The circumstances of this case relate to the Registrant’s treatment of a child patient. Allegations have been put to the Registrant in relation to inadequate care in a number of areas, failing to maintain an adequate standard of record keeping, failing to treat the patient with dignity and respect and failing to obtain informed consent. The allegations relate to the period 14 November 2017 to 16 November 2017. The Case Examiners considered evidence including a complaint from the patient and a clinical advice report.
The Case Examiners have determined that there is a real prospect of all of the facts alleged being found proved by a Practice Committee, a real prospect of the statutory ground of misconduct being established but no real prospect of a Practice Committee finding the Registrant’s fitness to practise to be currently impaired.
In the circumstances, therefore, the Case Examiners have determined to issue a warning to indicate to the Registrant that, whilst this matter has not been referred to a Practice Committee, his conduct was a departure from expected standards which warrants a formal response from the GDC.
The Case Examiners have taken into account their Case Examiner Guidance Manual (November 2016) regarding the criteria to be considered when minded to issue a warning, and also their Indicative Outcomes Guidance (February 2018) in relation to examples of types of cases for which it may be appropriate to issue a warning; including in relation to failing to maintain an adequate standard of professional performance, failing to obtain informed consent and allegations relating to acting responsibly towards patients.
Based on the guidance, the Case Examiners consider that a warning in this case is necessary to declare and uphold proper standards of behaviour and conduct. Further, the Case Examiners consider that publication of the warning for a period of 12 months is appropriate and proportionate in the circumstances and will ensure that a message is sent to the Registrant and to the wider profession regarding the importance of maintaining appropriate standards.
The Registrant is reminded that this warning will form part of his Fitness to Practise history, even after it is no longer published, and may need to be disclosed as required.
The Case Examiners have considered relevant GDC Standards.
‘Standards for the Dental Team’ (2013) states:
1.1 You must listen to your patients
1.2 You must treat every patient with dignity and respect at all times
2.3 You must give patients the information they need, in a way they can understand, so that they can make informed decisions
3.1 You must obtain valid consent before starting treatment, explaining all the relevant options and the possible costs
4.1 You must make and keep contemporaneous, complete and accurate patient records
7.1 You must provide good quality care based on current evidence and authoritative guidance
The Case Examiners warn the Registrant that:
• failure to undertake a systematic and appropriate assessment of a patient’s dental condition, which can include intra-oral and extra-oral examinations and basic periodontal examinations, may result in deficient treatment planning and inadequate care. It is necessary to ensure that sufficient diagnostic assessments are carried out as part of both general dental treatment and to assist with treatment planning.
• radiographs should be taken in accordance with established guidance.
• failure to maintain accurate and detailed records can impact upon ongoing patient care. Clinical records must be sufficiently detailed so as to allow future audit or review, to understand any and all clinical considerations, justifications and potential diagnostic conclusions reached as well as the actions carried out by the registrant and the information discussed with the patient.
• failure to act responsibly towards patients can cause offence and add to a patient’s anxiety and distress. The Registrant must ensure he treats every patient with dignity and respect at all times.
• failure to obtain and record informed consent can have serious effects on the individual patient, and on the wider trust and public confidence in the profession. The Registrant must ensure that he obtains full, informed consent prior to carrying out any procedures, and this should be fully documented.