The Professional Standards Authority (‘PSA’), an independent body accountable to Parliament, oversees the work of nine statutory bodies regulating health professionals in the UK and social workers in England. It reviews regulators’ performance and scrutinises decisions about whether people on their registers are fit to practise.
The PSA has now published its October 2015 revised paper on the concept of Right-touch regulation and reaffirms that this is the correct approach to take when regulating, following on from its original paper in 2010. The PSA confirms it will continue to promote this approach, which it believes has already led to improvements in regulation in the UK and elsewhere.
Although the core principles of Right-touch regulation remain unchanged, the PSA clarifies some areas, expands upon the concept of risk, discusses responsibility and defines Right-touch regulation more clearly in its 2015 paper. The main concepts are summarised below.
The concept of Right-touch regulation emerges from the application of the principles of good regulation identified by the Better Regulation Executive in 2000, to which the PSA has added agility as a sixth principle. The principles which provide the foundation for thinking on regulatory policy in all sectors of society are:
Regulation should be proportionate to the risk posed.
It must be consistent and implemented fairly.
It should be targeted on the problem identified.
It should be transparent, simple and user-friendly.
Regulators must be accountable and able to justify their decisions.
Regulation must be agile and able to adapt to anticipate change.
The emphasis is on finding the right balance and implementing the right amount of regulation needed for the desired effect, on the basis that too little is ineffective and too much is a waste of effort.
Right-touch builds on an accurate and informed assessment and analysis of the sector and the risks in it. It recognises that there is usually more than one way to solve a problem and that regulation is not always the best answer, and recognises that it may be more proportionate and effective to implement other measures (for example strengthening employment practices or fostering professionalism) than to regulate.
Through its work, the PSA has identified eight elements that sit at the heart of the concept of Right-touch regulation in practice. These are outlined below:
The problem needs to be identified before a solution can be decided upon. This avoids resources being spent developing a regulatory solution when the problem may be better dealt with in other ways.
The problem needs to be fully understood and the risks associated with it quantified and qualified. This two-fold evaluation involves gauging the likelihood of harm occurring and its severity and looking closely at the nature of harm and understanding how and why it occurs.
Once the problem has been identified and is fully understood, a solution that is as close to the problem as possible must be found. This involves understanding the context in which the problem arises and the different tools that may be available to tackle the issues. Working with organisations and individuals that are closer to the problem, to bring about change, may be necessary.
It is important to stay focused on the outcome rather than being concerned about process, or prioritising interests other than public safety.
Regulation should only be used when it is necessary after an evaluation of this against the options of doing nothing and the risks and benefits of intervening. Making changes to regulation should only be used as a solution when other actions are unable to deliver the desired results.
Regulation must be simple and clear so that all individuals involved will understand it.
Any probable unintended consequences of the regulation must be considered to ensure that it is workable.
Flexibility should be built into regulatory strategy to enable it to respond to change.
The PSA’s formal definition of Right-touch regulation is it: ‘…is based on a proper evaluation of risk, is proportionate and outcome focused; it creates a framework in which professionalism can flourish and organisations can be excellent’.
The PSA states that Right-touch regulation is about sharing the responsibility for mitigating the risk of harm between the different organisations and people involved in its management. It recognises that professional regulation is working in the public interest when it supports professionalism and allows it to flourish and also recognises the value and importance of patient involvement and the involvement of service users in assessing risks for themselves and making appropriate choices.
The PSA confirms that it will continue to promote this approach to regulatory decision-making and that people can feel confident that regulation is acting the best way it can. The PSA sees this as a work in progress and an approach to be debated and improved over time.