Case study

  • Date:
  • Category:
    Advice from INWO
    Concern within a small organisation
    Primary care concern involving the board
    Using the confidential contact


A dental nurse has concerns that equipment at the surgery isn’t being serviced and maintained appropriately.  As this only happens annually, there is limited evidence and long timescales involved.  

They raise the issue with the dentist they work with most often, but nothing changes.  They raise it again with another dentist, and start to feel that they are being treated differently, and are reluctant to speak up again.  Another six months go by, and they are still concerned that some equipment has not been serviced.

They speak to the board’s primary care confidential contact, who discusses options with them.  They agree to log the concern and the dental nurse is offered support through the Standards.  A senior manager within the board is appointed to look into the concern and they start an investigation at stage 2 of the procedure.  They use the board's inspection regime as a means to gain relevant information from the practice without revealing that a member of staff has raised a concern.

The investigation does not find evidence of any significant concerns, and while it is in progress, the dental nurse suffers further detriment, as dentists in the practice guess why the board is making enquiries.  The dental nurse is unhappy with how the issue has been handled, but doesn’t want to take further action until they have secured alternative employment.

When they are in a new post, they raise their concerns with the INWO.  Over two years have now passed since the issue was first raised with a dentist at the practice, and it is over six months since the board provided their stage 2 response to the situation.  However, the INWO is conscious of the detriment that has been suffered, and the reason for delay.  They are satisfied that exceptional circumstances apply, and agree to review the concern and how they were treated through the process, both by the board and by the practice.

Updated: January 9, 2020