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We often see the psychological impact GDC investigations have on the dental professionals involved as well as on their family, their reputation and their career.
We recently surveyed Dental Protection members who faced a GDC investigation between 2018-22 to get a better understanding of their experience, the impact on their mental health, and where improvements could be made.
125 members responded to the survey and nearly all of those (96%) said the GDC investigation caused stress/anxiety. 73% said it impacted on their personal life and more than 8 in 10 (82%) said that the investigation had a detrimental impact on their mental health.
14% of the 125 doctors surveyed left dentistry due to the investigation, and a further 38% considered leaving. Worryingly, over a quarter (28%) said they experienced suicidal thoughts during the investigation.
The GDC and the Department of Health and Social Care both have a part to play in bringing about improvements to the investigation process and communications, and ultimately reducing the impact on dental professionals’ mental health. Some key themes emerged in the survey, and through the anonymous commentary left by the those who participated. Our recommendations, set out below, align to those themes.
Expert instruction often relies on word of mouth. Moreover, the barriers to undertaking expert work (including time constraints, and a wariness of and unfamiliarity with the legal system) mean that expert work is often picked up by dentists in the latter part of their careers, some of whom have retired from clinical practice. Acting as a dental expert is a realistic career option for dentists and should be recognised as a prestigious achievement. Individuals should be encouraged and supported to undertake training to be able to act as expert witnesses. Everyone from regulators and employers to the dental profession can benefit from and play a part in the process.
The aim of our work here is to make recommendations to increase the pool of high-quality experts with appropriate clinical experience and training. Although systems issues and human factors are known to contribute to clinical errors, they are rarely discussed in reports. This is why we also want to encourage experts to comment on these factors and to what extent they may have contributed to the clinical outcomes under scrutiny.
60% of respondents said that if the process was less legalistic/adversarial it would have been less stressful
Over a third (34%) say less legalistic language in communications would have made the process less stressful.
“GDC investigation is the most distressful situation I faced in my life. The wait to go through the stages of their investigation is what takes most of the toll. The way it is set up assumes that you are guilty unless proven innocent.”
“I think that patient complaints to the GDC should be directed to a local resolution team initially because I am sure that the majority could be resolved at this stage. Or if remedial training/monitoring is required this can be provided locally.”
Recommendations:
74% of respondents said that they felt the tone of communications from the GDC impacted on their mental health most during the investigation
54% of respondents said that the GDC could adopt a more personable tone in communications to make the process less stressful
75% of respondents said that the initial unexpected notification of the investigation from the GDC impacted on their mental health most
35% of respondents said that the GDC could give more frequent updates on how the investigation is progressing to make the process less stressful
Many respondents expressed frustration about complaints to the GDC which are malicious, without merit, false or spurious.
“The whole process of GDC complaints needs overhauling. They should be able to differentiate the serious from the trivial.”
“The bar seems so low that almost any complaint, however unsubstantiated initiates a heavy handed and far too lengthy enquiry.”
82% of respondents said that they felt the length of the investigation impacted their mental health most during the investigation
75% said that if the process was completed more quickly it would have made it less stressful.
“Thankfully my case did not proceed to a hearing, as it was not substantial enough, but it took almost 3 years to clear, which was an extremely long time!”
“The whole process took a very long time (over 3 years). It affected my future career choices.”
Nearly all (96%) said the GDC investigation impacted on stress/anxiety, 80% said it impacted on their health and wellbeing, 73% on their personal life.
More than 8 in 10 (82%) said the investigation had a detrimental impact on their mental health.
Over a quarter (28%) of the respondents experienced suicidal thoughts during their investigation.
Nearly two in five (38%) considered leaving the dental profession and 14% did leave.
“It affected my health and wellbeing in such a serious degree that I had to see my GP and take counselling to be able to cope. I was in serious distress, unable to sleep at night and I could not focus on work or care for my family. I could not find any pleasure in my daily life. I was questioning myself even for the simplest clinical matters. I considered leaving dentistry many times.”
“I am responsible for two children; worrying about my ability to provide almost broke me”.
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