Shrewsbury dentists' treatment failed their patients

Robin Pope and Brian Knox have admitted a string of charges relating to work at Monkmoor Dental Practice in Shrewsbury in a recent professional conduct committee hearing by the General Dental Council.

Mr Pope admitted charges connecting to 11 patients, with Mr Knox admitting charges connected to 15 patients.

In Mr Pope's case, failures in record-keeping and clinical notes were found in all 11 cases, which examined incidents between 2010 and 2012 as well as "dishonest" claims for some treatment fees.

Since April 2006, NHS dentists have been paid according to how many "Units of Dental Activity" (UDAs) they do in a year.

One UDA is worth between £15 and £25. The committee said Mr Pope had dishonestly split treatments to claim UDAs to which he was not entitled.

In the case of Patient A, the committee found a charge that Mr Pope had undertaken two molar extractions that should have been done in hospital was proved.

Its finding said: "The potential consequences for the patient of your lack of awareness of the state of his teeth and roots could have been very serious."

It added he also made dishonest claims in relation to the treatment of Patient A.

It said in connection to one claim: "You were clearly planning on providing additional treatment to the patient, however you closed that course of treatment and then claimed a Band One fee to which you were not entitled. When the patient returned for further treatment, you claimed again."

In connection to two further claims the committee said: "In relation to the provision of the upper and lower dentures to Patient A as separate courses of treatment, the committee takes the view that in the light of your intention to provide an upper denture at the time that you were providing the lower denture, your splitting of the course of treatment was done with the intention of claiming a greater number of units of dental activity.

"The regulations are clear on this issue, and you yourself did not claim to be confused about them. You sought to persuade the committee that you did not intend to provide the upper denture at the same time as providing the lower denture. The committee did not accept this."

It also said Mr Pope had failed to diagnose gingival calculus in the case of Patient B. In the case of Patient E, dishonest claims relating to treatment were also made.

The findings said: "You were entitled to claim for two courses of treatment. In relation to these claims you were clearly planning on providing additional treatment to the patient when you began each course of treatment, but you chose to inappropriately split them into five courses of treatment. In all of the circumstances the committee is satisfied that in relation to these claims, you knowingly and dishonestly acted with the intention of claiming UDAs to which you were not entitled."

It added Mr Pope has also "knowingly and dishonestly acted with the intention of claiming UDAs to which you were not entitled" in the cases of Patients F, G and I.

Mr Pope contested a number of other charges against him, which were found not proved.

These included allegations by Patient A that Mr Pope had thrown an old denture at him, had "made repeated derogatory references to 'you people' in relation to your NHS patients" and when the patient queried a decision to extract his teeth had said "you either let me extract them or your treatment with me ends here".

It said in connection to all three charges: "The committee takes the view that it is inherently improbable that a dentist would treat their patient in the way alleged."

Mr Knox admitted dozens of charges in connection to incidents dating between 2007 and 2012, with one other incident in 2001. A determination from the conduct committee said there had been "wide-ranging and repeated failings" in the treatment of his 15 patients.

It said these included a failure to record and update medical histories; taking and evaluating appropriate radiographs; providing satisfactory crowns; providing definitive treatment for failing bridgework and making appropriate NHS claims.

It said: "In these respects you were responsible for neglecting necessary treatment and providing poor dental care, of both of which you were, or should have been aware.

"The committee considered that your clinical failings represented multiple and repeated breaches of the standards set by your regulatory body. Your poor practice persisted over a significant period of time and affected a large number of patients.

"You inappropriately prescribed antimicrobials and failed to provide appropriate treatment when necessary, on occasions leaving patients in pain. Also, you provided ineffective treatment and then neglected to inform the patients concerned that their treatments had been ineffective.

"In the committee's view, you demonstrated a lack of care and knowledge in basic and fundamental areas of dental practice to the extent that you caused harm to patients.

"The committee was in no doubt that your actions and omissions were serious and that they amounted to misconduct."

The conduct committee ruled Mr Knox's failings "are remediable" but added his fitness to practice is "currently impaired."

It said Mr Knox had made "some efforts towards addressing your clinical failings", including improvements in record-keeping, prescribing practice and attending courses.

But it added: "The committee also has ongoing concerns about your attitude and insight into the causes of your past poor practice. Although you have made extensive admissions in this case, it considered from your evidence that you are yet to accept full responsibility.

"The committee considered that there was a possibility that you could lapse into providing inadequate clinical care, if placed in similar circumstances. It therefore decided that there may be an unwarranted risk of harm to patients, if you were permitted to return to unrestricted practice. It also concluded that the public's confidence in the dental profession would be undermined if a finding of impairment were not made in these circumstances.

"The committee has determined that your fitness to practise is currently impaired."

Mr Knox has been sanctioned with 17 conditions imposed on his registration for the next 18 months. A decision into what sanctions Mr Pope will be given, if any, is yet to be made, with his hearing adjourned until July 23. No-one from the practice wished to comment.

Criticisms considered by the ruling body:

• Mr Pope admitted charges connected to 11 patients.

• Mr Knox admitted charges connected to 15 patients.

• Mr Knox has been sanctioned with 17 conditions imposed on his registration for the next 18 months. They include formulating a personal development plan to address “deficiencies” in areas such as communications and interpersonal skills, and practical skills such as radiography.

• A decision into what sanctions Mr Pope will face, if any, is yet to be made.