GDC research backs early remediation to strengthen patient safety and reduce fitness to practise burden

The General Dental Council (GDC) has published new research supporting the use of targeted remediation earlier in the Fitness to Practise (FtP) process, as part of a broader shift toward a more proportionate and learning-focused regulatory model.

The study—conducted by researchers from the Universities of Manchester, Newcastle, Nottingham, and Queen Mary London—explored how remediation could be used to address FtP concerns before cases are escalated to case examiners. The aim is to improve patient safety, reduce the emotional toll on dental professionals, and streamline regulatory processes.

Key findings identified by the researchers were:

• Remediation was generally regarded as the right approach to improving fitness to practise processes at the GDC amongst those interviewed, but there were mixed views on the acceptability of remediation as a case outcome.
• There was a common understanding that effective remediation could support improvements in patient safety and the quality of care. Those interviewed agreed that some issues, particularly certain attitudinal and behavioural issues, were irremediable, although in some cases, could be mitigated.
• The legal framework around remediation emphasised the need to balance public safety with professional support, and case law indicated that it should be considered as part of the ongoing fitness to practise process with the aim of ensuring and maintaining patient safety and public confidence.
• Reflective practice and tailored opportunities for improvement were found to be crucial to ensuring remediation was impactful and meaningful. And effective remediation needed to provide targeted interventions that allowed registrants to address specific deficiencies.
• Barriers to meaningful and early remediation included lack of trust in the regulator, lack of representation, lack of self-awareness, costs to registrants and the adversarial nature and culture within the process.
• Strategies that sought to fully understand the nature of a case or the allegations raised, before taking any action or making an admission, were also highlighted as a potential barrier to early remediation and an issue that could represent a challenge for an efficient and effective remediation process.   
• Clear guidelines and transparent processes were needed to ensure remediation was considered consistency and effectively across disparate cases. Researchers were also able to identify equality, diversity and inclusion process and support considerations, including generational and cultural differences.

Barriers to Implementation

The research identified two major obstacles:

• The adversarial nature of current FtP processes
• A lack of trust in the regulator among registrants

To overcome these, the GDC would need to:

• Foster a more supportive regulatory culture
• Encourage early engagement with remediation
• Consider legislative changes to enable more flexible outcomes

The findings will inform the GDC’s proposed Corporate Strategy for 2026–2028, which is currently open for consultation until 21 August.

“We know that fitness to practise investigations can be long drawn out and feel overly complex in relation to the issues raised, often leading to feelings of mistrust in and fear of the process among registrants. We need to think differently if we want that to change.” — Stefan Czerniawski, Executive Director of Strategy, GDC

The GDC is now considering how early evidence of remediation could play a greater role in fitness to practise outcomes and is committed to developing clear, targeted guidance to support this shift.

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