On 31 October the Department of Health published a paper for consultation seeking to radically change the face of healthcare regulation. Aimed at healthcare regulators, professionals and users, the consultation confirms the shared ambition of all four UK governments for a faster, simpler, less costly and more responsive system of healthcare regulation.
The current system of regulation is a historical patchwork which has resulted in huge inconsistencies in a system which is slow, complicated, overly adversarial and confusing. The consultation considers what reforms are needed across the UK healthcare regulatory system in order to support a culture of learning, rather than blaming, and workforce development whilst maximising public protection.
“The UK governments are looking to take this opportunity to design a flexible model of professional regulation which secures public trust, fosters professionalism and improved clinical practice, while also being able to adapt swiftly to future developments in healthcare”.
The consultation builds upon the recommendations set out in the Law Commissions review in 2014 and sets out the 5 objectives as follows:
To improve the protection of the public from risk of harm from poor professional practice
To support the development of a flexible workforce that is better able to meet the challenges of delivering healthcare in the future
To deal with concerns about the performance of professionals in a more proportionate and responsive fashion
To provide greater support to regulated professionals in delivering high quality care
To increase the efficiency of the system
Suggestions for reform include reducing the number of regulators as well as considering the correct level of regulatory oversight for different professional groups, dependent upon the risks and vulnerabilities associated with it, a role to be undertaken by the Professional Standards Authority (PSA).
Consideration is also to be given to the improvements which can be made to the, “currently cumbersome”, system of investigating and resolving fitness to practise complaints with a view to moving away from the current adversarial nature of proceedings to “a more inquisitorial approach that seeks to establish the circumstances of a case”, possibly in the form of dispute resolution or mediation.
Alongside this, somewhat mirroring the GDC’s “shifting the balance” consultation, there will be a focus on what action the regulatory bodies can take to support their registrants’ professional development, the aim being to “shift the regulatory focus upstream, to support professional standards before the need for fitness to practise proceedings arises”.
The consultation highlights issues which have been considered previously such as adopting cost effective approaches, powers to amend a regulators own procedures (whilst maintaining accountability to Parliament), data sharing and joint working between the regulators (with the possibility of a statutory duty on the regulators to work together) with suggestions of a shared online register, a single set of generic standards, a single adjudicator and a single organisation conducting back office functions.
In addition, it is proposed that changes should be made to the composition and structure of the councils of the regulatory bodies and that registration fees be reduced with the possibility of refunding registrants or investing potential savings to support professionalism.
The consultation is now open and will close on 23 January 2018. It will be interesting to see what, if any, changes occur as a result, given that a number of the issues highlighted in the consultation were the subject of recommendations from the Law Commission’s review in 2014 which saw very little resulting action. There is also an element of déjà vu of the intentions surrounding the Office of the Health Professions Adjudicator (OHPA) in aligning the regulators’ rules, which never came to fruition. In the wake of Brexit and the imminent coming into force of the General Data Protection Regulation (GDPR), it remains to be seen whether any of the proposals will actually be implemented.