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Principle One

Put patient's interests first


Principle Two

Communicate effectively with patients


Principle Three

Obtain valid consent


Principle Four

Maintain and protect patients' information


Principle Five

Have a clear and effective complaints procedure


Principle Six

Work with colleagues in a way that is in patients' best interests


Principle Seven

Maintain, develop and work within your professional knowledge and skills


Principle Eight

Raise concerns if patients are at risk


Principle Nine

Make sure your personal behaviour maintains patients' confidence in you and the dental profession


Learning Material Case Study

Raising concerns Raising concerns

Miss Smith is a dental nurse who worked for a Community Health Service.

Several dentists working at the service were concerned about the competence of Miss Smith and particularly her failure to follow appropriate cross infection control procedures. They arranged to meet with Miss Smith to discuss their concerns and suggest a way forward, but Miss Smith refused to meet with them and became very defensive. The dentists decided to raise the concern with the service manager who arranged for her to be observed. The observer found a number of failings in Miss Smith’s practice including;

  • leaving dirty instruments in a sink;
  • not operating a clear system of zoning;
  • not disinfecting the suction pump;
  • not washing hands appropriately;
  • no preparing appropriately for each treatment episode;
  • selecting the wrong instruments for the dentist; and
  • poor preparation of materials for the dentist.

The service manager wrote to the GDC and the case was considered by a fitness to practise caseworker.

The fitness to practise caseworker considered Miss Smith may have breached a number of the standards and guidance in Standards for the Dental Team including (but not limited to):

  • 1.9 You must find out about laws and regulations that affect your work and follow them.
  • 7.1.1 You must find out about current evidence and best practice which affect your work, premises, equipment and business and follow them at all times.
  • 7.2 You must work within your knowledge, skills and professional competence and abilities.
  • 7.3 You must update and develop your professional knowledge and skills throughout your working life.
  • 7.3.2 You should take part in activities that maintain update or develop your knowledge and skills.

Your continuing professional development (CPD) activity should improve your practice. For more information see the GDC’s advice on CPD.

The Investigating Committee thought that Miss Smith posed a risk to patients and decided to refer her to the Professional Conduct Committee.

When the Conduct Committee considered the case and thought that Miss Smith’s failings represented fundamental failures to maintain appropriate standards of cross infection control. In its view, Miss Smith’s did not demonstrate an acceptable level of competence in basic dental nursing skills and she should have maintained her competencies.

The committee felt that Miss Smith had not demonstrated insight into her failings and imposed conditions on her registration for a period of two years. The conditions included a requirement to undertake training in cross infection control as well as developing her knowledge of clinical policies and guidelines.

​As a registrant you have a responsibility to raise concerns if you think patients might be at risk due to the health, conduct or performance of a colleague. Your duty to raise concerns overrides any personal and professional loyalties you may have (8.1.1). Raising concerns about a colleague is a difficult thing to do, particularly as it’s likely to affect your own work but your priority has to be to your patients.

​If you have a concern about a colleague, you need to act promptly. See if you can raise your concern with your employer or manager first, but if this is not practical raise it with your local health commissioner or the Care Quality Commission (England), Healthcare Inspectorate Wales, the Regulation and Quality Improvement Authority (Northern Ireland) or Healthcare Improvement Scotland.

​You must refer your concern to the GDC if :

  • you think that the public and patients need to be protected from someone registered with us;
  • taking action at a local level is not practical;
  • action at a local level has failed;
  • the problem is so severe that the GDC needs to be involved;
  • there is a genuine fear of victimisation or deliberate concealment;
  • you believe a registrant may not be fit to practise because of their health, performance or conduct.