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A solid defence of a foundation dentist

Post date: 20/09/2018 | Time to read article: 3 mins

The information within this article was correct at the time of publishing. Last updated 14/11/2018

Dr F, a first year foundation dentist, contacted Dental Protection for assistance as he had been suspended from his foundation dental training.

When he telephoned Dental Protection, Dr F said that he had attended a meeting with the postgraduate dental dean, who had suspended him from his training practice after his trainer (principal of the practice) had raised concerns. Dr F was suspended while there was an ongoing investigation by an independent investigator. Naturally, he was very concerned about this, especially as he had secured a dental core training position following satisfactory completion of his foundation training. 

In the beginning

Dr F explained that he had been excited about starting his foundation training: he got on well with his new colleagues and the staff at the practice, but had never felt fully supported by the practice principal. The relationship had always been strained and over time it had become increasingly worse. It now appeared irreconcilable. Dr F had sought support from the programme director/patch associate dean as early as three months after starting the position, so they were already aware of the poor relationship.  

Dr F met with his trainee support tutor and the patch associate dean to discuss his multisource feedback, which was surprisingly poor. He reflected on this and sought assistance from a professional support unit at his deanery, who had offered mentoring, guidance, and CPD courses in areas including communication, negotiation, difficult relationships and diversity. Dr F had shown commitment and reflection by signing up for the courses.  

As part of the normal review of competence of foundation dentists, Dr F was asked to attend an interim review of competence progression (IRCP) panel meeting with the postgraduate dental dean. At this meeting he was informed that his trainer had raised concerns directly with the postgraduate dean about Dr F’s behaviour and performance. The trainer raised concerns regarding inappropriate comments made to staff in the practice, a breach of patient confidentiality and communication issues. The deanery considered that these concerns may impact on patient safety and a decision was made to suspend Dr F from dental foundation training immediately, so that an investigation could take place.

How Dental Protection assisted

Dr F did not know who to turn to for support: because the deanery was carrying out the investigation, the normal support structure for a foundation dentist was not available. The BDA informed Dr F that it was not within its scope to assist. Dental Protection therefore used its discretion and offered assistance to Dr F. If the investigation established misconduct of Dr F, it was very likely that the case would be referred to the GDC. Dental Protection was also able to offer CPD to Dr F.

Postgraduate dental training is part of Health Education England (HEE) and the independent investigation was to be carried out in line with the guidance Maintaining High Professional Standards in the NHS. The case manager at HEE, on behalf of the deanery, appointed an independent investigator to carry out the investigation.

Dental Protection’s dentolegal consultant – dentists with legal training – accompanied Dr F to the meeting with the investigator. The investigator presented the terms of reference and explained that her responsibility was to investigate and establish the facts in the investigation of misconduct. She explained that she would also be getting statements from the trainer, other staff members and the programme director. 

During the meeting the member was given the opportunity to respond to the allegations made by the trainer. These included reports of allegations from other staff in the practice about Dr F’s inappropriate behaviour and comments of a racist and sexist nature. Dr F was able to present his understanding of the situation and comment on the allegations.

Following this meeting the investigator considered it was safe for Dr F to return to clinical practice, and the postgraduate dental dean was able to secure him a position in another practice to complete his dental foundation training. He was, however, informed that the investigation was ongoing and may result in a disciplinary outcome. Dr F had been suspended from clinical practice for 26 days.  

The investigator reports

More than nine weeks later, Dr F received a copy of the draft investigation report, for his comments prior to a meeting with the deanery. He shared the report with Dental Protection.  Both Dr F and Dental Protection felt it was unfair and that there had been undue process, in that the independent investigator had not met again with Dr F after receiving statements from the other parties, including the trainer and his staff.   

Dental Protection wrote to the case manager at HEE on behalf of Dr F, setting out the errors in the report. It was also considered unfair that the investigator had not tested the accuracy and validity of statements included in the report, many of whom the investigator had not met. 

A senior dentolegal consultant accompanied Dr F to the trainee support meeting with the postgraduate dean, the case management team from HEE and the associate deans covering the foundation dentist’s new practice, to discuss the outcome of the investigation. At this meeting it was agreed that the factual errors would be redacted from the final report.  

Dr F presented his reflection on the investigation. The panel noted the CPD that he had completed, and there was very positive feedback from Dr F’s new foundation trainer and associate deans. Dr F would be able to complete his foundation training and was encouraged to continue to engage with the local professional support unit in his new training post.

Dental Protection was able to support Dr F very early in his career, at a time when his professional reputation was challenged and he felt very vulnerable.

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