negligence which may result in a civil claim to be taken by the patient and the higher test for impairment of fitness to practice which involves seriousness of misconduct and is the regulator's remit. Although it is accepted that the Dental Regulator (GDC) has a duty to promote its services in a responsible manner, this advert is seen to have crossed several boundaries. A particular criticism is that it may have contravened its own guidance on advertising and runs the risk of misleading patients into thinking that all complaints would be handled directly by the DCS. Others question why this newspaper as opposed to others was used and the cost entailed in taking out such an advert. In a Press Release the GDC defended its’ actions by stating that this was part of a publicity campaign launched in May 2014 to promote the Dental Complaints Service, as their survey in 2013 of patients and the public had demonstrated that 27% were unsure as to whom to complain. It remains to be seen whether such adverts will raise the number of complaints against Dentists, but many argue that this is yet a further attempt by a Regulator to cover up its own shortcomings, particularly following the recent report by the Professional Conduct Authority (PCA) which was published on 27 June 2014.(Click here for link)

 

PSA reports serious concerns over GDC

The Body responsible for policing Regulators “The Professional Standards Authority” published its annual Performance Review Report for 2013/2014, on 27 June 2014. Within its findings The General Dental Council in came in for particular criticism on a number of fronts having been found to have failed to meet a total of eight (8) Standards of Good Regulation, six in its “Fitness to Practice” function and two in “Registration” function.

Within the “Fitness to Practice” function they were deemed to have failed to meet the fourth, sixth, seventh, eighth, ninth and tenth standards from a possible ten: They failed to: (i) Ensure that their Fitness to Practice cases were progressed without delay. (ii) Have adequate processes for managing risk in Fitness to Practice case. (iii) Ensure they had provided good customer service to all parties in the Fitness to Practice process. (iv) Ensure that all Fitness to Practice decisions were well-reasoned, protect the public and maintain confidence in the regulated professions. (v) Ensure that all Fitness to Practice decisions were published and communicated to relevant stakeholders. (vi) Ensure that Fitness to Practice information was securely retained.

Within the “Registration” function they failed to meet the first and third standards, from a possible five. They failed to: (i) Place appropriate processes to consistently ensure that only those who met its standards were registered at all times. For example, a registrant was allowed to join the register despite having to re-sit their exams; registration continued whilst the registrant was under investigation for illegal practice and two applications were granted incorrectly without staff input. (ii) Did not ensure that they maintained accurate registers. Multiple errors were discovered due to human error, IT related and the movement of data between systems.

These failures are all the more important when read against the background from 2011 to the present date, as follows: The Secretary of State for Health requested an urgent investigation in May 2011 after the former Chair of the GDC raised a number of issues following his retirement. The Professional Standards Authority (PSA) reported back in February 2013 highlighting deficiencies in the support and operation of the GDC Investigating Committee, which impacted on its efficiency and effectiveness. Following publication of this report,  further new evidence then came to light concerning actual poor practice in the Investigating Committee itself, compromising the independence of its’ decision making process'.. A further Independent Review was commissioned which reported back in December 2013. Although no evidence was found that independence was compromised, the Review identified a number of serious concerns about the Investigating Committee processes and practices, including the following:

  1. Private discussions between Investigating Committee secretaries and Chairs about individual cases prior to Investigating Committee meetings.
  2. Preparation of draft decisions or parts, in advance of Investigating Committee meetings.
  3. Substantial changes made by GDC staff to Investigating Committee decisions following meetings.

Although the GDC accepted all the recommendations of the Review owing to other earlier concerns raised about the GDC’s management of their own disclosure, the PSA commenced yet a further investigation in April 2014 which is still on-going and to be reported upon.

These concerns are serious in promoting confidence in both the Public and Registrants (Dentists; Clinical Dental Technicians; Dental Hygienists; Dental Nurses; Dental therapists; Orthodontic therapists and Dental technicians) alike, since it is imperative that Regulators are beyond reproach and capable of maintaining the highest professional standards expected and relied upon. 

Chiropractor shows insight and is admonished

Our client was accused of numerous allegations by the GCC including attacks on his financial probity, clinical competence and note taking. Our client admitted 4 allegations (3 relating to note taking and 1 relating to not complying with a request for the return of funds by the client during a certain period) but denied the remainder. The PCC found all the remaining allegations not proved. It preferred the expert evidence from the defence to that of the prosecution. The PCC found that the chiropractor would be most unlikely to find himself in this position again, he had taken steps to prevent a recurrence, he had apologised and shown significant insight into his failings, it was effectively an isolated incident  and that in all the circumstances an admonishment was appropriate.
John Williams commented; "Our client's case showed the importance of instructing a good expert and for those facing disciplinary proceedings to approach them realistically. Making admissions where appropriate and showing 'significant insight' can have a significant bearing on the outcome."