raising concernsAlison Large, DDU dentolegal adviser, discusses what you should do if you have a concern about a colleague.

Dental professionals have a duty to inform someone if they have a concern about a colleague.

However, it is daunting to raise a concern or question a colleague about treatment or behaviour that may not be in line with best practice. Especially if the colleague in question is a more experienced dentist within the practice.

Case study

This was the case with a recent call to the DDU helpline from a dentist working in a dental practice for a few months. The behaviour of an experienced dentist colleague concerned them.

The newly-employed dentist believed their colleague was not treating patients according to best practice. For example not recording periodontal indices and not taking appropriate radiographs.

The DDU member was unsure what to do. Although she knew she had a duty to raise concerns she felt worried about doing so. Especially since she had only recently graduated.

The DDU adviser explained that all dental professionals have an ethical duty to put patients’ interests first. This must override personal and professional loyalties.

However, she acknowledged that the decision to raise a concern is a difficult one to make on your own. Especially if you feel a senior colleague or employer may take it as a criticism.

GDC’s position

At the DDU, we receive numerous calls from members each year. Many are unsure whether they should raise concerns. Something which can cause dental professionals a great deal of anxiety.

Initially it’s important to consider whether you base your concerns on fact or opinion. And whether the information gained is through direct observation, or reported via a third party. Such as a patient, or work colleague.

It is important not to turn a blind eye to issues, such as a colleague’s poor performance, that could potentially cause harm to patients.

However, even if a concern does not lead to any serious allegations, your actions should not be viewed in a negative light providing you acted honestly. Use the right channels and have patients’ best interests in mind.

In the GDC’s Standards for the Dental Team, principle eight focuses on raising concerns if patients are at risk.

It states that: ‘If you are not sure whether the issue that worries you amounts to a concern that you should raise, think about what might happen in the short or longer term if you did not mention the issue. If in doubt, you must raise your concern.’

The GDC explains that if possible, you should raise concerns first with your employer or manager. You should get advice from your defence organisation if this isn’t practical to do.

The GDC will only usually need informing to protect patients in certain circumstances. Such as if practices don’t address concerns locally.

The GDC has also issued further guidance on what circumstances to raise a concern and how to do so.

Raising concerns

In the situation above, the newly qualified dentist was advised to keep a record or log of the issues that she felt needed addressing.

If she decided to raise a concern, she should report concerns promptly, ideally in writing. Following the practice policy.

Also keep a copy of the letter and request a written confirmation or response setting out how the practices is dealing with concerns.

When raising concerns, include only facts and refrain from sharing your personal feelings about a colleague, good or bad.

If colleagues share the dentist’s concerns, it is a good idea to write a joint letter. This may add weight to the issues raised and have a greater impact.

If, after raising concerns locally, no action is taken to address the issues raised, and you are worried a patient may be harmed as a result, it is necessary to escalate the issue further.

If you are considering raising concerns about a colleague, you should first contact your dental defence organisation for advice. They can guide you through the process and offer support.