In the first instance, a complaint against an orthodontist or orthodontic practice should be made through the practice's own complaints procedure. This can be verbal or written and should be acknowledged within 3 woking days. If the complaint cannot be resolved directly with the practice, the complaint can either be referred to a NHS Complaints Procedure or a Private Complaints Procedure depending under which the treatment was carried out.
NHS Complaints Procedure
If a patient receives treatment within the NHS a complaint can be dealt with by the NHS complaints process. Information on how to complain is available from the local Primary Care Trust (England), Local Health Board (Wales), Health Board (Scotland) or Health and Social Services Board (Northern Ireland). If a patient is unhappy about the way a complaint has been dealt with under the NHS complaints procedure in England and Wales, they can contact the Care Quality Commission (CQC).
Private Complaints Procedure
If a patient has a complaint about private orthodontic treatment which has not been resolved to their satisfaction using the practice’s own complaints process, they can contact the Dental Complaints Service, set up by the GDC.
This service seeks to provide a mediation service and they have an on-line system to help patients write a letter of complaint to their orthodontist.
This is an ‘independent’ dental complaints service - wholly funded by the GDC with staff employed by GDC and reporting to the GDC’s Chief Executive.
There are no ‘formal’ procedures – no representation, no provision to call witnesses, no formal record of proceedings and no appeal mechanism.
What remedies can they offer?
The complaints service can provide an explanation and acknowledgement of what went wrong and make recommendations about how the matter should be put right including requesting the dentist to give the patient an apology. Where appropriate, their Complaints Panels can recommend that a refund of fees be made to the patient and/or a recommend that a contribution is made towards any remedial treatment needed. Complaints Panels are made up of trained independent volunteer panellists. Each panel comprises two members of the public and one dental practitioner.
There is no formal power to enforce recommendations made by DCS; however, non-cooperation with the DCS is likely to result in referral of the case to the GDC for consideration under its fitness to practice procedures.
GDC
If a patient thinks that their orthodontist or DCP has behaved in a way that calls into question whether he or she should be allowed to remain on the register and continue to practise, they can report it to the GDC. As part of their duty to protect the public, the GDC has the power to take action by either removing or restricting a dental professional's registration if they fall seriously short of the high standards expected. These have been published in the GDC’s ‘Standards for Dental Professionals’ guidance booklets.
The GDC has responsibility for all registered dentists and dental care professionals whether they work in the NHS or in private practice.
They can consider cases where a registrant's fitness to practise may be impaired due to their:
health
conduct, including convictions and cautions
performance
They look at every allegation received. The action taken may range from an advice letter to removing or restricting a dental professional's registration. They cannot award compensation - only the courts can do that.
Anyone can report a concern about a registered dental professional.
Several recent orthodontic cases have involved allegations regarding:
- treatment for TMD,
- lack of informed consent,
- poor record-keeping,
- making misleading statements to patients regarding the need for and efficacy of the planned treatment,
- carrying out ‘experimental’ treatments without properly informing the patients of alternatives,
- advertising,
- fraudulent claiming
There are three stages of the complaints procedures: -
Stage 1 – The Case Worker
Case workers decide whether an allegation raises an issue the GDC can deal with and whether the information provided appears to raise a question that needs to be looked into. If the answer to these questions appears to be 'yes', the matter is referred to the Investigating Committee (IC). No decision is made at this stage about whether an allegation is true.
Stage 2 – The Investigating Committee
The Investigating Committee (IC) considers the allegation, any comments from the dental professional, and any further comments from the person who made the allegation. All parties receive a complete copy of the paperwork. The Committee then decides whether to refer the allegation to a Practice Committee for a full public inquiry. The IC panel is made up of 5 members: 2 Dentists, 2 lay and 1 DCP.
If the IC decides there should be an inquiry they can, if necessary, refer the dental professional to the Interim Orders Committee (IOC) to consider whether to impose conditions or interim suspension until the inquiry has been held. If the IC decides not to refer a dental professional to the Practice Committee, they can send them a letter of advice or warning, or take no further action.
Stage 3 – Practice Committees
The Practice Committees are:
Professional Conduct Committee
Professional Performance Committee
Health Committee
The third stage is a full public inquiry before a Practice Committee. If allegations are proved, the Committee then decides whether the registrant is unfit to practise and what action they should take. The Committee can take a number of steps, including imposing conditions of practice, suspension and erasure. A dental professional has the right of appeal.
