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“Could we do more to promote diversity and
tackle inequalities in health and care?” We asked ourselves this question following the
murder of George Floyd and the Black Lives Matters movement. The answer was a
very definite “Yes”. As a result, we have now published our first Equality, Diversity and Inclusion (EDI) action
plan – instigated by those events, as well as (too many) others. We have
received advice and guidance from external experts to produce this plan. It focuses
on both internal and external actions and is made up of three key elements:
- We need to gain a
deeper understanding of EDI issues and how people with minority protected
characteristics are actually affected by the health and social care system.
- We need to make sure
that our own internal processes actively promote equality, diversity and
inclusion. As part of this work, we have appointed our first Associate Board Member from an under-represented demographic background. We’ll also be working
with the regulators to get information to analyse our own decision-making
around referring regulators’ decisions to the courts.
- We need to be clearer
about our expectations from the
regulators and accredited registers we oversee. They have an important role in
assisting their registrants to provide care which addresses the health
inequalities in this country and in running systems which are fair to all
registrants.
You can read the full action plan here as well
as a blog from Mark Stobbs, our Director of Scrutiny and Quality, who explains
more about the three key elements fundamental to achieving the actions we have
set out in the plan.
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Since our last e-newsletter, we have concluded 16 appeals.
We have appealed these
decisions based on our belief that they were insufficient to protect the
public. These cases involved a range of issues, including crossing professional
boundaries, trying to cover up mistakes, taking advantage of and/or mistreating
vulnerable service users/patients, forging signatures or lying about the
ability to carry out procedures, as well as being convicted of assault.
You can find out more
about these appeals, as well as the outcomes of recent Court Hearings, here. Or
find out more about the value added to public protection by our power to check
and appeal fitness to practise decisions.
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Does it take too long to publish a performance
review report? Do we really need a full report for each regulator every year? We
wanted to make sure our current performance review process was effective, but
proportionate, helping us to identify risk and allowing ourselves (and the
regulators) to target resources where they are most needed. We decided it was
time for a change. We had identified several areas where
improvements could be made and wanted to sense-check our initial proposals. We
launched our first consultation in December 2020 to get stakeholder feedback on
high-level proposals for a new approach.
The feedback we received helped us
shape our proposals. We then consulted on this in late 2021, concentrating on
three key areas:
- Moving from an annual process to one where we carry out our checks
periodically, with ongoing monitoring in between to maintain our oversight
- Our proposal to set this period as a three-year cycle
- The factors we will consider when determining whether we need to
look in more depth at a regulator’s performance.
What is changing?
Respondents broadly supported our
proposals, so we are moving away from our annual cycle. We are implementing a
three-year cycle of reviews, monitoring regulators’ performance in between the
three-yearly reviews. We expect that these changes will allow us to target our
resources to areas of greatest risk, and report much sooner after the end of
the performance review period. You can find out more about both consultations here,
including our report on responses received and next steps to introduce the new
process.
The new process is being introduced
for the 2021/22 review year onwards and the first is report is scheduled for
publication in summer 2022.
Performance reviews published
We have recently published reviews for Social Work England, the General Dental Council and the General Optical Council. These reports
were carried out under the old process – the PSNI’s performance review will be
the last one under this process and will be published towards the end of June. You
can find all our performance reviews here.
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Rehabilitation
Workers Professional Network joins the programme
We announced the accreditation of the register
run by the Rehabilitation Workers Professional Network (RWPN) at the end of
March. The RWPN is the professional body for vision
rehabilitation workers, and it sets and maintains standards for the workforce. They
work within a variety of contexts across health and care. Simon Labbett, the
Chair of the RWPN, provided a guest blog where he shared his thoughts on the
importance of accreditation. You can find out more here or read a summary of
our accreditation decision in this two-page snapshot.
First Standard One ‘public interest
test’ completed
We
now invite registers interested in applying for accreditation to have their
register assessed by us against Standard One before submitting a full
application. This helps us to check for eligibility under our legislation,
and if accreditation is in the public interest. A register must meet Standard
One before we can assess it against the remaining Standards. This involves
weighing the benefits of the roles registered, against the risks. Our decision
is provisional and designed to give the register an indication about whether it
is within the scope of the programme. It does not mean that their register is
accredited by us.
Athena Herd is a register working
with people practising ‘equine facilitated learning’. They are the first register
to approach us to be assessed against Standard One. Following a panel meeting,
we determined that Athena Herd had provisionally met Standard One. You can find
out more here.
Further new applications received
On 31 March, we received a new
application from the British Occupational Hygiene Society (BOHS). BOHS provides
information, guidance and expertise in the recognition, control and management
of workplace health risks. We have just received a full application from
Athena Herd, following our provisional decision on Standard One as set out
above. We continue discussions with other prospective applicants, with the aim
of supporting the continued growth of the programme and expansion of the
assurance it offers to those receiving care from roles not regulated by
statutory bodies.
