More Support for Compassionate Regulation

The dental regulator in the United Kingdom recently released a study it commissioned on its complaints and discipline process. The report is entitled: Experiences of GDC fitness to practise participants 2015 – 2021: A realist study. Using a methodology that included researching the literature, interviewing various participants in the process, reviewing documentation from files, and observing hearings, the authors found dissatisfaction with the process. Even though there was consensus that the outcome was generally fair, most participants found the process stressful and caused anxiety. Registrants, in particular, said the process negatively affected their health, wellbeing, behaviour, and practice. Some engaged in a defensive practice going forward and some even withdrew from the profession.

Complainants and, sometimes, registrants were unclear about the process and found the length of the process and lack of ongoing communication from the regulator challenging. The adversarial nature of the process was seen as problematic for many participants. Racialized participants felt that the process was disproportionately applied to them. Many registrants felt that minor concerns were allocated excessive resources.

Some recommendations include:

  • Regulators should enhance their “upstream” activities including ensuring awareness of candidates for registration on the role and processes of the regulator and using effective communication techniques, including employing real-world examples, on professional standards.
  • Gender and ethnic diversity of panels should be maintained where possible.
  • The tone of communications from the regulator should be less legalistic and clearer. The underlying messaging should be reassurance that the “focus is on finding facts on whether [there is misconduct] so that registrants are considered innocent until proven guilty.”
  • There should be one contact person from the regulator who is authorized to provide individual support to each participant, including non-registrants. There should be frequent updates.
  • Recognizing that the process can aggravate or even trigger mental health issues, there should be “self-referral processes for mental health needs assessments” and “early identification of vulnerable registrants.”
  • There should be enhanced training of regulatory staff regarding empathy.

Earlier screening of matters that need not enter the adversarial discipline process was also encouraged.

This study complements recent discussions on compassionate regulation.

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