Changes to Regulation of Healthcare Professionals

The Department of Health and Social Care has published its response to the consultation on proposals to reform the regulation of healthcare professionals. The changes are aimed at making the fitness to practise process more efficient and user-friendly as well as ensuring greater consistency in the powers of the various statutory regulatory bodies.

The reforms are perhaps not as radical as some of the proposals contained in the consultation; in particular the headline-grabbing idea of consolidating the nine statutory healthcare regulators into a far smaller number has been shelved.

Fitness to Practise

At the heart of these changes is the reform of fitness to practise processes. The current fitness to practise processes have been described by the government as:

bureaucratic, time consuming processes that are burdensome and can be stressful for patients, their families, registrants and employers.

All of the regulatory bodies will be given a full range of powers to investigate and resolve complaints about their registrant’s fitness to practise more quickly. The motivation behind this is to make the process more collaborative and less adversarial, more efficient and less bureaucratic.

One power is to remove registrants from the register automatically, without fitness to practise proceedings, where they have been convicted of certain criminal offences in the UK. The inclusion of a number of offences that may vary considerably in seriousness according to the circumstances of the offence mean that this power may be less uncontentious than it might at first seem. It remains to be seen how it will be implemented and in what circumstances a registrant will be able to insist on a hearing.

The most significant change will enable all of the statutory regulators to resolve fitness to practise cases without the need for a full panel hearing where it is appropriate to do so. Regulators will be able to use case examiners to consider complaints and, where appropriate, resolve them on a consensual basis. Experience of the few regulators currently operating a consensual disposal scheme suggests that reaching a mutually acceptable disposal will require early negotiation between the regulator and defence organisation, necessitating early consideration of the evidence with counsel and expert witnesses.

Greater Autonomy for Regulators

The reforms will provide the regulators with the autonomy to set more of their own operating procedures leading to more responsive regulation. This, it is envisaged, will free up resources for the regulators to invest in other aspects of their role in supporting healthcare professionals.

The proposed reforms are also intended to create greater accountability. This includes transparency in how the regulatory bodies discharge their regulatory functions. There will be a new requirement to update patients and family members on the progress of fitness to practise cases in which they have an interest.

Williams Review

In addition, two legislative changes recommended by the Williams review will be made to the regulatory framework:

• Removal of the General Medical Council’s (GMC) right to appeal decisions of the Medical Practitioners Tribunal Service (MPTS) to the High Court. The Professional Standards Authority (PSA) will have the sole right of appeal against such fitness to practise decisions, as is the case for the other eight regulatory bodies; and
• Modification of the GMC and General Optical Council (GOC) powers to require information from registrants for fitness to practise purposes to exclude reflective practice material.

Next Steps

The government will now draft secondary legislation to provide all nine UK regulatory bodies with a legislative framework. The priority for reforms will be changes to the regulators’ fitness to practise processes and operating framework.