AC-2025-LON-000160 - [2025] EWHC 3006 (Admin)

The factual background was largely uncontroversial. It was set out at paragraphs 10-23 of the PCC’s decision, which Mr Horne confirmed did not contain anything he challenged. The following summary of the background is based upon that and other matters of common ground between the parties.

Mr Mobasseri qualified as a dentist in Germany in 2001 and commenced practice in the United Kingdom the following year. In 2006 he purchased the Camden High Street Dental Practice, a dental surgery in Camden, London (the “Camden Practice”) for which he held an NHS General Dental Services contract (“the GDS contract”) and became the practice principal. By 2019, the value of the NHS contract was approximately £650,000 per annum (equating to around 18,111 Units of Dental Activity (“UDAs”)) and the practice staff consisted of three other associates (2 full-time and 1 part-time), 2 part-time dental hygienists, 3 dental nurses, a practice manager and a reception team.

Between 2010 and 2012, Mr Mobasseri completed a Diploma and MSc in Restorative and Aesthetic Dentistry with the University of Manchester. Later on (between 2019 and 2020), he completed theoretical training in Clear Aligner Therapy with the City of London Dental School/Safe Orthodontics. Mr Mobasseri was able to provide modern orthodontic treatment using clear, removable aligners to straighten teeth – known as “Invisalign” treatment.

As time went by, Mr Mobasseri himself performed an increasing amount of private dentistry and correspondingly less treatment on the NHS. The Camden Practice remained predominantly an NHS practice, with 85% of the work provided under the GDS contract. His associates at the Camden Practice performed many of the UDAs required by the contract.

In 2015, Mr Mobasseri began to rent a surgery room in premises at 20 Wimpole Street (“Wimpole Street”), working there a certain amount of the week (initially 2 days, later increasing to 3 days). He also continued to work at the Camden Practice for one and a half days a week, and would also routinely stop there on his way home from Wimpole Street.

Soon after Mr Mobasseri purchased the Camden Practice, it started to use Kodak R4 (“R4”) record keeping software. Claims for payment for NHS treatment under the GDS contract were sent electronically via that system to the NHS Business Services Authority (“NHS BSA”).

At some stage prior to 2018, Mr Mobasseri had started using Microsoft Word to make most of his clinical notes instead of entering those notes directly onto the R4 system. He explained to the PCC that various factors, including the birth of his daughter, his postgraduate studies (which required travel to Manchester), as well as IT issues at Wimpole Street, had led him to use this alternative method of record keeping. He explained that he dictated his clinical notes to his dental nurse who would type them into Microsoft Word using a laptop. Whether the consultation took place at his room in Wimpole Street or the Camden Practice, the patient’s notes would be transferred onto a USB stick, and Mr Mobasseri would then upload them to the server at the Camden Practice when he was next there. He originally intended that the Word records would be uploaded onto the R4 system rather than just kept on the server, but that approach started to fall by the wayside. By the time of the events relevant to the PCC hearing, the Word document had become embedded as Mr Mobasseri’s primary form of patient record keeping. It was accepted by the GDC before the PCC that the records kept in Word were a contemporaneous record of what had taken place at appointments.

In early 2019, R4 was replaced at the Camden Practice by EXACT from Software of Excellence (“SoE”). Specialist Invisalign software was also used to record scans for Mr Mobasseri’s private Invisalign patients, which had become one of his main practice areas.

From around the end of March 2020, when the Camden Practice was closed during the first COVID-19 national lockdown, Mr Mobasseri started transferring some of the records contained in the Word documents directly into SoE, so that these would form part of the SoE record itself. He explained in his evidence to the PCC that this was because he was using the large amount of free time which had become available to him as a result of the lockdown to complete various administrative tasks at the Camden Practice and to review his record keeping.

When transferring the records, he headed each entry as “Transferred from [date of the appointment]”. The SoE software also recorded a timestamped entry for the date on which the records were transferred. The PCC recorded that there was nothing objectionable about transferring the records in this way, provided that the contemporaneous clinical records either remained unaltered or were marked in a way which showed where alterations had been made. However, Mr Mobasseri did not do that. Rather, he made significant alterations when transferring the records into SoE and did not mark anywhere to indicate that such alterations had been made. The PCC noted that, because each entry was headed “Transferred from [date…]”, the records gave the impression that what was being transferred was the contemporaneous record, rather than an altered version of it. The PCC also noted that the alterations which Mr Mobasseri made to the records consisted of adding (and in some cases altering and deleting) significant clinical detail which had not been included in the contemporaneous Word documents. This detail related to appointments which had taken place weeks, months or years earlier. The alterations were not minor or purely editorial, such as correcting typographical errors, but instead altered the substance of the clinical record and provided substantially more clinical detail than had originally been recorded.

