Year: 2025
Type: report
Abstract: BackgroundEffective communication and support are critical in Fitness to Practise (FtP) proceedings to ensure procedural fairness and psychological safety for registrants, informants, witnesses, and staff.Previous evaluations of General Dental Council (GDC) processes highlighted communication as overly legalistic, impersonal, and confusing.Stakeholders reported distress stemming from unclear timelines, inconsistent updates, and insufficient emotional or procedural support. AimsThis study aimed to: 1) identify communication and support gaps within GDC FtP processes from the viewpoints of GDC registrants, informants, staff, and external stakeholders; and 2) recommend practical strategies to enhance GDC's FtP communication and support. MethodsA mixed-methods approach was used, including open-ended survey responses from GDC registrants and informants, documentary analysis of GDC materials, and qualitative interviews and focus groups with stakeholders.Framework analysis was employed to identify key themes, supported by triangulation across data sources. FindingsSix major themes emerged across the data sources:1. Building Trust Through Communication -Participants cited unclear expectations, infrequent updates, and impersonal language as sources of anxiety and mistrust.2. Emotional Labour and Wellbeing -Staff faced high emotional demands without consistent support or debriefing mechanisms.3. Inclusive Communication -Participants perceived that some less-well-served groups such as international registrants, neurodivergent individuals, and lower-paid professionals often experienced inequitable treatment.4. Clarity and Accessibility -Stakeholders were often "lost in the process" due to confusing formats, procedural opacity, and inaccessible digital tools. 5. Culture of Fear -FtP processes were seen as punitive, fostering defensiveness and disengagement rather than early resolution or remediation.6. Organisational Change -Efforts toward a more supportive, learning-oriented culture were evident but slow, hampered by siloed working, resource constraints, and inconsistent messaging. ConclusionWhile the GDC is transitioning toward a more supportive regulatory model, its communication and support structures remain procedurally driven and emotionally disconnected.Urgent improvements in clarity, empathy, cultural responsiveness, and operational consistency are needed.Co-designed, user-informed resources, staff training in trauma-informed communication, and improved internal coherence will rebuild trust in FtP processes.1 1 BackgroundEffective communication and robust support mechanisms are essential in Fitness to Practise (FtP) processes to ensure fairness, transparency, and proportionality.Registrants, informants, witnesses (Finn et al., 2022), and regulatory staff are often navigating complex, emotionally charged situations where clarity, empathy, and procedural guidance can make a significant difference to engagement and wellbeing.Poor communication or a lack of support can conversely exacerbate distress, reduce trust in the regulator, and impact the perceived fairness and legitimacy of the process, as well as negatively impacting on registrant reflection and remediation.Accessible information conveyed in a clear, compassionate tone of voice and can help mitigate harm, support professional identity, and uphold public confidence in regulation.A previously published evaluation of FtP at the General Dental Council (GDC) revealed widespread concerns about the tone and clarity of communication (Finn et al, 2022).Registrants described correspondence as overly legalistic, impersonal, and anxiety-inducing, themes recently raised across the broader health professions regulator landscape (Wallace and Greenfield, 2025).Many reported confusion around the process and dissatisfaction with the lack of consistent updates or clear signposting, especially in prolonged investigations.Support was perceived as inconsistent and insufficient.Dental Care Professionals, who may be less familiar with regulatory procedures often lacked access to legal or psychological support, contributing to feelings of isolation and distress.Informants and witnesses also reported significant negative emotional impacts, particularly in the absence of guidance or follow-up.A recurring theme emerging from the evaluation was the need for a more empathic, supportive approach.Participants called for communication that acknowledged the stress of being involved in the FtP process, avoided jargon, and maintained a compassionate human tone.Suggestions included individualised case contacts, early identification of vulnerable individuals, and mental health support signposted prominently in all materials.The report emphasised the importance of shifting from a punitive FtP model to a formative and supportive one that still upholds public protection but also recognises the psychological toll of investigation processes and the value of helping professionals learn and recover.To date, there has been little exploration of the impact of communication within Fitness to Practise.A recent study (Wallace and Greenfield; 2025) considered communication between regulators and employers relating to FtP, describing communication as sporadic and unidirectional.The absence of effective and timely communication meant the process of investigation was not transparent to the employer.The study detailed how organisations were not made aware of what was being investigated, or who had been approached to provide evidence, resulting in the organisation being unable to support colleague witnesses if they did not know they were involved. AimsThis study therefore aimed to:1. Identify communication and support gaps within GDC FtP processes from the viewpoints of GDC registrants, informants, staff, and external stakeholders 2. Recommend practical strategies to enhance GDC's FtP communication and support.
Authors: Finn, Gabrielle; id_orcid 0000-0002-0419-694X, Burford, Bryan, Vance, Gillian, Agius, Steven, Page, Michael, Buchanan , John, Drovandi, Aaron; id_orcid 0000-0002-8682-1218
Institution: Queen Mary University of London
Language: English
Topic: Healthcare Regulation
Subfield: Health Information Management
Field: Health Professions
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7113456122
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