9. On 24 May 2023, we contacted the Practice to ask for a copy of Ms A’s complaint file and relevant medical records. The Practice replied on 5 June and explained the GDC are investigating Ms A’s complaint.
10. We spoke to Ms A on 5 and 14 June and she confirmed she had also sent her complaint to the GDC but she could not tell us any details about the GDC’s progress. We explained we would contact the GDC to see if they could give us any information.
11. We also explained if the GDC are investigating her complaint it is more than likely we cannot investigate the same complaint at the same time.
12. On 23 June, the GDC confirmed it is investigating Ms A’s concerns about the dentist. This is a summary of what it is investigating:.
• failure to examine Ms A’s teeth properly • the dentist did not notice a large chunk of Ms A’s tooth was missing and instead they said it was enamel that had chipped off. Ms A said the dentist did not clean or fill the affected tooth before applying composite and she is now left with a hole and a large part of the tooth is chipped off • the dentist’s lack of concern and care • the dentist has been up to an hour or more late • the dentist does very quick repairs and has done nothing to save her tooth so the decay is getting worse.
13. Our guidance discusses what we do when there is another organisation who could investigate the complaint. It says, ‘We would usually consider though, that only one investigation should take place.’
14. Our guidance says we cannot investigate the same complaints another dispute resolution organisation are looking into. As the Practice and the GDC confirmed the investigation is ongoing we cannot investigate and must allow the GDC to complete its investigation.
15. Ms A may be able to return to us for us to consider any issues the GDC has not or cannot consider. It is important to note our legal time limit because we can only consider complaints made to us within 12 months of the date someone became aware of a problem. We can consider complaints outside of this time frame, but we have to be satisfied there are reasonable, special circumstances to allow us to do this.
16. Based on the information from the GDC, there are two complaints they are not investigating. These are the refund of the Invisalign consultation and treatment fees in December 2019 and the removal of Ms A and her son from the Practice’s list of patients. We have considered these below.
Refund of fees
17. The Practice’s complaint response dated 1 December 2022 said Ms A failed to attend an Invisalign appointment on 5 December 2019. It sent Ms A an invoice for a failed attendance fee of £25. It said Ms A failed to attend three other appointments in total, but it did not charge her for two of them.
18. The Practice said Ms A had another Invisalign consultation on 12 December 2019. It said the dentist discussed the Invisalign treatment, costs, benefits and risks with Ms A. It took payment of £95 from Ms A towards Invisalign Clincheck (a scan which is used to create a 3D video of what a patient’s teeth should look like after the treatment). It explained it cannot refund this to Ms A as it cannot proceed with any treatments unless Clincheck has been sent to Invisalign. As the Clincheck fee is a lab cost, not only is it non-refundable, but the patient must also raise any discrepancies within 12 months of the appointment.
Removal from Practice’s list of patients
19. The Practice said the dentist was deeply saddened to hear of the complaint against it and due to the breakdown in communication between it and Ms A, it did not feel comfortable giving Ms A and her children dental treatment.
20. It explained it could not change Ms A’s NHS dentist. Under its policy, it does not move patients to different dentists within the Practice. It said it told NHS England Ms A would be contacting it to find a new dentist.
21. We spoke to Ms A to understand how she had been affected by this issue and the fees not being refunded. We explained what we can and cannot do.
22. Ms A confirmed it cost her £120 (£25 and £95) and she would like this to be refunded.
23. Ms A said before she was removed as a patient, she told the Practice she had lost all trust in the dentist. After this, she says it removed her and her son from the list of patients. Ms A said it was rude of the Practice to do this and made it inconvenient for her to find another practice. Ms A explained it took her a couple of weeks to register with a new practice.
24. We have carefully considered the information Ms A has provided and we are sorry to learn of how she was affected by what happened, as it must have been a distressing time for her. The COVID-19 pandemic has led to people waiting far longer than usual for us to look at their complaint.
25. To address this, we decided to focus on the more serious complaints that people bring to us, where they may have faced a big impact. For example, these may be about a potentially avoidable death or where someone has suffered prolonged pain. These types of complaints are where we can often make the biggest difference. This will allow us to provide the right level of service to those people, as quickly as possible.
26. This means we are not looking into complaints where we can see there has been a smaller impact. Based on the impact Ms A has told us about, we consider this applies to her complaint.
27. We consider the impact of the fees and removal from Practice’s list of patients to be at the most level two on our severity of injustice scale (our scale). Our scale helps us decide an appropriate level of financial compensation based on the claimed impact (how someone says they have been affected). Level two is where there is an impact of distress that lasted between one week to six months. We consider this was a one-off event and the seriousness of the distress would reduce over time.
28. We log all the complaints we receive. This means, if we receive a similar complaint about the same organisation or we see a pattern from a number of complaints, we may raise this with the organisation in future. We hope this reassures Ms A that even though we are not taking forward her complaint, she did the right thing by bringing her complaint to us.
29. Even if we were to investigate Ms A’s complaint about the refund of fees, it is more than likely this complaint is outside of the time limit for us to investigate the complaint. This is because Ms A was aware of the fees in December 2019 and we did not get her complaint about this until January 2023, two years outside of the time limit.
30. The law says we cannot accept a complaint if it is brought to us more than a year after the person became aware of the problem. We can put this time limit to one side but only if we see good reason to.
31. We are sorry to learn of Ms A’s complaint. We hope we have explained the thorough consideration we have given to our decision.