Mr Mobasseri subsequently stated in his evidence to the PCC that he had made the amendments to “enhance” the clinical records because, having reviewed his record keeping, he was shocked and embarrassed by the poor standard of his records. He said that, with the exception of BPE charting, the alterations he made reflected what would have taken place at each appointment. His evidence was that he had been able either to remember the appointments in question or to construct an understanding of what would have taken place based on wider clinical records and his recollection of other more recent appointments for each of the patients in question. With regard to BPE charting, he stated that he would have undertaken the BPE itself but that the scores had not been recorded at the time. He accepted before the PCC that the scores which he retrospectively entered into the clinical records had been “made up” by him based on (what the PCC described as) guesswork from examining the patients’ scans and radiographs. Mr Mobasseri admitted before the PCC that in altering the records in this way his conduct was misleading and dishonest.

In 2020 an anonymous informant raised concerns with the NHS which resulted in an investigation by it into Mr Mobasseri’s claims for UDAs. The details of the informant and the concerns raised were not put before the PCC. However, as part of its investigation, the NHS wrote to Mr Mobasseri on 21 September 2020 to request the patient records of 25 patients of the Camden Practice. 15 of those patients were Mr Mobasseri’s – they correspond to Patients A-O. The request explained that these records were required “As part of our monitoring procedures” and that the records should include, where applicable: “Clinical and general notes, A chart of the dentition, Periodontal charting and notes, Soft tissue examination, Medical histories with updates, The FP17DC if applicable, [and] the treatment plan or computerised equivalent”.

Having received this request, Mr Mobasseri transferred the contemporaneous records contained in the Word documents for each of those patients into SoE, in the same way he had done earlier in the year with other patient records. Again, when transferring the records he made significant alterations without indicating anywhere that he had done so. He saved the altered records in SoE between 05:33 and 06:44 on 19 October 2020 and submitted these to the NHS later that day in response to its request. As noted by the PCC, the alterations consisted of adding sufficient clinical detail to the notes to support the corresponding claims for treatment which had been submitted to the NHS for payment and which would conform to the level of record keeping expected by the NHS (as had been indicated in its letter to Mr Mobasseri of 21 September 2020).

Mr Mobasseri admitted in the PCC proceedings that, in altering the records in this way, his conduct was misleading and dishonest. His explanation was that he had made the alterations because he was embarrassed and had panicked upon reviewing the poor quality of the requested records. He denied that he had made the alterations for any other purpose and he denied he was aware at the time that the NHS was investigating his claims for treatment.

As part of the GDC’s ensuing investigation into his fitness to practise, a number of claims for treatment which he had submitted to the NHS were identified as being inappropriate, in that he either had not been entitled to claim for the corresponding number of UDAs or because dates had been changed so that the course of treatment would fall within a different contract year, which the PCC described as potentially avoiding a clawback for underperformance of the contract. In the PCC proceedings, Mr Mobasseri admitted that most of these claims were inappropriate and misleading, but denied that they were made dishonestly. His position was that they appeared to be the result of an administrative or system error (including for some of the claims when the Practice changed from using R4 to SoE).

On 29 October 2020, an interim order of conditions was imposed on Mr Mobasseri’s registration for a period of 15 months. On 7 December 2021, the interim order of conditions was replaced by an interim order of suspension. That interim suspension continued (with extension by the High Court and Interim Order Committee reviews) until 19 September 2023, when it was replaced with an interim order of conditions. Mr Mobasseri remained subject to interim conditions until the substantive hearing before the PCC.

A number of points were made in the parties’ submissions concerning how different types of dental treatment were dealt with under the GDS contract and how payments were calculated and made. It is helpful therefore to set out some outline points in relation to the operation of the GDS contract, which were common ground between the parties.

The National Health Service (General Dental Services Contracts) Regulations 2005 [SI 2005/3361] established GDS contracts with effect from 1 April 2006 and govern their operation. Provisions around charging are found in the National Health Service (Dental Charges) Regulations 2005 [SI 2005/3477].

The parties to the GDS contract over the relevant period were the dental contractor (known as a “provider”) and NHS England. Clinical activity provided by a dentist was measured in UDAs for a complete course of treatment.

The provider was obliged to furnish NHS BSA (on behalf of NHS England) with details of the clinical activity performed by the provider’s “performers” (i.e. dentists) within two months of completing a course of treatment, giving details of the treatment provided, the patient’s details, including any NHS Charges payable and paid by that patient, and details of any exemption the patients declared.

Courses of treatment were categorised into three main charging Bands:

NHS England contracted with the provider for the provision of a set number of UDAs during the contract year (1 April to 31 March) for a total contracted value. Each UDA, therefore, had a fixed financial value.

At the outset of a course of treatment, the dentist was to provide the patient with a treatment plan – Form FP17DC. Once the course of treatment was completed, its details were sent to NHS BSA on Form FP17 or (as in this case) via its electronic equivalent through the record-keeping software.

On a monthly basis during the contract year, NHS BSA would pay the provider 1/12th of the annual financial value of the contract. Then, at the conclusion of the contract year, i.e. the end of March, the number of UDAs provided was compared with the number that the dental contractor was obliged to provide under their GDS contract:

Mr Mobasseri held GDS Contract 688045/0001 in the period material to the allegations in this case, namely the 2017-18 and 2018-19 contract years. For those years he was contracted to provide 18,111 UDAs. In the 2018-19 year, the financial value of the contract was £608,167.