Trial of enhanced DBS checks for self- employed
registrants
In February, we launched a pilot to trial DBS checks, in conjunction with the Association of Child Psychotherapists (ACP). The Disclosure and Barring Service (DBS) carries out
criminal records checks and maintains lists of individuals who are barred from
carrying out certain activities, in England and Wales. There are four levels of
checks; our pilot will focus on the Enhanced with Barred List check. A small,
randomly selected sample of self-employed ACP registrants were checked. The
results will be used to inform our understanding of eligibility and the
practical implications of other Accredited Registers making these checks. The
UK Government also announced its Independent Review into the Disclosure and
Barring Regime which will seek to provide assurance to Ministers about the
effectiveness of the disclosure and barring regime in safeguarding children and
vulnerable adults. It will review the definition of ‘regulated’ activity, used
to determine who is eligible for a higher-level DBS check; and eligibility gaps
for disclosure checks for the self-employed. This review will be relevant to
the statutory regulators as well as Accredited Registers.
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Health and Care Act
The Health and Care Bill has now passed into
law as the Health and Care Act 2022. It is a large and wide-ranging piece of
legislation, however the elements of interest for professional regulation
include new powers for the Secretary of State to:
- merge
or abolish any of the healthcare professional regulators
- deregulate
professional groups.
We published our view of the
Government’s proposals for reform of professional regulation in October
2021.
The Government commissioned KPMG to carry out a
review of the regulatory landscape and provide options for reconfiguration. They
also consulted on introducing a new transparent process for deciding when
statutory regulation is appropriate, see further details below.
Within the wider provisions of the Act is the formal
establishment of integrated care systems (ICSs). ICSs are partnership
organisations that bring together providers and commissioners of NHS services
across a geographical area with local authorities and other local partners to
plan health and care services to meet the needs of the local population. This
represents a shift from the previous focus on competitive purchasing of
services via Clinical Commission Groups (CCGs).
The Government also amended the legislation to
commit to introduction of a licensing scheme for non-surgical cosmetics, see
further details below.
Non-surgical
cosmetic procedures
The UK Government announced on 28
February that it intends to introduce an amendment to the Heath and Care Bill
for a licensing regime in England for non-surgical cosmetic procedures such as
Botox and fillers. This follows recent new legislation to ban procedures for
cosmetic purposes on under 18s in England. A public consultation will help
inform the scope and details of the regulations. We are in discussions with our
two Accredited Registers (the JCCP and Save Face), and UK Government, on the
proposals. We
have published our opinion on this amendment.
Healthcare regulation: deciding
when statutory regulation is appropriate
The Government consultation was
launched on 6 January and ran to 31 March 2022. The Government plans to
introduce a new policy for deciding which groups should be regulated by law,
based mainly on the risk they pose to the public.
We published a news update on the
consultation announcement back in January along with some FAQs. We also submitted
our formal response to the consultation welcoming the move to a transparent,
risk-based approach to deciding which roles are regulated.
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Below you will find a short round-up of some of our recent events, consultation responses and the latest blogs we have published.
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Recent events: annual Welsh seminar
We held our annual joint regulation
event with the Welsh Government on 3 March 2022. It was entitled Regulatory
developments and the Welsh context 2022: Safety under pressure – protecting
patients through challenging times.
Speakers included the Chief Medical
Officer for Wales, the Board of Community Health Councils, the Royal College of
Nursing (Wales), Healthcare Inspectorate Wales and the Health and Care
Professions Council and we had attendees from a range of organisations from
Wales and across the UK.
We published a blog summarising highlights from the event.
Scotland Board meeting
We held our May Board meeting in Edinburgh. We are a four-country oversight body; and many of the regulators and registers we
oversee span the UK. In addition to the Board meeting, we visited the Scottish
Parliament, including a meeting between our Chief Executive and Chair with
Humza Yousaf – the Cabinet Secretary for Health and Social Care.
We followed this with a round-table discussion with
stakeholders, as well as outlining our role and current priorities, we also discussed
the priorities of the organisations in the room, including the Scottish
Government, Healthcare Improvement Scotland, the Scottish Public Services
Ombudsman, and representatives from accredited registers and regulators. There
was considerable agreement about the challenges we face in the wider
patient/public safety landscape, and how working together more closely might
help us to address these challenges.
Over the next few months, we will hold Board meetings in Wales and in Northern Ireland.
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Recent consultation responses
We have recently responded to
consultations on:
You can find all our consultation responses here.
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Recent blogs
We have published blogs on:
You can find all our blogs here or read our latest news here.
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