The Emerging Concerns Protocol (‘the protocol’) has been developed by the Health and Social Care Regulators Forum. The aim is to provide a visibly distinct mechanism for organisations with a role in the quality and safety of care delivery to share information that may indicate risks to people who use their services, their carers, families or professionals. The protocol formalises existing sharing arrangements between health and social care regulators.
Whilst regulators have a statutory duty to promote and protect the wellbeing of service users, the protocol takes this duty a step further as it provides a tool for regulators to raise and share concerns in a cooperative manner. Ian McNeill, Head of the Regional Liaison Service at the General Medical Council has stated that: ‘this collaborative approach will help us better identify emerging risks, so they can be addressed in the fastest, most effective and coordinated way possible.’ The protocol has received a positive response as it already has the signatories of eight regulators including the Care Quality Commission, the Health and Care Professions Council and the Parliamentary and Health Service Ombudsman.
The protocol After a successful pilot utilising operational staff from various organisations, regulators can expect to be informed by other bodies falling within the protocol about concerns relating to a registrant’s fitness to practise and any potential safeguarding issues which will impact service users and patients. The list of concerns that can be shared is not exhaustive and the protocol emphasises in its principles that ‘no issue will be too small for an organisation to consider’ and that non-emergency situations should also be shared between organisations. There are three categories under which information can be shared:
- concerns about individuals or groups of professionals;
- concerns about healthcare systems and the healthcare environment (including the learning environments of professionals); and
- concerns that might have an impact on trust and confidence in professionals.
The protocol establishes a process for organisations to share concerns at an early stage, and any organisation that has signed up to the protocol can initiate the use of it. To share a concern, the organisation holding the information will contact the relevant organisation(s) and convene, chair and take minutes at a Regulatory Review Panel (RRP). The RRP is a voluntary group organised by the signatories, and it does not have specific legal powers as each signatory retains their respective powers under its’ relevant legislation. However, the RRP is responsible for facilitating conversation between the relevant organisations to ensure that the full nature of a concern is understood by all, and subsequently the RRP assists the relevant organisations with developing a coordinated response.
The protocol covers England only, and it emphasises that it is not a mechanism to replace the existing responsibilities and arrangements for taking urgent action, which include responsibilities under the Duty of Candour and Fit and Proper Persons Regulations.
Commentary As the protocol promotes early intervention by sharing non-urgent concerns, it can be viewed as an enhanced way of promoting the safety of service users. Mechanisms such as this are likely to be eagerly welcomed by regulated healthcare professionals, especially in light of recent affairs such as the issues arising in the care of the patient in the Bawa-Garba case. This protocol has the potential to be key in assisting professionals with tackling systemic concerns to patient safety, thereby assisting them to adhere with their personal regulatory responsibilities. This is because the RRP process prompts organisations to have an open dialogue about concerns no matter how small; which may lead multiple regulators to discover a mutual concern about a registrant or a certain health or social care provider. Furthermore, in the protocol, each organisation identified interests that they would want be informed about, with two regulators (The General Pharmaceutical Council and the Nursing and Midwifery Council), specially mentioning systemic concerns.