For some years I had an annual speaking engagement to final year students at a college which was training some of the regulated health and care professionals of the future.
As students filed into the lecture theatre, I could see from their facial expressions that expectations of what was to come – a lecture on regulation – were not that high. And maybe my starting point could have been more compelling. I would work through and describe the core regulatory functions of registration, standards, quality-assurance of higher education, and fitness to practise. Many of the students, if not most, looked quite bored and I’m not sure I blamed them. Even so, I did glare at anyone checking their phone.
But where I went from there did get the students more interested, and maybe thinking that there might be more to this than they’d initially realised. I would talk in more depth about fitness to practise. I’d provide some statistics about the kinds of cases that the regulators looked at (including their own regulator to be), providing the list of categories of different kinds of misconduct, and would share some details of particular cases. Who were the people involved; what went wrong; what harm was caused?
This would lead to a conversation about why it is that some people go off track in their professional work, while others continue to be compliant with the regulator’s standards. Where’s the difference? What sort of circumstances and combinations of internal and external factors might lead to someone causing harm, intentionally or otherwise? Could the students sympathise – almost always, yes – but how then might they then remain vigilant about themselves and others when there were early signs of trouble? Who could they talk to? Where could they turn for support to ensure that patients were kept safe?
By now this would be an animated discussion of the role played by regulation, of professionalism, of standards, of patient safety and of the importance of acting early when hazards arose. It was always extremely rewarding and enjoyable for me as the speaker, and I hope I contributed to the students having a more constructive and positive attitude to the regulator and the part played by regulation within the landscape of care.
I thought of these lectures recently in our conversations with stakeholders about our report Safer care for all, and in particular, at our conference earlier in the month. Within organisations delivering care, who people believe, who they trust and who they fear is instrumental in many decisions and actions relating to patient safety. We need to be sure that as far as regulation is concerned, professionals understand the regulator’s role and purpose and have a constructive approach to what the regulator’s requirements mean in the workplace – how they are interpreted and understood, and what it means to comply.
If we want to support professionals to have a positive attitude to being regulated, a clear sense of the purpose of regulation, and a constructive approach to tackling small problems before they become large ones, the best thing we can do is start early.