GDC’s Fitness to Practise process comes under fire

The General Dental Council (GDC) has published two research reports that deepen understanding of Fitness to Practise (FtP), providing valuable insight into how the process could be further improved.

As part of the GDC’s commitment to improving the FtP process, it commissioned two research projects, led by the University of Manchester, to understand participants’ experiences.

The first developed and evaluated a survey of registrant and informant experiences up to the Case Examiner decision; while the second examined communication and support throughout the FtP process, involving registrants, informants, and GDC staff

Survey findings

The survey was sent to registrants and informants over a three-year period for cases reaching a decision between 1 April 2022 and 31 January 2025.

Most respondents were dissatisfied with the FtP process and the outcome of their case.

A higher proportion of registrants than informants were satisfied with the case outcome, felt communication had been clear, and felt their case was treated appropriately and proportionately.

Only a quarter of informants felt their case had been taken seriously by the GDC.

The research identified key areas for improvement, including the length of time of the investigation, the support received by both registrants and informants, and the speed of response to informants’ queries, which a third of respondents highlighted as requiring improvement.

Communication and support research findings

The research found evidence that the GDC was moving towards a more-supportive, learning-oriented culture, but highlighted this needed to be implemented more quickly.

Participants identified unclear expectations, infrequent updates, and impersonal language as sources of anxiety and mistrust.

And FtP processes were seen as punitive, fostering defensiveness and disengagement, rather than early resolution or remediation.

Participants felt ‘lost in the process’ due to confusing formats, lack of procedural transparency, and inaccessible digital tools.

We know that FtP investigations can take too long and feel overly complex, often leading to feelings of mistrust and negatively impacting the mental health and wellbeing of those involved

Some less-well-served groups such as international registrants, neurodivergent individuals, and lower-paid professionals were perceived to experience inequitable treatment.

Staff also faced high emotional demands without consistent support or debriefing mechanisms.

The research concluded that while the GDC is transitioning towards a more-supportive regulatory model, communication and support structures remain procedurally driven and emotionally disconnected.

The research also highlighted the need for urgent improvements in clarity, empathy, cultural responsiveness, and operational consistency.

Theresa Thorp, executive director of regulation at the GDC, said:

“While we have made significant improvements in recent years, this research makes it clear there is more we need to do.

“We know that FtP investigations can take too long and feel overly complex, often leading to feelings of mistrust and negatively impacting the mental health and wellbeing of those involved.

“We’re committed to making evidence-based changes that will have the greatest impact on improving the process.

“We’re already taking action to improve how we communicate with participants, provide better support, and reduce the time investigations take.

“We want to work collaboratively with dental professionals and our partners to ensure the process is fair, transparent and supportive, while protecting the public.”

Next steps

Based on this research, the GDC is looking at the information it provides to ensure it is communicating clearly so participants understand the process and providing realistic timelines.

It is also improving practical support for registrants, informants, and witnesses through hearing support co-ordinators and introducing improved support for vulnerable witnesses at hearings.

Over the past few years, key changes have been made to improve fitness to practise:

• A streamlined approach for single patient clinical concerns has halved the time to complete the initial assessment stage from 30 to 15 weeks
• Regular training is delivered for caseworkers and managers by a specialist mental health charity to help staff identify participants in distress and signpost support earlier
• Further training is provided to help staff take a more-supportive and empathetic approach when dealing with fitness to practise cases

Whilse these changes have improved the FtP process, the GDC said it recognises there is more to do.

“We recognise that many cases involving less-serious concerns will eventually close with no finding of impairment or sanction,” it states.

“In many cases there are opportunities for earlier interventions around remediation and learning.

We want to work collaboratively with dental professionals and our partners to ensure the process is fair, transparent and supportive, while protecting the public

“We are, therefore, looking at remediation as an approach to addressing potential fitness to practise issues before cases are referred to case examiners, to support learning, improve patient safety, and reduce the negative impacts of lengthy investigations.

“The publication of these reports comes as we have published our new strategy 2026-2028 this week, which champions a model of regulation that supports professionalism, enables learning, and resolves issues quickly and proportionately.”