Why we need action in blue at GDC blue references

Neel Kothari discusses the implications of the color blue in GDC blue referrals and how the very nature of dentistry and its complex regulations can drive them.

In recent months there has been some widespread reporting of General Dental Council (GDC) fitness to practice cases that have been prompted by registered colleagues, called ‘blue to blue’ referrals.

With an average wait time for initial GDC sessions of 10 months and 20 days, it’s safe to say that the process will result in severe mental distress for many registrants, and for some it may even be life-threatening. For this reason alone, it is important that all blue-to-blue referrals are made for completely honest reasons.

Complex regulations

Over the past few years, the percentage of cases brought by registered peers has been variable, with an upward trend of 9% in 2017, 10% in 2018 and 13% in 2019. This then fell to 10% in 2020, 9 % in 2021 and finally 6% in 2022.

It is not entirely clear why this decrease occurred, but it is nevertheless welcome news for the profession.

Of course, dentists should report peers to the GDC where necessary and appropriate, but as Len D’Cruz points out in 2020. BDJ article, ‘Blu-on-blu’, not all references are made so sincerely. Some registrants use the GDC as a weapon in inter-professional disputes or as part of financial disputes – and it is not always possible to distinguish clearly between the two.

Part of the problem is that because dental rules and regulations are so complex and ever-growing, very few can say with absolute confidence that they meet all regulatory requirements all the time.

There’s no doubt that dental rules and regulations are more like software terms and conditions than a set of easy-to-follow principles that we can all adhere to. This means that if a registrant wants to find fault with their peers, they will most likely be able to do so.

Herein lies an important distinction between a public referral to GDC and that of another registrant.

Imbalance of power

In situations where there is a power imbalance, it is also possible that a blue-on-blue referral can leave some registrants vulnerable to narcissistic and malicious types within our profession.

Recently, I have come across two cases where newly qualified associates have been forced to stay in their NHS practice using the threat of a GDC referral. Sadly, I suspect this may be an under-reported and growing issue within NHS dentistry, particularly as recruitment difficulties have become widespread.

I recognize that, when grown honestly, dental professionals are ideally placed to identify failures that could put patients at risk. However, whenever I have seen colleagues refer other colleagues to DPD, there have always been other issues running concurrently. It seems to me that where this is the case, this is important information that the GDC needs to know about if they want to assess the caliber of the referral.

I think we have to accept that dentistry is a curious mixture of health care and business and that due to the nature of human behavior, registrars will not always refer for purely altruistic reasons.

For this reason alone, it is my contention that, as an absolute must, clinicians should inform the GDC of any ongoing disputes, legal or otherwise, so that the GDC is able to derive the context of why a referral was made.

In the interests of all

I think we as a profession need some form of code of conduct for referrals that sets the thresholds that clinicians must follow. Ideally this would come from GDC, but it should not be limited to a single organization.

I would encourage all dental organizations to consider whether this is a task they can undertake. After all, it is in everyone’s interest to maintain kindness among colleagues wherever possible and at least ensure that our registration fees are spent judiciously.

I’m not entirely sure what this threshold document would look like, but a good start would be to encourage local resolution and a series of tests so that it is carefully considered before registrants choose to refer their peers. others.

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